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Does Pain Cause depression?

Why do I feel low when I am in pain?

For years we have known there is a link between pain and mood, but we haven't been able to say exactly why that is. If you suffer from chronic pain i.e. long term pain, you are four times more likely to suffer from depression. Thankfully, we now have a much better understanding of why this is the case.

Why is it that when we are in pain, we become angry or easily irritable? How long one has pain has different effects on your nervous system and how the brain processes it. In acute (new) pain, there are different mechanisms at play, than in chronic (old) pain.

Let’s take this example of acute pain: you’ve just bent over to pick something off the floor. Out of nowhere your back 'goes', seizes up and you feel a sudden surge of pain that runs through your spine.

What happens initially is a massive increase in sensory information from your spine that shoots into the brain. The brain will then send signals out to cause a surge of stress hormones to be put into the body. This, in addition to other factors, initiates processes that help ignite an inflammatory response, designed to begin healing. The brain has to now reconfigure and work significantly harder to tell the body to keep moving, but without putting any stress on the now injured area. If it doesn’t like a particular movement, the brain will tell certain muscles to go into spasm – painful! The brain has the difficult task of figuring your injury out. This is comparable to suddenly becoming a learner driver again, you must think about every move you make. All this new brain activity requires more concentration and more energy.

Thankfully, a lot of injuries like this will heal and the pain will reduce steadily over a period, resulting in a return to normalised brain function.

If, however, the back pain continues to become chronic (over 3-months), other changes begin to happen in the brain. The way the brain works and connects itself together alters, which can result in the brain becoming more sensitive to those signals coming from your spine. We call this central sensitisation. Hypersensitivity around the injured area can happen because of this too. This process continues to other centres of the brain as the brain adapts and changes as a result of the prolonged pain signals – we call this neuroplasticity. If the centres of your brain that control emotion get caught up in these changes, we can see developments of depression or mood changes.

In daily practice, we see changes in the way people act and react when they are in pain. What gives hope is that those same changes and pathways that can cause low mood or irritability, can also be prevented, and changed by taking away the pain. As said, the brain is plastic, meaning just as it moulds into being sensitive, it can often remould itself out of sensitivity. It is actually this process of how chiropractic care works!

To summarise, it's not necessarily anyone’s fault for being in a bad mood or upset when in pain. There is always something to be done about it, starting with getting a full assessment of the issue. If you are in pain and feel ready for help, please get in touch to see if we can help you.

This article was written by Guildford Chiropractor, Scott Gimby.


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