Many know the benefits of some drugs with an anti-depressant effect in the treatment of the chronic pain of fibromyalgia. Well, now it would seem that there is no overwhelming evidence supporting the use of anti-depressants in the treatment of chronic low back pain. Although, the authors of a recent review (in the "Cochrane Database of Systematic Reviews") of the subject are quick to point out that this does not mean that depressed patients with back pain should not receive medical treatment for their depression.
The hypotheses for even considering anti-depressant drugs for chronic low back pain does, nonetheless, make sense: First, patients with chronic low back pain often also suffer from depression, and improving the mood with medication may improve in turn pain tolerance. Second, many anti-depressant drugs have actual pain-relieving activity which often occurs at lower doses than those utilized for the treatment of depression. Finally, many anti-depressant drugs have a sedating effect, and perhaps the improvement of sleep in those who experience insomnia may improve pain tolerance.
Well, the conclusion of the Cochrane review included the finding that there was no difference in pain relief between different types of anti-depressants and placebo. And, it appears that patients with chronic low back pain do not experience a reduction in depression with the use of anti-depressants.