Pain due to herniated disc causes depression

When numbness and pain starts, it requires a very comprehensive treatment process such as the use of painkillers, the use of muscle relaxants, the application of various physical therapy exercises, and the change of diet and lifestyle. In this context, hernia pain can sometimes lead to depression due to severe pain experienced. Medicana International Istanbul Hospital Mental Health and Diseases Specialist (Psychiatrist) Dr. Emel Kurt gave important information about the mental problems due to herniated disc.

Treatment of lumbar hernia-related complaints requires long-term follow-up in patients. The most prominent complaint of the patients is related to pain due to herniated disc. Physiologically, we can describe pain formation as the neurons responsible for transmitting the pain sensation, which is common in the body, to the brain, passing through the medulla spinalis (spinal cord), firstly to the brain stem and thalamus, and then to the cortex of the brain (the outer layer of the brain), as a result of which the person receives the pain sensation. Pain is a subjective sensation, it cannot be measured, but the severity of pain can be graded according to one's own experience. Any kind of pain disrupts the biopsychosocial balance of the person. The estimated annual incidence of low back pain is reported to be 5-20% in the USA and 25-45% in Europe. Pain can affect the physical and psychological state of the person, leading to limitation of daily functions. Pain that lasts longer than 3 months is defined as chronic low back pain. Psychiatric disorders or complaints accompany most of those with chronic pain. It is possible to explain this association from both aspects: various psychological factors can cause pain, as well as pain itself can cause psychological problems. chronic pain; It causes symptoms such as irritability-tension, sleep disorders, feelings of burnout, turning one's attention to one's body, sexual reluctance, slowing down in movements, and social withdrawal. These individuals may feel insecure and exhibit chronic pain behavior. They can express pain physically with gestures, facial expressions and groans, they may have difficulty in fulfilling their responsibilities, and they may visit a doctor frequently. Pain can almost become a part of their lives.

Chronic Pain Leads to Depression

Stating that there is a strong relationship between pain and depression, Psychiatrist Dr. Emel Kurt stated that as chronic pain has a risk of causing depression, depression also has an effect on revealing or increasing the sensation of pain. Chronic pain reduces a person's quality of life. An individual who constantly feels pain may have difficulty in carrying out his responsibilities, may experience reluctance to engage in pleasurable activities, may become intolerant, and interpersonal relationships may deteriorate as a result. All these losses can cause the person to become more and more hopeless about the vicious circle he is in, not being able to fix the broken interpersonal relations with his thoughts that he is not understood by his environment, and ultimately depression. Corticotropin-Releasing Hormone and Arginine-Vasopressin secreted from the brain region called Hypothalamus in acute stress-related situations cause the release of cortisol (glucocorticoid) from the adrenal glands with a series of reactions. This circuit is called the Hypothalamo Ptiter Axis (HPA). Cortisol enables the person to exhibit various physiological and behavioral reactions to stress in the acute period. In the case of chronic stress (for example, chronic pain), the HPA system is disrupted and some hormones such as cortisol rise in the blood. The deterioration in HPA is thought to be related to the depression that occurs in chronic pain states. Considering that patients with depression perceive the pain as more severe, it is predicted that the pain complaints related to the primary disease will decrease with the treatment of depression. When all these are evaluated, it is recommended that patients with lumbar hernia problem causing chronic pain should also be evaluated psychiatrically.