Up to half of people enduring pain for three months or longer also suffer from depression or another mood disorder, research suggests.

That’s partly because pain may stem from a physical cause, like a fall, “but it’s perceived in the brain,” says Robert Kerns, Ph.D., a professor of psychiatry, neurology, and psychology at Yale University. “And the parts of the brain involved in perceiving pain also regulate mood.” That means that pain can amplify—or even cause—depression and anxiety, and vice versa.

Yet healthcare providers often don’t screen patients with pain for depression or other mental-health problems. “When pain is present, doctors are trained to look for a physical cause,” Kerns says. “But if you have chronic pain, your doctor should also ask questions to get at how it’s affecting you emotionally.”

The promising news is that certain treatments—notably mindfulness meditation, relaxation, and cognitive behavioral therapy (CBT)—can ease chronic back pain.

How the Treatments Help

New back-pain guidelines from the American College of Physicians recommend those treatments, which can reduce your perception of pain by shifting the way you think about and react to it.

Stress and tension can worsen pain, so any technique that relaxes you can sometimes help you hurt less. And dwelling on pain makes it worse, so meditation and CBT help by teaching you to put some mental distance between you and your physical problems.

With CBT, you learn to identify negative thoughts and behavior linked to your pain and develop ways to change them. For example, you might be fearful that activity will worsen your condition. A therapist can encourage you to question that idea and find ways to start moving again. With time, you “develop the sense that pain is manageable,” Kerns says.

Cognitive behavioral therapy usually involves seven to 12 sessions, Kerns says, and if it’s going to work for you, expect to see results within four sessions.



Editor's Note: This article also appeared in the June 2017 issue of Consumer Reports magazine. This article and related materials are made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program, which is funded by the multistate settlement of consumer-fraud claims regarding the marketing of the prescription drug Neurontin (gabapentin).