Around 61,200 cases of lower back pain in Australia could partially be attributed to depression, researchers say.
Their meta-analysis and systematic review of 11 studies involving over 23,000 people found people with depression had an increased risk of lower back pain (OR 1.59 CI 1.26-2.01).
The risk was higher in people with more severe depression (OR 2.51, CI 1.58-3.99), found the researchers from the George Institute for Global Health and The Institute of Bone and Joint Research at the Kolling Institute.
The observed magnitude of risk between symptoms of depression and low back pain may be considered weak, but could still have substantial implications, the researchers said.
“If we apply our summary OR to the worldwide prevalence of depression we can estimate the population proportional attributable risk … considering a 12 month prevalence of depression of 6% the population attributable risk would be 3.4%.”
“In Australia this corresponds to 61,200 cases of LBP that may be partially attributable to depression considering that LBP affects 1.8 million Australians (9.2% of the total population,” they wrote in Arthritis Care & Research.
The researchers acknowledge that there has been considerable debate about the relationship between pain and depression.
Even among researchers who believe in a casual link between the conditions there is no agreement on the direction of the causality, they say.
A complete picture of the relationship would be much more complex, but the current review attempts to “investigate a single/simple facet of this complex association and bring some light into the field,” they wrote.
Health professionals should be aware that symptoms of depression might be an additional risk factor for lower back pain, as this makes appropriate detection and treatment of depression even more important than it currently is, they say.
“As current conservative treatments for LBP have only shown small to moderate effects the results of this review point to an additional treatment model, where the focus of LBP management could be extended from treating specific impairments to the management of associated co-morbidities such as depression,” they added.