Living with Chronic Pain and Depression

This study published in the Journal of the American Medical Association found that a course of antidepressants followed by a pain self-management program improved both depression and pain. If you haven’t yet, consult a pain specialist for a treatment plan, along with a mental health specialist for a proper evaluation and treatment for depression, Kerns said. It’s also important to communicate regularly with your providers and pay attention to changes, Thorn added. When to Proceed with Caution One of the biggest challenges of treating both pain and depression is that feelings of helplessness and hopelessness lead people to try cures that are ineffective and even damaging, according to Kerns. “Continued doctor-shopping is problematic.” Also problematic is pursuing more and more aggressive pain interventions, which he said only reinforce the “sense of helplessness and hopelessness and demoralization.” Opioid medication is another concern. According to Kerns, there’s very little evidence that opioids are helpful for chronic pain. Instead, there’s “abundant evidence of the potential harm of long-term opioid therapy.” For people with pain and depression, “who may be vulnerable to pursue these kinds of interventions,” it’s best to be cautious. Most experts “argue for very limited use of pharmacological agents and support education, encouragement and judicious use of non-opioid, over-the-counter [medi...
Source: Psych Central - Category: Psychiatry Authors: Tags: Chronic Pain Cognitive-Behavioral Depression Disorders General Healthy Living Psychotherapy Self-Help American Medical Association Chronic Pain And Depression Clinical Health Psychology Comorbidities Healthcare System Integrative Source Type: news

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AbstractDepressive symptoms are common among individuals with chronic pain. Previous work suggests that chronic pain patients have difficulty regulating emotional responses, which is a risk factor for the development of major depressive disorder (MDD). Function of the mesocorticolimbic system, a neural network associated with reward processing, contributes to emotion regulation. This network ’s dysfunction has been described in chronic pain and MDD research and potentially underlies the relationship among emotion dysregulation, chronic pain, and MDD development. Given that mood induction paradigms have been used to m...
Source: Brain Imaging and Behavior - Category: Neurology Source Type: research
Abstract Among chronic low back pain (CLBP) patients, workers' compensation is associated with longer term prescription opioid analgesic use (OAU). The aim was to study the association between receiving Social Security Disability Insurance (SSDI) benefits and course of OAU. This prospective cohort study utilized data from primary care patients diagnosed with non-cancer CLBP. The outcomes were morphine equivalent dose (MED) - categorized as no OAU, 1-50mg MED, or>50mg MED - and change in MED over time using mixed multinomial logistic regression models. Covariates included sociodemographics, pain severity, pain m...
Source: Pain Physician - Category: Anesthesiology Authors: Tags: Popul Health Manag Source Type: research
Discussion: Results from these clinical trials suggest that the benefits of home-based, telehealth-delivered CBT and SC treatments for chronic back pain were comparable when delivered by a primary care nurse or mental health professional.
Source: The Clinical Journal of Pain - Category: Anesthesiology Tags: Original Articles Source Type: research
h L Abstract BACKGROUND: One model of care that has not been tested for chronic low back pain (LBP) is patient-led goal setting. We aimed to compare the clinical effectiveness and healthcare use of a patient-led goal setting approach (intervention) with simple advice to exercise (control) over 12 months. METHODS: An assessor-blinded randomised controlled trial. Intervention was education combined with patient-led goal setting compared with a control group receiving a standardised exercise programme. The primary outcomes were back pain disability and pain intensity. Secondary outcomes were quality of life, kin...
Source: British Journal of Sports Medicine - Category: Sports Medicine Authors: Tags: Br J Sports Med Source Type: research
CONCLUSIONS: A risk-tailored short intervention to prevent chronic LBP in general practice had no significant impact on the clinical course compared to care as usual. A subgroup analysis comparing adherent and non-adherent patients suggests that it is possible to have a positive impact on patient-relevant outcomes. PMID: 30796580 [PubMed - as supplied by publisher]
Source: Schmerz - Category: Anesthesiology Authors: Tags: Schmerz Source Type: research
The objectives of this study were to define the role for surgery in the treatment of chronic low back pain (cLBP) and to develop a new classification of cLBP based on the pattern of injury.HypothesisSurgery may benefit patients with cLBP, and a new classification based on the injury pattern may be of interest.MethodA systematic literature review was performed by searching Medline, the Cochrane Library, the French public health database (Banque de Données en Santé Publique), Science Direct, and the National Guideline Clearinghouse. The main search terms were “back pain” OR “lumbar” OR &...
Source: Orthopaedics and Traumatology: Surgery and Research - Category: Orthopaedics Source Type: research
This study aimed to determine whether systemic cytokines/CRP during acute LBP were associated with recovery at 6 months. Acute LBP (
Source: Brain, Behavior, and Immunity - Category: Neurology Source Type: research
You are dispatched to a nursing home for an 80 year old female with a “rapid heart rate.” You arrive on scene and the charge RN gives you report. Per the RN, assistive staff were checking the patient’s vitals this morning when they noted her heart rate to be elevated. They consulted the RN, who found the patient to have a rapid and irregular pulse, so he in-turn consulted the nursing home physician, who requested the patient be transported to the community emergency department approximately 30 min away for further workup and management. When you walk in the room, you find a pleasant-appearing woman sittin...
Source: EMS 12-Lead - Category: Cardiology Authors: Tags: Cases Vince DiGiulio Source Type: research
CONCLUSION: A single session of leech therapy is more effective over the short term in lowering the intensity of pain over the short term and in improving physical function and quality of life over the intermediate term (4 weeks and 8 weeks, respectively). The limitations of this trial are the lack of blinding and the small number of patients. Leech therapy appears to be an effective treat- ment for chronic low back pain. PMID: 30636672 [PubMed - in process]
Source: Deutsches Arzteblatt International - Category: General Medicine Tags: Dtsch Arztebl Int Source Type: research
Education with recommended first-line care may not improve pain outcomes in patients with acute low back pain. When comparing patients who received education with those who received professional consultation without information or advice, researchers found patient education was no more effective than placebo at reducing depression or incidence of chronic low back pain...
Source: The Rheumatologist - Category: Rheumatology Authors: Tags: Conditions Back pain Chronic pain low back pain patient education Source Type: research
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