Neck Pain, Depression, and CBT

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neck pain depression cbt

Could CBT break the vicious cycle of chronic neck pain and depression?

Neck Pain and depression are often interlinked with some studies showing a four-fold increase in the risk of depression in those with chronic pain. The connection between the two conditions is often extremely complex, involving the immune system, endocrine system, and neurotransmitters, as well as psychosocial factors and other problems that may go unrecognized and, therefore, unaddressed. Many patients feel that their doctor has simply given up on identifying the cause of their pain if they suggest that it has a psychological root but oftentimes this is the case and may provide the answer where countless medications, physical therapies, and even neck surgery have failed to resolve the chronic neck pain.

CBT for Neck Pain and Depression

Not all patients with neck pain and depression respond to cognitive behavioral therapy, but there have been numerous studies showing benefits for patients with chronic pain disorders. This type of treatment allows patients to break the cycle of negative thought patterns connected to their pain and depression, which may then help them pursue treatment for the pain or even reduce pain as their depression lifts and tension and inflammation subsides. CBT can also help patients communicate their needs to family members, friends, and employers more effectively so that they feel that their pain is legitimate and worthy of assistance and accommodation. CBT may also help patients achieve more restful sleep which can help reduce pain and depressive symptoms in itself. CBT can, therefore, be beneficial both for patients with neck pain caused by depression and for patients whose neck pain has resulted in depression.

neck-pain-and-depression

Which came first - stress and depression or neck pain?

Latest Research on CBT for Chronic Pain

A paper presented at the 6th World Congress of the World Institute of Pain detailed the findings of a study of CBT for chronic pain management and confirms the benefits of the treatment. A cognitive behavioral therapy program remained beneficial even three years after the patients’ finished treatment according to Magnus Olason, MD, who presented the paper. His team did not treat patients with opioids, analgesics or other medications and instead helped patients to manage relapse control and pain without such drugs. Over a hundred patients took part in the study which gave them a six-week program of pain management for noncancerous, musculoskeletal pain; nearly half the patients had had pain for five years or more, with 40% suffering from lower back pain. The patients had been prescribed pain relievers, NSAIDs, antidepressants, and relaxants but were screened by Olason’s team to see if CBT might help them.

Long-lasting Positive Effects of CBT for Pain

Seventy-nine patients were assigned to receive either CBT or a non-CBT program with the patients randomly assigned (the others were given a pain management program). Non-CBT patients had physical rehabilitation and exercise as the primary therapies and all patients appeared to have statistically significant reductions in pain, as well as anxiety and depression at the end of treatment and after a year. The differences however, between the CBT group and the others was that at three years the former still had a meaningful improvement in symptoms whereas the non-CBT groups had reverted to baseline scores for pain and other measurements such as quality of life. It is thought that CBT may help effect positive changes in the brain where chronic pain has resulted in abnormal thoughts and associations. This has been found in research using MRIs to look at patients’ brain patterns before and after cognitive behavioral therapy. Increased gray matter in the prefrontal cortex after CBT appears to indicate better control of pain in patients, and pain perception is also changed due to alterations in pregenual cingulate and somatosensory cortices according to Magdalena Naylor, MD, PhD, professor of psychiatry and director of the Clinical Neuroscience Research Unit at the University of Vermont’s MindBody Medicine Clinic in Burlington.


Antidepressants for Neck Pain

Many patients with chronic nerve pain are familiar with the drug amitriptyline, an antidepressant that is also an analgesic. In most cases, those with neurological pain in the neck are prescribed a low dose of amitriptyline rather than the higher doses given to patients where the drug is being used as an antidepressant. If depression is suspected in a patient, whether as an isolated condition, a problem causing the neck pain, or as an effect of neck pain, it may be that a physician decides a higher dose of amitriptyline could be beneficial.

Treating Neck Pain and Depression

The key it seems to treating neck pain and depression is to treat neck pain and depression. By addressing both conditions the patient has a better chance of relieving both, especially in cases where it is unclear which condition came first and which may be contributing to the other. Some medications may be helpful for both conditions, such as nervines, anxiolytics, and antidepressants, whilst therapies designed to aid relaxation are also often beneficial for both neck pain and depression. Yoga, CBT, acupuncture, and even massage therapy could help a patient to relax, break the cycle of stress, anxiety, and pain, and increase motivation to achieve a healthy state for both body and mind. Even by reducing pain a little it may appear to be more manageable and allow a person to return to work, social activities and exercise, and active participation in family life, all of which can then further increase happiness and motivation to fully resolve neck pain and depression.

References


Olason, M., CBT and Chronic Pain, an Interdisciplinary Approach, 6th World Congress of the World Institute of Pain: Abstract 260. Presented February 5, 2012.

Alda M, Luciano JV, Andrés E, Serrano-Blanco A, Rodero B, Del Hoyo YL, Roca M, Moreno S, Magallón R, García-Campayo J., Effectiveness of cognitive behaviour therapy for the treatment of catastrophisation in patients with fibromyalgia: a randomised controlled trial. Arthritis Res Ther. 2011 Oct 23;13(5):R173.

Dunne RL, Kenardy J, Sterling M., A Randomized Controlled Trial of Cognitive-behavioral Therapy for the Treatment of PTSD in the Context of Chronic Whiplash. Clin J Pain. 2011 Dec 30.

Aggarwal VR, Lovell K, Peters S, Javidi H, Joughin A, Goldthorpe J., Psychosocial interventions for the management of chronic orofacial pain. Cochrane Database Syst Rev. 2011 Nov 9;11:CD008456.

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  465. Mup
    Mup says:

    Today paying by phone is well and truly standardized with many people in the developed world making several transactions per day. The wide range of mobile wallets and compatible sites means phone payments could become more popular than a debit or credit card in the near future. As far as other services are concerned, only prepaid cards can offer this kind of secrecy, but those can be inconvenient to obtain. Pay by Phone, on the other hand, is available via your smartphone, which you always have on you. Moreover, since only you can confirm the transactions, there is no need to worry about anyone else making charges to your phone bill. Using Pay by Phone will allow you to fully enjoy yourself at your favorite online casino, without the need to worry about someone else misusing your funds. This is increasingly becoming a thing of the past now with the advent the pay by phone casino. Pay by phone technology means that players can log in, click the pay by phone option and in some cases after having entered a secure code, any deposits to the casino will be taken from mobile pay-as-you-go credit or added onto a monthly phone bill. https://www.fitday.com/fitness/forums/members/k9itpln169.html The Bonus Canada website is a top source of online casino bonuses for Canadian players. We share new casinos, no deposit bonuses, free spins and online casino reviews. All Casinos listed here cater for Canadian slots and online casino players. On the website you will find Slottica online slots games from well-known manufacturers, which means that the casino offers both classics favorite by players and many new products. Some of these offers Slottica for free offers players to test in the form of a demo, so that they can easily and without risk recognize the rules of the game – this applies primarily to fruit slots. We are not responsible for incorrect information about bonuses, offers and promotions on our site. We always recommend that the player should check the terms and conditions and double check the bonus directly on the casino website. To withdraw money from the casino, you must submit a withdrawal request.

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  485. Dew
    Dew says:

    FAIL # 5: Missing splashguards at roof valleysA lot of water collects a the roof valleys and heads toward the gutters at high volume and high speed.  Splashguards help to prevent overflow and directs the water back into the gutters.  The photo above was taken of a house with an expensive roof and gutter system.  Overflow at the valley caused major structural damages to the main level and finished basement. Keep Gutters Flowing Gutters are designed to divert water down and away from the foundation of your home.  Once the water is down to ground level, there are several ways to channel it away.  A simple as a plastic tray under the downspout is very common, or some type of corrugated tubing connected to the downspout to lead it away from the home. If you notice standing water in your gutters, you may need to adjust the slope so they’ll properly drain toward the downspouts. And if there’s standing water at the bottom, consider adding downspout extensions to carry the water farther away from your home’s foundation. https://integratedpredictions.com/community/profile/lyndonpink7864 You can create a window washing solution by mixing 2 gallons of water with 1 teaspoon of dishwashing soap. If you don’t have dishwashing soap, you can also mix equal parts water and white vinegar for the same cleaning effect. Apply the solution with a sponge or paper towel, then wipe the windows dry with an absorbent cloth. For tips from our general contractor reviewer on how to clean and dry your windows so they’re streak free, read on! I’m often asked for tips on getting sparkling results – “What’s the secret to getting the windows looking so clean?” my clients commonly ask. So, this web page (and the next one on cleaning small windows) answers this question – to help both householders and the professionals. You only need to clean your windows once or twice a year. For best results, clean on when windows are shaded, or on a cooler, cloudy day so your cleaner doesn’t dry too quickly on a hot surface.

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