Depression and Back Pain
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Depression and Back Pain: What’s the Connection?

by Dr. Brent Wells, D.C.

Have you ever considered the connection between a physical ailment and a mental condition? Sure, if you slam your finger with a hammer while hanging up a picture you might feel sad or angry for a second or even a couple of minutes, but then both of those problems go away and you continue on with your life. Did you ever consider that bigger pain problems cause greater emotional or mental health problems and vice versa?

As our main topic is depression and back pain and how they are connected, let’s see what the data says about back pain and major depressive disorder.

The number of people that suffer from back pain is quite astounding with over 80% of the world’s population dealing with the ailment at some point in their lives. When it comes to major depressive disorder, there are more than 16.1 million people in the United States alone that have been diagnosed. It’s the number one reason for people being deemed disabled for those ages 15 to around 43.

Now that you have those numbers, did you ever contemplate how many people are suffering from both back pain and depression at the same time? There are plenty, and there is a reason for the connection. Find out more about how the two are related and possible treatment options.

Pain Causes Depression and Depression Causes Pain

If you have never experienced chronic pain before, it’s a severe case of aches and discomfort that last much longer than what it should normally take for the body to heal. When you hurt your back, for example, it should take a couple of weeks at most for things to steadily get better before the problem is completely gone.

Sometimes that pain lingers without getting better at all for several weeks, months, or even years, as is the case if you suffer from degenerative arthritis. The condition can even come and go during that time span, but as long as the same issue comes back consistently it is considered to be chronic pain. But does chronic pain cause depression?

For those that have dealt with this type of pain before, you know how absolutely frustrating it can be on a daily basis. You wake up in the morning hoping to feel refreshed and reenergized only to find out that your body still isn’t doing any better than the day before. You’re stuck in this position of not being able to perform your daily activities like:

  • Working
  • Exercising
  • Sleeping
  • Playing with your kids
  • Sitting or standing for extended periods of time
  • Completing routine tasks

How are depression and pain related? When your body isn’t performing like it’s supposed to, or like it used to, especially if you are someone that is normally very physically active, there is no way that you can stop it from altering your mood. For the first few weeks or even months, you may be able to work past the way you are feeling inside.

The question is: can chronic pain cause depression? Studies indicate that people that are dealing with chronic back pain eventually can’t ward off the condition of depression from setting in.

People get tired of sitting on the sidelines watching life pass them by because they can’t do what they want. Pain is keeping them from the things that they love, and as a result, they start to feel disappointed and sad. When those feelings stick around for an extended period of time, depression is inevitable. 

What is the first sign of depression? Some of the factors that determine a depression diagnosis include:

  • Feeling hopeless, sad, blue, or irritable
  • Frequent crying spells
  • Significant weight loss or gain
  • Problems with too much or too little sleep
  • Agitated feeling
  • Low energy
  • Decreased sex life
  • Feeling guilty or worthless
  • Issues with concentration and memory
  • Feeling suicidal or thinking of being dead

Depression and chronic pain are often intertwined. If you never been in this position before you might think that contemplating suicide because of back pain might seem a little extreme, but it’s a very real situation that people live with every single day.

Now, let’s take a look at how things work in the opposite manner. Sometimes people can be diagnosed with depression without any existing pain. It’s just an illness that has occurred for one reason or another. In such situations, there’s no link between back pain and depression.

Some of the most common reasons for depression are:

  • Physical, sexual, or emotional abuse
  • Traumatic childhood events
  • Medication
  • Personal disputes or conflicts with friends or family
  • Grief from loss or death of a loved one
  • Genetic background
  • Moving, getting divorced, having a child, getting married, or other stressful life events
  • Social problems
  • Major medical conditions
  • Substance abuse

So, is there a connection between depression and physical pain? There are some studies that suggest that people who are depressed feel pain more intensely than those that aren’t depressed by up to four times the amount. Research and science take it a bit further by proving that people suffering from depression have an increase in proteins called cytokines.

These proteins have a direct effect on how the immune system reacts to disease and illnesses. In particular, these cytokine proteins can lead to inflammation in the spine. Inflammation is one of the leading causes of back pain, so these increased cytokines can be a primary cause for the discomfort. This is how research and science explain the answer to the question: “how does depression cause physical pain?”

When you hear that depression can cause back pain, it’s not something that is just in the person’s head. There is scientific evidence that backs it up. To add to that, when you are feeling depressed, you are less likely to be active. You aren’t going to be out exercising and building the core muscles in your body. In fact, depression is one of the world’s leading causes of disability.

That can lead to stress on the ligaments, joints, and disks found in the back. The added stress makes you more susceptible to injury, the straining of muscles, and general lower back pain.

Getting Stuck in the Pain and Depression Cycle

Depression and Back Pain

When pain and depression are both present in the same individual, it’s easy to get stuck in a cycle of dealing with both. Even if you get relief from one, the other is still present. Eventually, things will loop right back around.

Say your back feels better for a few days, but you’re still depressed. With those cytokines and other factors like not getting out of bed and getting moving, there is a greater chance that from lack of physical activity the back pain is going to come right back.

The only way that you can get relief from back pain and depression is by treating both of them with a comprehensive approach. Treating one without the other isn’t going to do you any good at all. It might provide relief for a short period, but the problem will undoubtedly come back at some point or another.

Treating Chronic Back Pain and Depression Comprehensively

When seeking treatment for back pain and depression at the same time, it’s important that the medical professional you are working with is aware that both conditions are existing so that they can come up with the appropriate plan.

If you only tell them that you are depressed, they may provide a prescription medication to alter your mode and suggest counseling not knowing that your back is keeping you from living your life. Then, when things aren’t getting any better, due to a lack of both a prescription medication for back pain and depression, it can be extremely confusing for everyone.

Instead, there need to be several different treatments included in the plan to ensure the best results. Some appropriate treatments for depression include:

  • Exercise
  • Social support system
  • Healthy diet
  • Getting proper sleep
  • Reducing stress
  • Therapy or counseling
  • Antidepressant prescription medications

Appropriate treatment options for chronic back pain include:

  • Exercise
  • Healthy diet
  • Getting proper sleep
  • Pain relievers or muscle relaxers
  • Antidepressant medications
  • Injections
  • Physical therapy
  • Surgery

When comparing chronic pain and depression treatments, you can quickly see that there are similar treatment options for both problems, such as regular exercise and proper diet. Those should be implemented first, and then if additional help is needed, the others can be added in. It’s always recommended to start with the least invasive method to reduce the risk of side effects and other issues.

Exercise is a great start to treating depression and back pain because you can build up your back strength while releasing the chemical in the brain known as serotonin. These are endorphins that make you feel good which can naturally reduce the effects of both symptoms. Moreover, regular physical activity helps with warding off ostheoporosis and keeping your bones strong. Before starting any sort of treatment plan, you should always consult with your primary care doctor to ensure your body is capable of withstanding what you have in mind.

Seeing a Chiropractor for Back Pain

Depression and Back Pain

Chiropractors are educated and trained at treating the body as a whole for overall better health and well-being. These professionals know that there is a direct relationship between pain and mood and they create treatment plans that relieve the symptoms of both physical pain and depression.

With more and more people turning to non-traditional, holistic approaches at healthcare, the idea of visiting a chiropractor has become a lot more popular. In fact, somewhere around 35 million adults and children in the United States get treated by these experts every single year.

When you go in for a chiropractic visit, tell your professional about all of the symptoms you are dealing with in both categories. He or she will check the spine to see if there are any misalignments. Sometimes a simple adjustment of one of the vertebrae in your spine can lead to better blood flow and relaxation of the muscles. Just like that your back pain is lessened and so are your depression symptoms because you are more capable of completing your everyday tasks once again.

If you don’t want to be administered potentially harmful prescription medications to deal with your health condition, a chiropractor is an effective natural option to try out.


As you can see, depression and back pain are very much intertwined. One often accompanies the other, and can even cause it, perpetuating a vicious cycle which can only be broken by applying a holistic approach that addresses and treats the source of both problems equally.

Guest post by Dr. Brent Wells, D.C.

Dr. Wells is a practicing chiropractic physician and the founder of Better Health Chiropractic & Physical Rehab. He is widely known as one of the best Wasilla chiropractors in Alaska.

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