Is Chronic Back Pain Stressing You Out? Here’s How to Deal

When back pain comes with stress, anxiety or depression, it can make coping even harder. Learn how to manage both pain and mental health.

Dealing with chronic back pain can be difficult for anyone. But when that pain comes with psychological issues such as excessive stress, anxiety or depression, it can make coping even harder. That’s because mental distress may exacerbate pain, and pain can worsen mental distress, creating a vicious cycle.

Fortunately, there are many treatments available for mental health troubles and chronic back pain—and some that may help you get a handle on both at the same time. Here’s what you should know about their connection, along with the therapies that can help you feel better.

Back pain mental healthBack pain and mental health issues commonly appear together.

Chronic Back Pain and Mental Health

Back pain is a very common health problem; it’s estimated that about 80 percent of Americans will experience it at some point in their lifetime. A smaller proportion will develop chronic back pain, or pain that lasts more than 12 weeks. About 20 percent of people with low back pain will have chronic back pain symptoms after a year, according to the National Institutes of Health.

Chronic back pain can be caused by a vast range of medical problems, from injuries to illnesses such as arthritis and spinal stenosis. It feels different to different people, depending on the cause, the area affected and the individual. For some people, the pain may feel like a mild, persistent ache. For others, it’s constant agony.

One big factor in the severity of chronic back pain is your emotional response to it. If you stress about or fixate on the pain, you may perceive it to feel much worse. This can lead to more stress, as well as:

  • Depression
  • Anxiety
  • Fatigue
  • Mood swings
  • Appetite changes
  • Sleep troubles

These problems can then feed back into the pain. Altogether, they may greatly affect your relationships, your work, your ability to function and your overall quality of life.

To begin feeling better, the single best step you can take is to reach out to your doctor. They can screen you for mental health issues, begin treatment for your psychological and physical troubles and refer you to specialists who can help.

Importance of Psychotherapy in Chronic Back Pain

There are many different approaches to treating chronic back pain and the psychological troubles associated with it. Not every therapy works for every person, and the best treatment is often a combination of techniques.

Psychotherapy—particularly talk therapy—can help treat both physical and emotional pain. One of the best-supported, most-researched forms is cognitive behavioral therapy (CBT).

CBT back painCognitive behavioral therapy can be effective for both back pain and mental health issues.

During CBT, you learn to identify your negative reactions to chronic back pain and work to change them into positive thoughts. The idea is, if you can alter your initial response, you can better manage how the pain affects you. CBT is directed by a therapist, and can be done individually or in a group setting.

For many people, medication is an effective way to manage mental health issues linked to chronic pain—and some drugs even help to relieve the pain itself. For people with depression, for example, antidepressants such as serotonin and norepinephrine reuptake inhibitors (SNRIs), selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) are often prescribed to address both issues.

While these drugs can be helpful, however, many may come with side effects. Antidepressants, for example, can cause:

  • Blurry vision
  • Drowsiness
  • Dizziness
  • Bathroom issues

…and more.

Enrolling in a chronic pain rehabilitation program is another option for some. During pain rehab, a team of doctors from different disciplines work together to address the medical, physical and mental issues related to your pain.

Each program is personalized to the patient, and treatments are often conducted at a medical center. The goals of pain rehab often include addressing your underlying medical conditions, improving your physical function, reducing your reliance on pain medication and helping you cope with your stress, anxiety, depression and more.


Complementary Health Practices

Many people find that alternative health approaches help control their back pain and ease their mind. And while there isn’t much scientific proof for some practices, such as cupping and dry needling, research has shown that certain other practices actually work to relieve patients.

There’s low- to moderate-quality evidence that the following therapies may lessen chronic lower back pain, according to the National Center for Complementary and Integrative Health:

  • Acupuncture
  • Low-level laser therapy
  • Mindfulness-based stress reduction, such as breathing exercises and guided imagery
  • Progressive muscle relaxation
  • Spinal manipulation (chiropractic therapy)
  • Tai chi
  • Yoga

Yoga and back painComplementary practices such as yoga, which has a strong mental health component, can help many patients with their back pain.

Electromyography biofeedback, during which electric signals are used to help you gain control over muscle movement, has also been successful for patients in some studies. And though the scientific proof is lacking, some patients find journaling, massage, prayer and other relaxation techniques to be helpful in coping, as well.

While these alternative practices are widely considered to be safe when done correctly, there may be risks for certain patients, including pregnant women and others with pre-existing conditions. Speak with your doctor if you have questions or a health issue that may be affected by complementary treatments.

Lifestyle Changes

One of the most effective and most widely recommended methods of relieving stress, anxiety, depression and chronic pain—and improving physical function—is getting regular exercise. Low-impact workouts like stretching, walking, swimming and yoga are often helpful for people with chronic back issues. Speak with your doctor about physical activities that are safe for you, though, as over-exerting yourself can lead to further injury.

Prioritizing good sleep can help, as well, as poor sleep and sleep deprivation can increase stress, leading to more pain. Most adults should shoot for between 7 and 9 hours nightly, according to the National Sleep Foundation. To foster good sleep, try to wake up and go to bed at the same time each day and remove electronic distractions from your room.

Lifestyle changes and back painA healthy diet can boost your physical and mental health.

What else? Eating a healthy diet can boost your mood and help relieve back pain, partly by fostering weight loss. Aim for well-rounded meals full of lean proteins, whole grains and produce—and limit your intake of processed foods, added sugars and saturated fats. Try to avoid excess alcohol, as well, and if you smoke—quit; both habits are linked to chronic back pain.

Above all, try to go easy on yourself. Learning about your chronic back pain and searching for successful treatment can be a long and frustrating process in itself. But understanding your condition—and cutting yourself a little slack—can go a ways toward helping you feel better.

Want more tips for dealing with back pain? Register with SpineUniverse and sign up for SpineAdvisor, our weekly newsletter!

Updated on: 04/01/20
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Depression is Connected to Back Pain
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