American Chiropractic Association
Chronic Pain and Depression
Pain serves an important function in our lives. When you suffer an acute injury, pain warns you to stop the activity that is causing the injury and tells you to take care of the affected body part.
Chronic pain, on the other hand, persists for weeks, months, or even years. Some people, often older adults, suffer from chronic pain without any definable past injury or signs of body damage. Common chronic pain can be caused by headaches, the low back, and arthritis. Unfortunately, there is scant objective evidence or physical findings to explain such pain.
Until recently, some doctors who could not find a physical cause for a person’s pain simply suggested that it was imaginary— “all in your head.” This is unfortunate because we know that all pain is real and not imagined, except in the most extreme cases of psychosis. Emerging scientific evidence is demonstrating that the nerves in the spinal cord of patients with chronic pain undergo structural changes.
Psychological and social issues often amplify the effects of chronic pain. For example, people with chronic pain frequently report a wide range of limitations in family and social roles, such as the inability to perform household or workplace chores, take care of children, or engage in leisure activities. In turn, spouses, children, and co-workers often have to take over these responsibilities. Such changes often lead to depression, agitation, resentment, and anger for the pain patient and to stress and strain in family and other social relationships.
How is depression involved with chronic pain?
Depression is the most common emotion associated with chronic pain. It is thought to be 3 to 4 times more common in people with chronic pain than in the general population. In addition, 30 to 80% of people with chronic pain will have some type of depression. The combination of chronic pain and depression is often associated with greater disability than either depression or chronic pain alone.
People with chronic pain and depression suffer dramatic changes in their physical, mental, and social well-being—and in their quality of life. Such people often find it difficult to sleep, are easily agitated, cannot perform their normal activities of daily living, cannot concentrate, and are often unable to perform their duties at work. This constellation of disabilities starts a vicious cycle—pain leads to more depression, which leads to more chronic pain. In some cases, the depression occurs before the pain.
Until recently, we believed that bed rest after an injury was important for recovery. This has likely resulted in many chronic pain syndromes. Avoiding performing activities that a person believes will cause pain only makes his or her condition worse in many cases.
Signs and Symptoms
Some of the common signs and symptoms of chronic pain include:
Pain beyond 6 months after an injury
Allodynia—pain from stimuli which are not normally painful and/or pain that occurs other than in the stimulated area
Hyperpathia—increased pain from stimuli that are normally painful
Hypersensation—being overly sensitive to pain
Signs of major clinical depression will occur daily for 2 weeks or more, and often include many of the following:
A predominant feeling of sadness; feeling blue, hopeless, or irritable, often with crying spells
Changes in appetite or weight (loss or gain) and/or sleep (too much or too little
Poor concentration or memory
Feeling restless or fatigued
Loss of interest or pleasure in usual activities, including sex
Feeling of worthlessness and/or guilt
What is the treatment for chronic pain and depression?
The first step in coping with chronic pain is to determine its cause, if possible. Addressing the problem will help the pain subside. In other cases, especially when the pain is chronic, you should try to keep the chronic pain from being the entire focus of your life.
Stay active and do not avoid activities that cause pain simply because they cause pain. The amount and type of activity should be directed by your doctor, so that activities that might actually cause more harm are avoided.
Relaxation training, hypnosis, biofeedback, and guided imagery, can help you cope with chronic pain. Cognitive therapy can also help patients recognize destructive patterns of emotion and behavior and help them modify or replace such behaviors and thoughts with more reasonable or supportive ones.
Distraction (redirecting your attention away from chronic pain), imagery (going to your “happy place”), and dissociation (detaching yourself from the chronic pain) can be useful.
Involving your family with your recovery may be quite helpful, according to recent scientific evidence.
Feel free to discuss these or other techniques with your doctor of chiropractic. He or she may suggest some simple techniques that may work for you or may refer you to another health care provider for more in-depth training in these techniques.
Chiropractic Care Proven To Help Diminish General Anxiety Disorder & Depression
There are many fascinating studies into chiropractic care and how it can help with certain conditions published in the Journal of Vertebral Subluxation Research. One such study, co-authored by chiropractor Dr. Nathan Olsen and associate editor Dr. Madeline Behrendt was about a 19 year old female with General Anxiety Disorder. After four months of chiropractic treatments, this patient experienced a substantial 80% improvement in her anxiety symptoms and a 90% reduction in headaches.
The treatments undertaken by the teenager in the previous 24 months consisted of many visits to the emergency room, seeing untold medical doctors and being prescribed drugs such as Paxil and Xanax. Two years of this and nothing made any difference to the poor girl’s condition. But now, after the chiropractic care she got, she can have a normal life, and is prescription drug-free.
Dr. Madeline Behrendt describes this 19 year olds ordeal before she underwent chiropractic care as: “two years in crisis, going from emergency room to private specialist, spending thousands of dollars for tests and drug therapy, without any resolution of her problems.” A look into the girl’s medical history revealed a few motor vehicle accidents, including one where her head shattered the windshield, and yet nobody had recommended her to a chiropractor for care.
After a simple spinal screening took place, the results showed subluxations which, had they have been treated at the time, could have eased the patients anxiety symptoms & stress. These subluxations can also impact the nerves, which would affect the nervous system and can lead to mental health issues. Another thing to note is the fact that these subluxations are not only caused by impact traumas, but also by stress and other conditions.
The Anxiety Disorders Association of America strongly believes that anxiety costs America more than $42 billion per year. That’s due to the lost productivity and an increased number of visits to the doctor and emergency room which the condition causes. Also, The National Institute of Mental Health claims the cost is so high because anxiety is the most common mental health illness affecting more than 19 million Americans aged between 18 and 54.
Drugs are always the first thing to be prescribed for anxiety and other mental disorders, and it is a fact that most people think of chiropractic work as the very last resort to healing the symptoms and problems they have. The drugs being prescribed have recently been place under the microscope by the public, as they seem to make no difference to patients with anxiety illnesses, and cause them more problems and side effects than what they originally started with. The drugs are also known to have some very disturbing side effects like depression, likelihood to self-harm and even suicidal tendencies in young people.
Despite the fact that these drugs are being scrutinized, few doctors will recommend chiropractic treatments to the many sufferers of anxiety & depression. There is a distinct lack of information available to all U.S. public about holistic & non-drug alternatives, and about the health benefits and savings it brings to the public. As a Chiropractic office we often face these questions like: “How many other people are suffering unnecessarily because they are missing the proper screening at the E.R.?” and “How many people indeed could have a much improved condition with chiropractic treatments?”
It is astounding that with these types of side effects, the enormous amount of money the public spends on prescription drugs, office visits to a doctor, and the fact that these drugs don’t work, that few if any alternative holistic treatments such as chiropractic care are ever offered or suggested to patients who suffer from anxiety & depression problems. Drug prescriptions seem to be the only kind of treatment people know about. This deficiency in the knowledge of alternatives, like chiropractic care, means people will continue to suffer, and a substantial amount of money will remain going in the pharmaceutical companies pockets. How many other people are suffering unnecessarily because they are missing the proper screening, and the main-stream medical society isn’t willing to educate the public on any other form of treatments besides prescription drug care?
If you have any questions regarding this informational article, please ask Dr Benjamin. He will be glad to answer any questions you have about how chiropractic care can heal you.