An estimated four million Australians suffer from low back pain and for many, it may be connected to what’s going on in their heads.
New research from the University of Sydney has found that people with depression are 60 per cent more likely to suffer low back pain in their lifetime.
Published in the journal Arthritis Care and Research, the study analysed data from 11 international studies of over 23,000 participants.
Study author, Associate Professor Marina Pinheiro, embarked on the research after noticing a pattern with her patients. “I would treat patients in my clinic suffering from low back pain, and very often these people also had some mood problems such as depression,” the physiotherapist tells SBS. “I started to notice that those people started to respond differently than people only with simple low back pain.”
They are more likely to be less physically active, less likely to engage socially and tend to have worse sleep quality. We know that all of these factors lead to low back pain as well.
While it’s unclear what causes the link between depression and low back pain, Pinheiro has two hypotheses. The first is lifestyle. “People with depression tend to change their behaviour,” she says. “They are more likely to be less physically active, less likely to engage socially and tend to have worse sleep quality. We know that all of these factors lead to low back pain as well.”
The second theory, which she is embarking on further research to explore, is a genetic predisposition. “The two conditions may share some biological pathways. It’s possible that changes in the brain chemicals caused by depression can actually lead to low back pain, but both hypotheses need to be tested.”
Pinheiro believes that her research highlights the need for a new approach to treatment for lower back pain, which she says Australia currently spends $4.8 billion on each year. “People with simple low back pain, they respond well to simple treatment like medication or exercise,” she explains. “When people have both conditions, they don’t respond well to this treatment. We should also manage mood, or point patients to health professionals who can deal with that.”
Most people with back pain and with depression, they engage less socially, they go out less, and all of this could be to leading to one thing or another.
She says that while her research focused on one correlation, how depression can lead to low back pain, the link is bi-directional. “Most people with back pain and with depression, they engage less socially, they go out less, and all of this could be to leading to one thing or another. That’s why we seem to have a bi-directional relationship between them although in this study we only tested one direction.
“The idea of managing the two conditions needs to be tested. We should try and treat those patients with low back pain with education and exercise, and more complex treatments for those patients with more complex conditions. But more research has to be done.”
Low back pain is most common in people aged 40 to 50 but according to the Australian Institute of Health and Welfar, back pain is one of the most common health conditions reported by young adults and teenagers.
One recent study published in JAMA found that exercise could be the key to preventing low back pain in the future, reducing the risk by 20 to 40 per cent.