I just did one of those continuing medical education courses — in psychiatry, my very own field no less. It says that people who get a bout of depression are twice as likely to get a bout of back pain. What I read is a meta-analysis. That means some clever person who probably needed the publication on his (or her) resume did a statistical (and critical) analysis of research other people did. This a noble attempt to asymptotically approach “the Truth and the Light” on a subject. It is also a delightfully erudite way to do research and get a publication without using a lot of time and money that the author had to scrape up.
Look, the relationship between depression and low back pain is something I have seen from every imaginable angle. As a neurosurgeon, it did not take me terribly long to figure out that surgery was not a very good solution for back pain. Of course, we rigorously restricted ourselves to operating focalized sciatica. Cases where we could reasonably infer that an intervertebral disc seemed to be compressing a distinct (lumbar) nerve root that formed part of the sciatic nerve (plexus) that descended from the spinal cord to the leg and foot. There was the physical examination. If someone were lying flat on his (more rarely, her) back and their straight leg was raised toward the ceiling, pain would appear on a trajectory anatomically consistent with one of those nerves. This was the sign of Laseque. And we took it to be as solid as money in the bank. Read more on Depression and Low Back Pain…
Filed under depression, Disease, Doctors, medicine, News, Research by on Jul 19th, 2017. Comment. 
The psychological ability to adjust to chronic medical illness is an area where there has been very little study. Lately, I find myself working mostly with this population of people. I’m noticing that some adjust very well and some do it very poorly. It depends on a lot of factors.
The situation is clearest when the illness we’re talking about is back or neck pain. Back pain, more than neck pain, has been clearly correlated to the presence of major depression. If a person walks into the office crying and says they’re having trouble controlling what’s going on, it’s a pretty sure bet we’re dealing with depression.
Most back pain patients aren’t prepared for the kinds of life adjustments they are required to make. Generally, many will need to switch from a job that has involved lifting or other physical work to a job that is more sedentary. Quite honestly, most back pain patients are in no way prepared to do this. Mostly, this is because anything that is sedentary is going to require a higher level of education. Most of the folks I’m seeing are not highly educated, so the back pain leads to incapacity. Read more on Adjusting to Medical Illness…
Filed under depression, Diagnosis, Disease, Doctors, medicine, Mental Illness by on Nov 5th, 2012. Comment.
Eli Lilly gets credit for being economically savvy and the first out of the chute.
Cymbalta (duloxetine) is a much awaited antidepressant that is supposed to be effective especially on the bodily aspects of depression. Those pesky aches and pains that are associated with depression in one form or another.
They seem to have secured “back pain” as an indication for Cymbalta. Read more on Cymbalta For Back Pain…
Filed under depression, medicine, prescription drugs by on Nov 29th, 2010. Comment.