Approximately 80 percent of people will experience back pain at some point in their lives. Back pain is notoriously challenging to treat, as it impacts each person differently and it is often chronic, which means that it is recurring. One of the most common treatment recommendations for managing back pain involves taking antidepressant medication.
However, recent studies show that antidepressant medications may not be as effective in treating back pain as we once thought. So, should or shouldn’t you take antidepressants for back pain? Let’s dive into the potential benefits and consequences of this treatment option.
How Do Antidepressants Relieve Back Pain?
Truthfully, experts still don’t know much about why antidepressants have the potential to relieve back pain or generalized chronic pain. It’s important to note that in this instance, antidepressants are not being used to solely address mental health concerns. Instead, the goal of using antidepressants for chronic back pain is to give people greater mobility and functionality in their everyday lives.
To better understand the ways that these medications might reduce back pain, we have to look at how antidepressants actually work. Antidepressants are meant to introduce certain hormones within a patient’s body to regulate any chemical imbalances they might have as a result of depression, anxiety, or other mental health disorders.
These main chemicals include serotonin and norepinephrine. Serotonin is in charge of managing a person’s mood and emotions. Simply put, when the levels of serotonin are low in somebody’s body, it often results in anxiety, depression, and other mood disorders. Norepinephrine controls one’s energy levels and feelings of being alert.
When both of these hormones are in balance, the end result is often positive, with the individual feeling happy, attentive, and in control of any worries that might come to the surface. On the other hand, when these hormones are out of balance, it can cause extreme anxiety, constant sadness, body aches, and other symptoms of mental health disorders.
One of the most widely accepted theories as to why antidepressants have the potential to relieve back pain is because these medications release serotonin and norepinephrine along spinal pathways where the pain is often located. The release of these hormones can help to block pain signals in the back from reaching the brain. Thus, antidepressants may bring moments of pain relief.
Of course, as with any medication for pain, this does not resolve the root of the problem, but it can offer enough relief for patients to try other treatments, such as physical therapy. Many experts also recommend using antidepressants as a secondary treatment option for back pain. Rather than relying only on medication, patients often find better results by combining this approach with other treatments and interventions.
While antidepressants were a go-to option for people who needed some relief from their back pain, researchers are now challenging and examining the actual effectiveness of this treatment option.
What Do New Studies on Antidepressants and Back Pain Say?
Right now, there are certain serotonin and norepinephrine reuptake inhibitors (SNRIs)—a type of antidepressant—that are approved for treatment of back pain. These include medications such as duloxetine, which is commercially known as Cymbalta.
Research has always shown varying results on how well antidepressants work for back pain. In recent years, studies have revealed that antidepressants don’t make a big difference for most cases of back pain. Overall, out of the thousands of people who participated in clinical trials throughout the course of multiple studies, only a small percentage of those participants actually experienced pain relief.
What is more interesting is that antidepressants seem to have more of an impact on people who have osteoarthritis than those who have generalized back pain and/or sciatica. From a study conducted in 2020, we can come to the conclusion that antidepressants for back pain might not be the true solution.
The most up-to-date study, published in January of 2021, indicates that using antidepressants or other prescription medications can actually cause more harm than good in patients. As stated above, antidepressants are usually most effective when combined with other therapies that can help to correct the issue rather than temporarily reducing pain. This study argues that too many doctors prescribe antidepressants for pain without fully recognizing the consequences.
Moreover, because we do not know much about the effectiveness of antidepressants for chronic pain treatment, this recent study emphasizes that many experts in the medical field don’t acknowledge the fact that these medications only help a small portion of the patients who use them.
So, if your doctor has suggested taking antidepressants for back pain or other conditions that might cause chronic pain, keep in mind the potential pros and cons before making a decision.
Should You Take Antidepressants for Back Pain?
Ultimately, the decision to take antidepressants for back pain is entirely up to you and your specific needs. The reality is that some people need pain relief—even if it is only temporary—to fulfill their daily responsibilities or to have the type of mobility that’s needed to begin to heal the place where the pain originated. Additionally, many experts believe that there is less risk associated with taking antidepressants for pain treatment than using opioid painkillers, as antidepressants have a much lower chance of leading to addiction.
There are important things to consider if you are thinking about taking antidepressants for back pain, though. These include risk factors that come with taking antidepressant medications. If you are currently taking antidepressants or considering this treatment approach, be sure to monitor your mental health response. Unfortunately, antidepressants can sometimes worsen mental health conditions if you do not have the right dosage and the medication is not prescribed specifically for depression, anxiety, or other disorders.
The side effects of antidepressants depend on what you are taking, the dosage, as well as any outside factors that could influence their effectiveness. These typically include:
- Fatigue
- Weight gain
- Gastrointestinal distress
- Changes in sleeping patterns
- Mood changes
- Worsening anxiety or depression
- Thoughts of suicide
These side effects can be extremely uncomfortable and even life-threatening if left untreated. Though back pain might be your main concern, keeping track of any changes that occur if you begin taking antidepressants as treatment is important. Always update your doctor if you have any change in symptoms.
If you are someone who struggles with chronic back pain and you feel as though nothing works to ease your discomfort, antidepressants could potentially be something that can help. But it seems as though antidepressants might not be the best option for long-term treatment. Until we know more about how exactly antidepressants can ease pain, all you can do is (safely) try different treatments to find something that works for you.
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