Musculoskeletal Problems, Migraines, Sleep, and Mental Health – What's the Connection?

A recent study in Spain has investigated the prevalence of painful musculoskeletal conditions such as arthritis, neck pain and back pain with migraine, anxiety, depression and problems sleeping. What they found should help influence health care policy worldwide.

The musculoskeletal disorders included in this study were arthritis, osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, muscular dystrophy, and neck or back pain. Researchers looked at data from the Spanish national disability and dependence survey (2007–2008) of 16,932 adults aged 18 or older who have disabilities.

A Third of Europeans Have Chronic Pain

Chronic pain was reported by a third of the European population and 12% of the Spanish population, and was an oft cited factor in the disability (which affected 8.9% of Spaniards). As it appears that depression is not only linked to back pain but also to other types of chronic pain, and that altered mood, anxiety, and sleep disorders can be factors in chronic pain, the researchers wanted to establish these links in the data.

Two-Thirds of Those with Disabilities Have Musculoskeletal Conditions

Painful musculoskeletal conditions were present in 66.9% of people reporting a disability, and migraines or other headache in 23.4%; both conditions were more commonly diagnosed in women than in men. Those who were older, who had a sleeping disorder and/or who had chronic anxiety and/or depression were more likely to have a musculoskeletal condition or migraine condition than those suffering from a different form of disability.

Why Chronic Neck Pain, Depression, and Sleep are Connected

To determine the exact link between these was not the aim of this study but there are a number of hypotheses regarding the connections. For example, those with pain may find it difficult to sleep, while those who get insufficient sleep have a higher sensitivity to pain. The connections can also run deeper in that systemic inflammation may be linked both to depression and back pain, as well as to autoimmune conditions.

Medications for some conditions can also alter mood, while those with chronic pain may become depressed due to reduced quality of life, stress about impending surgery, or due to a reduced ability to engage in healthy eating and exercise patterns.

This kind of research helps highlight the need for holistic treatment programmes for those with ongoing back pain and neck pain. Such plans would incorporate therapy to support better sleep and mental health in addition to conventional treatments.