Chronic pain may impact a patient psychologically. Be it irritability, depression or anxiety, the chronic condition can trigger a vicious cycle, making it refractory to complete cure. Therefore when treating such patients, physicians and orthopaedics worldwide, add an anti-depressant in their prescription to lessen the emotional baggage and promote healing.  

Researcher Giovanni Ferreira et al at the University of Sydney set out to investigate the effectiveness and safety of antidepressants for back and osteoarthritis pain compared with placebo.

Results showed, these anti-depressants were either ineffective or the effect was small -- unlikely to be considered clinically important by most patients.

For osteoarthritis, the outcome was slightly different. Researchers found that serotonin and norepinephrine reuptake inhibitors (SNRIs), a class of medications used to treat depression, had a slightly stronger effect on pain after three months. Compared with placebos, the effect, although small-- an average difference of 9.7 points on the pain scale, meant that a worthwhile effect could not be excluded.

While tricyclic anti-depressants (TCAs) were ineffective for back pain and related disability, both TCAs  and SNRIs seemed to reduce pain in patients with sciatica. Still, the certainty of this evidence  ranged from low to very low, which means that the efficacy of anti-depressants in the treatment of chronic pain may be overestimated and needs re-evaluation.

Team at Dr Joints avoid prescribing antidepressants like medicines and focus more on exercises which has better outcome.