[Study] Back pain may raise mental health problems

Many studies have been conducted about the numerous ways back problems can negatively impact a person’s physical health.

According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, these unwanted consequences include experiencing numbness or tingling, having high levels of pain without relief, feeling weak, and more. However, one recent study has revealed that mental health can be impacted by back pain as well.

Research finds link between mental health and back pain

This particular piece of research was published in the November-December, 2016 edition of the journal General Hospital Psychiatry: Psychiatry, Medicine and Primary Care and involved the study of almost 200,000 adults worldwide. Participants were assessed based on the presence of back pain, as well as whether or not they experienced a specific set of mental health issues.

After reviewing the data, researchers concluded that there were “significant associations” between back pain and depression, anxiety, sleep problems, and even sensitivity to stress. Furthermore, these associations were often greater for those individuals who were classified as experiencing back pain of a chronic nature.

The question of cause and effect

Although the correlation exists, Nikki Martinez, Psy.D., LCPC, says that the real question here is, “Which came first, the pain or the mental health issue?” Realistically, either scenario can happen, explains Martinez. “Living with prolonged and unrelenting pain that leaves an individual incapable of doing activities they once enjoyed can leave the person depressed and anxious after a certain amount of time,” she says. “Then you have other cases where the person holds their tension and anxiety so tightly and tensely in their back that they actually cause themselves a strong feeling of continued and prolonged pain.”

In the case of the former, when back pain leads to a lower quality of mental health, “it is all in your head,” says Jared Heathman, MD with Your Family Psychiatrist – Houston, “specifically the brain.” What does he mean?

“The brain is the body’s control center,” says Heathman. “It processes sensory information, stores memory, and determines your next course of action. As neurons and the brain receive sensory information like pain, a response is distributed to different parts of the brain.”

This response has a number of different impacts on the person with the back pain. “Movements may occur to stop or avoid continued pain,” says Heathman, noting that “memory is stored to prevent similar painful actions and restore safety. Mood is also altered by pain as one of the brain’s core functions is protecting the body. Anger, fear, and sadness are feelings that promote a response appropriate with preservation.”

Chiropractic for better mental health

Because of this correlation between back pain and mental health, treatment of the pain via chiropractic care could have a positive effect on the patient’s levels of sadness, anxiety, and stress. And it’s one that is chosen fairly often as an article published in Psychological Reports shares how chiropractic is one complementary and alternative medicine (CAM) treatment method that approximately 21 percent of people with acute issues related to depressive disorder, anxiety disorder, schizophrenia, and substance abuse search out in an attempt to find relief.

This puts you, the DC, in a great position to help your patients experience a higher level of mental health by treating their back pain effectively.

On the flip side, it’s also important to identify patients who are experiencing feelings of depression and anxiety as one 2014 study conducted on 925 patients and published in Chiropractic & Manual Therapies found that depression “was associated with a worse outcome in chiropractic patients with LBP [low back pain].”

This can easily be accomplished by speaking with your patients directly during treatment sessions, or by having them complete a questionnaire that you can review to determine their level of mental health.

In the end, based on studies like these, it’s clear that the correlation between pack pain and mental health isn’t a one-way street. Therefore, the first step is to discover with each individual patient which is the cause and which is the effect. That way you’ll be able to begin to treat both issues more effectively, giving your patient the best care possible…mentally and physically.