- Depression as a Risk Factor for Back Pain
There’s no question that low back pain can lead to depression, but can depression lead to low back pain? The answer appears to be yes.
In a three-year prospective study of 148 people aged 35 - 70 years, depression proved to be a stronger predictor of low back pain than the results of magnetic resonance imaging (MRI). The three-year incidence of back pain was 67%; those who reported depression when the study began were 2.3 times as likely to have back pain as those who didn’t report depression.
In contrast, any progression of anatomic abnormalities, as seen on MRI, was infrequently and only occasionally associated with new onset of back pain. Most of the participants were men; none had any back pain when the study began. Those who reported depression were either being treated for depression or had their activities limited by depression. While MRIs were taken only at the beginning and end of the study, all of the participants were interviewed every four months regarding back pain and functional status. This intriguing study was reported in the journal Spine (Volume 30, page 1541).
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Acupuncture for Low Back Pain
Acupuncture has a role in treating chronic back pain, a new review of the topic concludes. The review, reported in Annals of Internal Medicine (Volume 142, page 651), is a meta-analysis of 22 previously published randomized studies. It found that acupuncture is "significantly more effective” than fake acupuncture or no treatment in people who have chronic back pain. However, the researchers stated that there is no evidence to suggest that acupuncture is more effective than other active therapies for chronic back pain, such as massage, medication, or chiropractic adjustment.
For acute back pain, the researchers noted that acupuncture’s role remains uncertain because the studies available for review are, in their opinion, limited in quantity and quality. On a positive note, the researchers add that several large, well-designed studies add to the growing support for acupuncture as a modality for treating back pain. At the time that this meta-analysis was published, these studies had not yet been published, but their results had been presented at conferences.
