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Ask a doctor: Depression is common for people with back pain, UCI doctor says

November 10th, 2008, 6:00 am · 4 Comments · posted by Jennifer Muir

These questions come from reader Mary Trausch. The answers come from Dr. Charles Rosen, a spine surgeon and founding director of UCI’s spine center.

If you’d like to ask our doctors anything, please send an email to Jennifer Muir (jmuir@ocregister.com) or Courtney Perkes (cperkes@ocregister.com).

Q. How common is it for spine patients with back injuries to become dependent on pain medications?

A. That’s a very pertinent question because it is , unfortunately , common for people with back pain to be referred for “pain management” to treat the pain , but not actually having a diagnosis as to the cause. Sometimes the narcotics they are prescribed on an on-going basis as “treatment” often lead to narcotic addiction after 3-6 months. This situation can be made worse by the prevalence of long acting narcotics such as oxycontin and the like, as well as vicodin. People may not realize that these are essentially morphine analogs made synthetically.

My suggestion is that a specific DIAGNOSIS be made before narcotic usage goes beyond a few weeks. Then, treatment, whether it is injections, PT, non-steroidal anti-inflammatories or surgery be initiated without long term narcotics being in the picture. I see too many regular working people who now have two problems instead of one , namely back pain and now drug addiction.

Q. And also how common is depression with spine patients?

A. Depression occurring usually after 6 months of chronic back pain is fairly common. It should be treated as well as the back pain. Again, a diagnosis often not made and the person continues to have back pain that can lead to job loss, marriage difficulties, narcotic addiction to say vicodin, and the downward spiral begins. Aggressive treatment for the back pain , as well as the depression is needed. It should be noted that narcotics by definition are depressants and make the mental situation worse.

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Posted in: Ask A Doctor • Uncategorized • • • •
 
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 4 Comments

  • Anne says:
    November 10, 2008 at 2:03 pm

    Hi!
    I have been taking Oxycontin for several years twice a day since surgery. Yes, I am sure that I am dependent. I had cut the dose in half for six months and then injured or strained my back (made it worse) and was back up to my highest doseage .

    I have a difficult time in concentrating on projects and completing them. My back starts to hurt badly and I am lying down again (a lot of the time).

    I also take Cymbalta to compensate for the affects of the Oxycontin (nervousness, irritable and no energy). I also take a low dose of Provigil to counter the affects of Cymbalta. The combination of these medicines sometimes gives me enough energy to pain relief to put in a good day of everyday things.

    I am 67 years old and wouldn’t seem that old if———. I was recently tested to see if there was another answer but there isn’t right now accept to try surgery again. No thank you.

  • Fellow judges testify that Joyce complained of back pain (Pittsburgh Post-Gazette) | Back Pain says:
    November 10, 2008 at 7:17 pm

    [...] Depression common for people with back pain (Orange County Register) Ask a doctor: Readers ask questions of UCI specialist [...]

  • Mary Trausch says:
    November 21, 2008 at 7:58 pm

    I would just like to respond to Dr. Rosen, by saying that many patients are very unaware of many things like this peticular discussion. And also many other problems that back pain can develop. Especially in emergent situations. Some patients just have difficulty in explanning to their physicians what is occurring to their own bodies.
    Thou I think it is wise to have an DIAGNOSIS too.

  • V. Pilger says:
    February 4, 2009 at 3:30 pm

    I have worked at a desk job for 35+ years. My back has been getting increasingly painful for the last three years. Last November I was hospitalized because I could not walk as a result of nerves in my back. It took two epidural shots, morphine, and Hydrocodone (is that the same as Oxycontin?) to ease the pain. I am able to walk again.

    My back has been diagnosed by two UCI Doctors with the following conditions: 4 missing discs (completely degenerated) two herniated discs, scoliosis, spinal stenosis, arthritis and bone spurs. I also have other conditions like spasmadoic torticollis, diabetes, HBP, etc. All complicating more as I age. Now I have depression to look forward to also? Wow. I can see how this can be depressing, I am already bummed by all this and by not being able to work at what I have been doing for 35+ years. I wonder if my UCI doctors will treat the depression too. More pills! I can’t keep track of them!

    I did get off of the morphine and Hydromorphone, by just quitting and tolerating the pain. I think the two epidurals helped. Ice packs on the lower back also calm the nerves in there down quite a bit.