As the name suggests, antidepressant medication is typically prescribed for patients with depression. Over the years however, it has become a common treatment for various pain conditions, including back pain. We continue to be surprised by the number of patients presenting with chronic back pain who are being treated primarily with antidepressants. Although some patients do report some mild benefit, the most common answer to the question, “Do they help?” is “Not really.” New research published in the British Medical Journal seems to support the idea that these types of medications are not very effective for back pain. The researchers analyzed data from 33 randomized controlled trials that compared the pain controlling ability of antidepressants versus placebo. They found the effect to be very small. The authors of an editorial linked to this study conclude that drug treatments are “largely ineffective for back pain and osteoarthritis and have the potential for serious harm. We need to do a better job of helping people with these disorders to live better with their pain without recourse to the prescription pad.” This highlights the role that chiropractic can play in treating patients suffering from back pain. By emphasizing improved joint movement, healthier muscles and increased activity, pain and disability can effectively be managed just as the editorial authors suggest…..without a prescription pad.
Ferreira G E, McLachlan A J, Lin C C, Zadro J R, Abdel-Shaheed C, O’Keeffe M et al. Efficacy and safety of antidepressants for the treatment of back pain and osteoarthritis: systematic review and meta-analysis BMJ 2021; 372 :m4825
Underwood M, Tysall C. Antidepressants for musculoskeletal pain BMJ 2021; 372 :n80