The Link Between Depression and Chronic Back Pain
Most people with chronic back pain also develop clinical or major depression. Psychological theories state that it is because chronic pain reduces the patient’s ability to engage in different types of activities that they used to enjoy (i.e., family activities, work, recreation, and even self-care). According to a study (Gatchel and Turk, 1999), the decreased ability to perform any activity leads to a downward physical and emotional spiral called “physical and mental deconditioning.” 
The three main reasons why depression is common for chronic pain sufferers are listed below:
- Because pain may result in difficulty sleeping, this leads to fatigue and irritability during the day.
- Due to the pain, patients will have difficulty performing their activities of daily living, which leads to social isolation or even inability to enjoy recreational activities.
- Financial difficulties may also become an issue due to the patient’s inability to work.
Having chronic back pain is life limiting. A patient’s decreased ability to do physical activities does not only affect them, but also affects the people around them because pain affects one’s mood, self-esteem, and thinking. This can cause feelings of hopelessness, helplessness, and worthlessness: the three main symptoms of major and clinical depression.
Managing Depression and Chronic Back Pain
It’s very important to stay active despite the pain. Being sedentary can worsen your symptoms. Exercise is known to help with depression as it helps release endorphins, the brain’s natural feel-good chemicals.
Endorphins not only help in decreasing the perception of pain, they also leads to feelings of euphoria, usually termed as “runner’s high”. 
Strenuous activities are not recommended for people with chronic back pain. It is best to consult a specialist or a chiropractor to create an exercise programme that is just right for your activity tolerance.
Chiropractic Care and Chronic Back Pain
Chiropractic care is very effective in treating chronic pain. After a careful evaluation by a chiropractor, a treatment plan will be created. Spinal manipulation/alignment can help relieve pain and hence remove the cause of depression.