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Depression is by far the most common emotion associated with chronic back pain. The type of depression that often accompanies chronic pain is referred to as major depression or clinical depression.

Depression Chronic Back Pain

Depression is by far the most common emotion associated with chronic back pain. The type of depression that often accompanies chronic pain is referred to as major depression or clinical depression. This type of depression goes beyond what would be considered normal sadness or feeling “down for a few days”.

Chronic pain and depression are two of the most common health problems that health professionals encounter, yet only a handful of studies have investigated the relationship between these conditions in the general population.

Major depression is thought to be four times greater in people with chronic back pain than in the general population.

The symptoms of a major depression occur daily for at least two weeks and include at least 5 of the following:

  • A predominant mood that is depressed, sad, blue, hopeless, low, or irritable, which may include periodic crying spells
  • Poor appetite or significant weight loss or increased appetite or weight gain
  • Sleep problem of either too much (hypersomnia) or too little (hyposomnia) sleep
  • Feeling agitated (restless) or sluggish (low energy or fatigue)
  • Loss of interest or pleasure in usual activities
  • Decreased sex drive
  • Feeling of worthlessness and/or guilt
  • Problems with concentration or memory
  • Thoughts of death, suicide, or wishing to be dead

Major depression is thought to be four times greater in people with chronic back pain than in the general population. In research studies on depression in chronic low back pain patients seeking treatment at pain clinics, prevalence rates are even higher. 32 to 82 percent of patients show some type of depression or depressive problem, with an average of 62 percent.

In a recent study it was found that the rate of major depression increased in a linear fashion with greater pain severity. It was also found that the combination of chronic back pain and depression was associated with greater disability than either depression or chronic back pain alone.

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There are a variety of pain treatment options for the treatment of chronic pain. Under the general category of medications, there are both oral and topical therapies for the treatment of chronic pain.

Pain Treatment Options

Pain can be a debilitating condition, but there are ways to keep it under control. Learn about different pain management options.

Know Your Pain Treatment Options

Whether your pain is from arthritis, cancer treatments, fibromyalgia, or an old injury, you need to find a way to get your pain under control. What’s the best approach to do that?

The first step in pain management is scheduling an appointment with your doctor to determine the cause of your pain and learn which pain management approach is often the most effective for it. There are many different pain management options available: You can find the right treatment combination to get the relief you need.

Why Do People Experience Pain Differently?

Pain is real and it’s physical — there’s no mistaking that. But pain is measured and specific to one person based on that person’s perception of the pain, and that’s why everyone’s pain is different.

What the brain perceives is indisputably modifiable by emotions, people who are fearful of pain, depressed, or anxious may experience pain differently, and perhaps more severely, than someone who has pain but isn’t experiencing those other emotions.

Pain Management: Treating Mind and Body

While chronic pain medication can be effective and important for pain management for many people, it isn’t the only tool available when it comes to pain treatment, and it shouldn’t be the only tool that’s used.

Medications. There are a lot of medications that are prescribed for pain. Although opioids (narcotics) and benzodiazepines may not be the best options. Those treatments have their own problems, and there are no good studies on using opioids for long periods of time for the treatment of chronic pain.

Types of chronic pain medication used include:

  • NSAIDs (non-steroidal anti-inflammatory drugs), including ibuprofen, naproxen, and aspirin.
  • Acetaminophen (Tylenol).
  • Antidepressants, which can improve sleep and alleviate pain.
  • Anti-seizure medications, which can be effective in treating pain related to nerve damage or injury.
  • Steroids, like dexamethasone and prednisone, to alleviate inflammation and pain.

Therapy. Therapy can be aimed at both the mind and the body. Try to look at any of these therapies as not being purely physical or purely psychological — they are always a mixture of both of those things.

  • Physical therapy is a very important part of any pain management program. Pain can be worsened by exercise that isn’t done correctly (or interpreted incorrectly as pain rather than overuse), and a physical therapist can tailor the right exercise regimen for you. Proper exercise slowly builds your tolerance and reduces your pain — you won’t end up overdoing it and giving up because it hurts.
  • Cognitive-behavioral therapy allows people to learn and have a better understanding of what the pain is from, and what they can do about it. This therapy is really about understanding the role of pain in your life and what it actually means for you.

Other pain management options. A variety of approaches and modalities can help you deal with both the physical and emotional parts of pain:

  • TENS (transcutaneous electrical nerve stimulation) therapy.
  • Meditation.
  • Relaxation techniques.
  • Visual imagery, as simple as picturing a peaceful scene, for example.
  • Biofeedback, which teaches control over muscle tension, temperature, heart rate and more.
  • Heat and cold therapy.
  • Manipulation and massage.

The bottom line: Seek help for your pain as soon as it becomes a problem in your life. When chronic pain starts to destroy your ability to function in the world, then it’s a problem that needs to be addressed.

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Pain medicine is a discipline within the field of medicine that is concerned with the prevention of pain, and the evaluation, treatment, and rehabilitation of persons in pain.

Pain Medicine

The specialty of Pain Medicine, or Algiatry, is a discipline within the field of medicine that is concerned with the prevention of pain, and the evaluation, treatment, and rehabilitation of persons in pain. Some conditions may have pain and associated symptoms arising from a discrete cause, such as postoperative pain or pain associated with a malignancy, or may be conditions in which pain constitutes the primary problem, such as neuropathic pains or headaches.

The practice of pain medicine is multi-disciplinary in approach, incorporating modalities from various specialties to ensure the comprehensive evaluation and treatment of the pain patient.

Pain Specialists

Pain Medicine Specialists use a broad-based approach to treat all pain disorders, ranging from pain as a symptom of disease to pain as the primary disease.  The pain physician serves as a consultant to other physicians but is often the principal treating physician (as distinguished from the primary care physician) and may provide care at various levels, such as treating the patient directly, prescribing medication, prescribing rehabilitative services, performing pain relieving procedures, counseling patients and families.

Pain Medicine Specialists direct a multidisciplinary team, coordinating care with other health care providers and providing consultative services to public and private agencies pursuant to optimal health care delivery to the patient suffering from pain.

The objective of the pain physician is to provide quality care to the patient suffering from pain. The pain physician may work in a variety of settings and is competent to treat the entire range of pain encountered in delivery of quality health care.

Pain Medicine specialists typically formulate comprehensive treatment plans, which consider the patients’ cultural contexts, as well as the special needs of the pediatric and geriatric populations.

Evaluation techniques include interpretation of historical data; review of previous laboratory, imaging, and electrodiagnostic studies; assessment of behavioral, social, occupational, and avocational issues; and interview and examination of the patient by the pain specialist.

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