Do antidepressants help patients with back pain?

That depends on which study you read and what kind of back pain you have.
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In a review of 10 studies on back pain and antidepressants published recently by the Cochrane Collaboration, an international organization that reviews medical studies, Australian researchers found no clear evidence that antidepressants are more effective than sugar pills in helping patients with low-back pain. The finding is somewhat perplexing because, as the Australian researchers themselves noted, there is evidence that antidepressants can help with other types of chronic pain.

The researchers' findings also conflict with recent guidelines issued by the American Pain Society, which does recommend antidepressants for back pain, said Dr. Roger Chou, director of the guideline program. But he cautioned in an e-mail that antidepressants are not recommended as the "first line" treatment for low back pain partly because they can have side effects and partly because the benefit of antidepressants for back pain is "small to moderate."

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Antidepressants Don’t Ease Back Pain

Nearly one in four primary care doctors prescribes antidepressants as a treatment for low back pain. But a new report shows there’s no evidence the drugs offer any relief.

The finding comes from a review by the Cochrane Collaboration, a not-for-profit group that evaluates medical research. The use of depression pills to treat back pain has been controversial. Some studies have suggested a benefit while others have shown the drugs don’t help. Complicating matters is the fact that depression is common among sufferers of chronic back pain, so it’s not always clear if doctors are prescribing the drugs for pain relief or as a preventative measure against depression.

The Cochrane review, led by Donna Urquhart, a research fellow at Monash University in Melbourne, Australia, analyzed 10 published studies that compared antidepressants to placebos in patients with low back pain. Some of the patients had ruptured discs, slipped vertebrae, pinched nerves or other problems; some were depressed, while others were free of depression.

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