Should we be using anti-depressants for lower back pain ?
An interesting meta-review was just published in the journal of Systematic reviews.
They were trying to answer the question of weather physicians should be be prescribing anti-depressants as a means to assist with the pain and disability caused by lower back pain ?
Certainly I seeing a lot more patients on anti-depressants since working with a more American population in Okinawa and I guess the stress of the covid-19 pandemic has only increased the this.
The authors concluded that in a review of 23 quality randomized controlled trials the best evidence available does support the prescription or efficacy of anti-depressants to address low back pain. In there words ” Taken together, these data indicate treatment of LBP symptoms with antidepressants has no important benefit; is less acceptable, less safe and less tolerable; and may be harmful, compared to treatment with a placebo medicine “.
That’s not so say that antidepressants don’t have legitimate reasons for their prescription. Simply that they should be prescribed as a modality to treat lower back pain or perhaps even the depression that can be directly linked to the chronic pain.
What does seem to offer better results are exercise therapy, physical therapy or when that fails other medications commonly used to treat chronic pain such as pain medications and anti-inflammatorys and muscle relaxations.
Remember too you should never decide to alter your medication by yourself and in some cases this may be dangerous . Always talk to your primary health care practitioner that prescribed your medication and discuss with them.
If you would like to read the article it is below.
Ferraro, M.C., Bagg, M.K., Wewege, M.A. et al. Efficacy, acceptability, and safety of antidepressants for low back pain: a systematic review and meta-analysis. Syst Rev 10, 62 (2021). https://doi.org/10.1186/s13643-021-01599-4