Chronic back pain often leads to varying degrees of depression. Chronic pain and depression are two of the most common health problems that physicians deal within practice. Depression is more commonly experienced by those with chronic back pain than acute or short duration back pain. The relationship between depression and back pain will vary from individual to individual. In some cases chronic or severe back pain will lead to a secondary or reactive form of depression.  In other cases depression may precede the onset of low back pain rendering the individual more susceptible to a lower tolerance or threshold for pain.  

There are many reasons why chronic low back pain may lead to or cause depression Some of the reasons are listed below.

• Back pain often makes it difficult to sleep, leading to fatigue and irritability during the day.
• Social isolation and lack of participation in enjoyable activities.
• Lack of gainful employment which leads to financial problems which impact the whole family.
• The development of secondary symptoms due the use of medications. This may include gastrointestinal distress and impairment of cognitive function.
• Impairment of memory and concentration secondary to pain and related sleep deprivation.
• Loss of libido and/or inability to have sex

The presence of one or more of the above situations combined with unremitting back pain can lead to feelings of despair, hopelessness and other symptoms of depression. Back pain can increase family stress from financial strain. The person with back pain may unable to contribute as much to the household and parental responsibilities thus straining the martial relationship.

Symptoms of depression include:

• Recurrent bouts of anger and frustration
• Lose of weight not associated with diet or exercise
• Taking risks such as reckless driving and extreme sports
• Loss of concentration
• Isolation from family and friends
• Avoiding pleasurable activities
• Chronic fatigue
• Loss of interest in work and hobbies
• Alcohol or substance abuse
• Suicidal thoughts
• Social isolation
• Unable to make critical decisions
• Changes in sleep patterns (sleep too much or cannot sleep)
• Uncontrollable bouts of crying without proportionate cause
• Violent behavior
• Feelings of sadness and hopelessness
• Thoughts of death and dieing

Depression may also present with physical symptoms such as back pain, headaches, digestive problems, and chronic pain.