Depression
Can Lead To Chronic Back Pain
Clinical
researchers have
known that chronic
back pain can lead to
major depression,
but newer
studies are looking
at how
depression and
anxiety may be linked
to the onset
of a back pain
problem.
Depression
impacts spine surgery
outcome
Research has
clearly demonstrated
that depression,
anxiety, thought
patterns, and
personality style can
impact a spine
surgery outcome.
Unfortunately, it
appears that in many
cases, having a major
depression may not
bode well for the
outcome of a spine
surgery.
For instance,
spine surgery
patients who are
clinically depressed
pre-operatively may
continue to display
depressive symptoms
post-operatively and
these can negatively
impact the surgery
outcome. Particular
symptoms that may
impede post-operative
recovery include such
things as low
motivation, sleep
disturbance, slower
healing time,
difficulty with
physical
rehabilitation and
inability to perceive
improvements.
Pre-surgery
considerations for
patients with
depression
It
is important to
consider whether the
individual is
experiencing a
"reactive depression"
or shows a pre-injury
history of more
chronic depression. A
reactive depression
is defined as
depressive symptoms
in response to the
chronic back pain and
associated problems
(loss of work,
friends, etc).
Reactive depression
occurs in back pain
patients who have no
previous history of
depression.
However, many
chronic back pain
patients have a
history of problems
with depression even
before the onset of
the back pain. As
reviewed previously,
individuals with
chronic depression
may be at greater
risk for developing a
low back pain
condition. It is also
likely that this same
group is at greater
risk for a poorer
outcome to spine
surgery.
If a patient is
facing a spine
surgery and has a
chronic back pain
problem with
significant
depression, he or she
may want to consider
postponing the
surgery until the
depression can be
treated. Treatment
for depression is
often part of a
preparation for spine
surgery program.
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