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Depression: An Important Factor Related to Other Pains among Patients with Chronic Low Back Pain

Author(s): Ya-Hsin Chou, Tsai-Sheng Fu, Ching-I Hung


No study has compared the associations of the pain intensity of low back pain (LBP), depression, and anxiety with other non-low-back pains among orthopedic outpatients with chronic low back pain (CLBP). This study aimed to investigate the above issue.


Two-hundred and twenty-five participants with CLBP were enrolled from a medical center. Depression and anxiety were evaluated using the Depression and Somatic Symptoms Scale (DSSS) and the Hospital Anxiety and Depression Scale. Major depressive episode (MDE) and anxiety disorders were diagnosed using the Structured Clinical Interview for DSM-IV-TR. A visual analogue scale was used to evaluate the intensities of LBP and seven other pains. Multiple linear regressions were used to determine the associations of the pain intensity of LBP, depression, and anxiety with other pains.


A current MDE was the most important factor related to headache, chest pain, and general muscle pain. Severe LBP was the most important factor associated with other bone/joint pains, neck/shoulder pains, and limb pain. The depression subscale of the DSSS explained a greater variance in terms of predicting five other pains (headache, abdominal pain, chest pain, general muscle pain, and limb pain) as compared with the intensity of LBP and anxiety.


Some other pains, such as headache, chest pain, and general muscle pain, appeared to be more strongly associated with depression than with the pain intensity of LBP. Depression should be evaluated among patients with non-low-back pains. Integration of depression into the treatment of LBP might help to improve multiple pains.

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