Back Pain Could Be a Sign of Depression

There's no greater evidence of the mind-body connection than when it comes to back pain and depression. Studies show that back pain can cause depression and depression can manifest as back pain. Find out what you need to know about back pain and depression.

Clinical or major depression is often associated with chronic back pain. We know that living with pain increases stress levels and irritability and decreases activity levels, self-esteem, ability to work and socialize, appetite, ability to sleep, enjoy sex and other activities. What scientists now know is that sometimes, depression causes back pain and in some depressed patients, back pain is their only symptom.

A study conducted at the University of Alberta Department of Public Health showed that depression is a risk factor for onset of severe neck and low back pain. Researchers followed a random sample of nearly 800 adults without neck and low back pain and found that over time, people with depression were four times more likely to develop intense or disabling neck and low back pain than those who were not depressed.

Why does depression cause pain? Scientists speculate that depression disables one's ability to regulate negative emotions associated with feeling pain, which makes the pain feel worse. Rather than just being a consequence of having pain, depression may cause or precede the pain and make it more intense.

One of the problems in diagnosing depression that's concurrent with back pain occurs when doctors and patients treat back pain as a strictly medical condition. The patient may not recognize they're depressed and the doctor may focus only on the patient's pain and not consider depression. When back pain is chronic or recurrent however, doctors are now helping their patients make the mind-body connection.

Many doctors recommend treating depression and back pain with a one-two punch - antidepressants for the underlying mood disorder and anti-inflammatory and pain medications to treat the pain. They also recommend exercise, physical therapy and counseling.

While doctors may prescribe antidepressants to target the pain and assist with mood elevation and sleep, a review of 10 studies indicates no clear evidence that anti-depressants are actually more effective for treating low back pain than placebo. 

What does work to treat both back pain and depression? While some patients definitely need antidepressant medication and counseling to treat their mood disorder, experts say the best way to treat chronic back pain is with exercise, massage, stress reduction and physical therapy. In other words, despite the pain, patients have to move to get better. Exercise is also proven to help many patients overcome depression. 

If you've been suffering with chronic or recurrent back pain, ask your doctor whether you might also be suffering with depression. Then, ask for a referral to a physical therapist and fitness expert to help you design a mind-body work out to eliminate both your back pain and depression.


Wiley-Blackwell (2008, January 25). No Clear Evidence That Antidepressants Assist In The Management Of Chronic Low Back Pain.

Science Daily

Feb 27, 2004

Depression Can Lead To Back Pain