The Impact That Back Pain Has On Mental Health

Back pain is known to be a leading cause of disability and affects 1 in 10 people worldwide, more than any other condition. Back pain negatively impacts a person's quality of life and increases the risk of developing other physical health-related problems. What hasn't been researched though, is what impact back pain has on the mental health of patients, especially from low and middle income countries diagnosed with this condition.

Therefore, researchers conducted a study with the aim to discover the epidemiology of back pain in 43 low and middle income countries (LMICs), and to investigate whether a relationship exists between back pain and mental health conditions including the depression spectrum, stress, the psychosis spectrum, sleep disturbances and anxiety.

The study

A research team from Anglia Ruskin University in the UK searched through data from the World Health Survey of 2002-2004 that included nearly 191,000 patients, from 18 years and older, and who were from 43 countries (19 low-income and 24 middle-income).

The findings

When the data was analyzed, the following findings were made:

• Back pain affected just over 35% of the population of these LMICs, with nearly 7% reporting chronic back pain. The lowest levels of back pain were reported by China with nearly 14% of the population being affected.
• Nepal reported the highest percentage of patients complaining of back pain at just over 57% of the population, Bangladesh with over 53% of their population and Brazil reporting back pain affecting 52% of their population. What was astonishing about this finding was that more than half of these country's citizens complained of back pain.
• It was discovered, on analysis of the questionnaire data, that patients who experienced back pain were two times more likely than those who didn't complain of back pain to experience mental health issues such as depression, anxiety, stress, psychosis or sleep deprivation.
• Individuals diagnosed with chronic back pain were three times more likely to experience a depressive episode and over 2,5 times more likely to experience psychotic symptoms.
• These results seemed to be reproduced in all the 43 LMICs irrespective of socio-economic standings.

READ Lower back pain: Causes and risk factors

The clinical significance

Seeing that this study used data from such a large population group from countries all over the world, it would be fair to say that these findings are highly reliable. It would also be fair to say that since back pain is such a prevalent condition worldwide, that any link to mental health issues needs to be paid attention to, thoroughly understood and managed accordingly.

Back Pain: Causes & Symptoms 

As mentioned in the previous section of the article, back pain is a leading cause of disability that causes physical and mental health complications. It's also one of the main reasons why people miss days off work and visit doctors.

95% of cases of back pain are mechanical in nature which means that the cause is due to muscle cramps and joint inflammation from being overweight/obese, not following correct postures and lifting heavy weights using the back and not the legs. The good news is that these issues can be managed with conservative and home remedies, as well as by following advice on correct posture and how to pick up objects properly. 

Causes

The most common conditions associated with back pain include the following:

• Muscle or ligament strain -  actions such as sudden movements and lifting of heavy objects can cause a strain on the muscles and ligaments of the back. Constant strain of this anatomy can result in painful spasms of the back muscles, especially if one is in poor physical condition.
• Arthritis - spinal stenosis, which is a narrowing of the space where the spinal cord passes through, can be caused by arthritic changes in the back.
• Bulging or ruptured disks - the disks located between the bones (vertebrae) of the back act as cushions between these bones, so that they don't grind against each other, and also offers the flexible nature of the back. When these disks bulge or rupture, then they tend to press on the spinal cord or nerves that exit the spinal cord and can cause pain. 
• Osteoporosis - when the bones become brittle, then patients can sustain compression fractures of the vertebrae which causes pain.
• Skeletal irregularities - severe abnormal curvatures of the spine, due to conditions such as scoliosis or kyphosis, can cause back pain.

Symptoms

The following issues may be experienced by those with back pain.

• There's limited range of motion or flexibility of the back.
• Muscle aches affecting parts of or the whole back.
• Stabbing or shooting pain.
• Pain radiating down the leg.

READ Natural Treatment for Lower Back Pain

It would be advisable to seek immediate medical attention if severe back pain is experienced and is associated with the following:

• Intense or constant pain.
• An injury to the back that is sustained through a fall or a direct impact to the back.
• The pain spreads down to and is experienced in one or both legs.
• Gets worse at night or during rest.
• There's numbness, weakness or a tingling sensation in one or both legs.
• New bladder or bowel problems are experienced.
• A fever accompanies the pain.
• There's a throbbing sensation or pain in the abdomen.
• There's unexplained weight loss