March 5, 2004 -- Disabling back pain is twice as likely to come back when a person is depressed.
That's the finding from a major study designed to end a major controversy. Earlier studies have split over whether depression affects back pain. Now the relationship is clear, conclude Linda J. Carroll, PhD, of the University of Alberta, Canada, and colleagues.
"Our results provide evidence that depression is an important and independent risk factor for troublesome pain," Carroll and colleagues write in the January 2004 issue of the journal Pain. "Those with both back pain and depression use twice the sick days and incur twice the health care costs as those with either problem separately."
The study collected data from 790 randomly selected patients who had been treated for back pain but were not in pain at the time the study started. The researchers then contacted the patients six and 12 months later and queried them on symptoms of back pain and depression.
Two Common Health Woes Collide
The researchers found that back pain can lead to depression -- and that depression can lead to back pain.
"Both conditions can come and go and both are very common," Carroll says in a news release. "In fact, only 20 percent of the population has not experienced any neck or low back pain in the past six months. So it's important to try to deal with these conditions before they become troublesome and lead to a vicious cycle."
Carroll says there are two basic ways people deal with pain. One is to be passive: withdrawing from activity because of pain or fear of pain, and wishing for better pain medication. The other is to be active: getting exercise and staying busy.
"We're wondering if depression leads people to cope passively when they experience the kinds of mild pain episodes that most of us are periodically subjected to," Carroll says. "This in turn may increase the likelihood that pain will become a problem in someone's life."
The researchers are now looking into how people with depression cope differently than other people.