Few physical ailments are more common than back pain, which will affect 8 of 10 people at some point in their lives. Of course, there are many back pain causes, which come along with symptoms ranging from a mild, temporary soreness to chronic, debilitating pain requiring serious measures to fix. However, in some cases, back pain may result in a secondary, unexpected result: the onset of depression.

According to Joseph Garbely, DO, chief medical officer of Friends Hospital in Philadelphia, depression is not a risk factor for everyone with back pain. But if you have severe or long-lasting back pain, then you might need to be concerned about your mental health as well. “Major depression is thought to be four times greater in people with chronic back pain than the general population,” says Dr. Garbely. “Chronic back pain is the key here. Acute pain is not associated with depression, but chronic pain is.”

What’s more, it appears that your risk of depression increases with the severity of your back pain. “A 2004 study showed that major depression increased in a linear fashion with severity of pain and that the greater the pain, the higher the depression rate,” adds Garbely.

Why Does Back Pain Cause Depression?

At first glance, it might seem strange that a physical problem like chronic back pain and a mental problem like depression are so strongly linked. But when you look a little closer, it starts to make sense. Garbely explains that the symptoms of back pain can cause a slippery slope that leads to depression.

First of all, people with chronic back pain tend to not get enough sleep. “Sleep is so important to all of us, and if we are sleep-deprived for periods of time, eventually that’s going to take its toll on our emotions and lead to major depression,” says Garbely.

In addition, the physical pain often makes people withdraw from their regular activities and social interactions, which also can contribute to depression. The pain can cause people to withdraw from sex or intimacy with a loved one, and the inability to work can eventually lead to financial difficulties as well.

Sometimes, the pain medication itself can lead to depression. Garbely says that many medications prescribed for pain "have a dulling or depressive effect. The medicine also affects your memory and concentration, all symptoms of depression.”

The bottom line? “Both sides of the cycle (pain and depression) have been looked at independently of one another, and studies have concluded that each can cause the other,” says Garbely.

How to Fight Back Pain-Related Depression

What’s interesting about back pain and depression is that they seem to be so closely tied that getting depression relief may actually lead to back pain relief. So Garbely advises treating both your depression symptoms and chronic pain symptoms with the help of an expert. “Depressed mood will increase the perception of pain, so it actually intensifies the pain itself,” says Garbely. “So if you treat depression, pain is improved.” To do this, Garbely recommends seeing your doctor to determine if therapy or medication might be appropriate for treating your depression.

On the flip side of the coin, getting back pain relief can also help the depression improve. To treat your back pain, ask your doctor if he can recommend a physical therapist or a stretching and strengthening program.

“If movement is very physically difficult for you because of the pain, seek some help,” says Garbely. “Try physical therapy or non-pharmacalogical ways of alleviating the pain first. Of course, in some cases surgery or more extensive medical procedures may be necessary, but this is generally the first course of treatment for back pain.”