A new study by Yang, et al., explores the “Bidirectional Comorbid Associations Between Back Pain and Major Depression in US Adults.” Funded by a grant from the NCMIC Foundation, this is the first population-based study on the bidirectional comorbid association between these two globally recognized key health problems.1
The goal of the study: “to explore the cross-sectional and longitudinal comorbid associations between major depression and back pain in a national sample of adults in the U.S.” using data from the Midlife in the United States Survey (MIDUS). Back pain patients were defined as patients who had experienced back pain “almost every day” or “several times a week” in the previous 30 days.
The study found that “major depression is likely to be prospectively associated with back pain, and that back pain is linked to subsequent major depression.” This bidirectional association between back pain and major depression is consistent with findings from previous research.2-3 The study also found that “age was inversely related to major depression” and that “there was a higher proportion of female participants with major depression (24.1%) and a higher proportion of female participants with back pain (14.1%).”
Needless to say, these comorbid and bidirectional associations between back pain and major depression may have implications for the management of patients with both ailments. As both cause high levels of disability, there is likely a benefit to managing patients with depression by examining their back pain and vice versa. Addressing both complaints simultaneously has the potential to be much more effective than focusing on a single ailment.
According to the NIH National Institute of Mental Health, in the past year “an estimated 21.0 million adults in the United States had at least one major depressive episode. This number represented 8.4% of all U.S. adults.4 The Yang, et al., findings set the stage for doctors of chiropractic to reach out to mental health care providers in an effort to collaborate with and co-manage patients who suffer from both back pain and depression. The likely result: significant improvements in overall patient care, as well as a better clinical understanding among providers of how major depression and back pain are related.
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When I graduated from chiropractic college in 1981 and started practice, I heard it all, and very little was positive. “You are a quack; you do not know what a subluxation is; you couldn’t get into a real health care program, so you chose the one that is slightly above a mail-order degree; you have no proof that chiropractic works; Are you really licensed?”, and so much more.
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A central challenge in creating our identity is that chiropractic is a method of care, not a technique or procedure. This is an important concept for us to promote. Our patients are treated with lifestyle modification, exercise, nutritional supplements, diet and a whole-body approach to accelerate the natural healing process. We are not simply CMT providers.
The results of a global survey released late last year (2023) unveiled some startling findings among medical and nursing students. The “Clinician of the Future: 2023 Education Edition” surveyed 2,212 students, of which 446 were in the United States, from 91 countries.
