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June 2022 Update

Chronic Pain and Depression

Pain serves an important function in our lives. When you suffer an acute injury, pain warns you to stop the activity that is causing the injury and tells you to take care of the affected body part.


Chronic pain, on the other hand, persists for weeks, months, or even years. Some people suffer from chronic pain without any definable past injury or signs of body damage. Common types of chronic pain can include headaches, low back pain and arthritis. Unfortunately, there is scant objective evidence or physical findings to explain such pain.  But, emerging scientific evidence is demonstrating that the nerves in the spinal cord of patients with chronic pain undergo structural changes.


Psychological and social issues often amplify the effects of chronic pain. For example, people with chronic pain frequently report a wide range of limitations in family and social roles, such as the inability to perform household or workplace chores, take care of children, or engage in leisure activities. In turn, spouses, children and  co-workers often have to take over these responsibilities. Such changes often lead to depression, agitation, resentment and anger for the person in chronic pain, as well as stress and strain in family and other social relationships.

How is depression involved with chronic pain?

Depression is the most common emotion associated with chronic pain. It is thought to be three to four times more common in people with chronic pain than in the general population. In addition, 30 to 80 percent of people with chronic pain will experience some type of depression. The combination of chronic pain and depression is often associated with greater disability than either depression or chronic pain alone.


People with chronic pain and depression suffer dramatic changes in their physical, mental and social well-being—and in their quality of life. Such people often find it difficult to sleep, are easily agitated, cannot perform their normal activities of daily living, cannot concentrate, and are often unable to perform their duties at work. This constellation of disabilities starts a vicious cycle—pain leads to more depression, which leads to more chronic pain. In some cases, the depression occurs before the pain.


Until recently, the medical community believed that bed rest after an injury was important for recovery.  Now we know that this advice likely resulted in many chronic pain syndromes. Avoiding performing activities that a person believes will cause pain only makes their condition worse in many cases.


Depression associated with pain is very powerful and needs the correct treatment.  If untreated, it is powerful enough to have a substantial negative impact on the outcome of any other treatment, up to and including surgery.


What is the treatment for chronic pain and depression?

The first step in coping with chronic pain is to determine its cause, if possible. Addressing the problem will help the pain subside. In other cases, especially when the pain is chronic, you should try to keep the chronic pain from being the entire focus of your life.


Stay active and do not avoid activities that cause pain simply because they cause pain. At SOSR, we can help direct the amount and type of activity, so that activities that might actually cause more harm are avoided.

Relaxation training, hypnosis, biofeedback, and guided imagery can help you cope with chronic pain. Cognitive therapy can also help patients recognize destructive patterns of emotion and behavior and help them modify or replace such behaviors and thoughts with more reasonable or supportive ones.

Distraction (redirecting your attention away from chronic pain), imagery (going to your “happy place”), and dissociation (detaching yourself from the chronic pain) can be useful.

Involving your family with your recovery may be quite helpful, according to recent scientific evidence.
If you are experiencing symptoms of depression or chronic pain, the SOSR team is here for you.  We can suggest some techniques that may work for you or may refer you to another healthcare provider for more in-depth training or additional treatment options.  Mental health is an important part of pain recovery and we can help connect you to resources in Southern Oregon.