Three Facts That Will Change How You Think About Pain

Summary of the Links Between Depression & Pain from Literature:

• Certain antidepressants are prescribed as pain killers
• The comorbidity between depression and patients with chronic pain syndromes is high.⁷
• Pain avoidance can lead to continual withdrawal from activities and eventual depression.
• Negative emotional experiences can cause the sensation of pain in the absence of tissue damage.³
• Cognitive processes like expectation can modulate the effectiveness of analgesia
• Depressed chronic low back pain (CLBP) patients had higher levels of pain compared to CLBP patients without depression.⁸ Work and activity impairment was twice as high in the depressed individuals.⁸
• Opioid-stimulated and total striatal dopamine (DA) release levels are reduced in animal models of chronic pain, suggesting a neurological link to depression.⁹

References:

1. Melzack R. Pain and the Neuromatrix in the Brain. Journal of Dental Education. 2001;65(12):1378-82.
2. Taylor A et al. Microglia Disrupt Mesolimbic Reward Circuitry in Chronic Pain. Journal of Neuroscience. 2015;35(22):8442-8450. doi:10.1523/jneurosci.4036-14.2015.
3. Borsook D, Edwards R, Elman I, Becerra L, Levine J. Pain and analgesia: The value of salience circuits. Progress in Neurobiology. 2013;104:93-105. doi:10.1016/j.pneurobio.2013.02.003.
4. Shulman B, Marcano A, Davidovitch R, Karia R, Egol K. Nature’s wrath—The effect of weather on pain following orthopaedic trauma. Injury. 2016;47(8):1841-1846. doi:10.1016/j.injury.2016.05.043.
5. Figueiredo ECQ, Figueiredo GC, Dantas RT. Influence of meteorological elements on osteoarthritis pain: a review of the literature. The Brazilian Journal of Rheumatology. 2011; 51(6):616-628.
6. Funakubo M, Sato J, Obata K, Mizumura K. The rate and magnitude of atmospheric pressure change that aggravate pain-related behavior of nerve injured rats. International Journal of Biometeorology. 2010;55(3):319-326. doi:10.1007/s00484-010-0339-8.
7. Asmundson GKatz J. Understanding the co-occurrence of anxiety disorders and chronic pain: state-of-the-art. Depression and Anxiety. 2009;26(10):888-901. doi:10.1002/da.20600.
8. Tsuji T, Matsudaira K, Sato H, Vietri J. The impact of depression among chronic low back pain patients in Japan. BMC Musculoskeletal Disorders. 2016;17(1). doi:10.1186/s12891-016-1304-4.
9. Massaly N, Morón J, Al-Hasani R. A Trigger for Opioid Misuse: Chronic Pain and Stress Dysregulate the Mesolimbic Pathway and Kappa Opioid System. Frontiers in Neuroscience. 2016;10. doi:10.3389/fnins.2016.00480.