Depression is quite common with people suffering from chronic pain. I mean who wouldn’t feel a bit low when trying to cope with constant pain but there is help out there to deal with this type of depression. Research shows that some of these antidepressants may help with some kinds of long-lasting pain.

Web MD state that Doctors don’t know exactly why antidepressants help with pain. They may affect chemicals in your spinal cord — you may hear them called neurotransmitters — that send pain signals to your brain. 

It’s important to note that antidepressantsdon’t work on pain right away. It can be a week or so before you feel any better. In fact, you may not get their full effect for several weeks.

After my second spinal surgery I was put on a very low dose of an antidepressant which I took over a period of 20+years. I am still on this antidepressant ( Prozac) even though over the many years I haven taken it there have been numerous articles on the pros and cons of taking it for so long. In fact, only last year the Professor of Medicine whom I call my Medicine Man who I see on a regular basis, suggested that maybe I should stop taking it.

I started with reducing it to one every other day and had no ill effects except that I wasn’t feeling as perky as I usually am. I put it down to the fact that at that time last year I ways constantly going back and forth to stay at my Dads so that I could go and be with him in hospital. He was in three months and my sister and I would do three week shifts of going in for most of the day over a period of three weeks then coming home for a rest. Sadly Dad passed away in hospital by which stage I had already started increasing my drug to nearly what I had been on before as I had an even bigger reason for feeling low.

On the NHS website they say that even though a type of antidepressant called tricyclic antidepressants (TCAs) weren’t originally designed to be painkillers, there’s evidence to suggest they’re effective in treating chronic (long-term) nerve pain in some people.

Chronic nerve pain, also known as neuropathic pain, is caused by nerve damage or other problems with the nerves, and is often unresponsive to regular painkillers, such as paracetamol.

Amitriptyline is a TCA that’s usually used to treat neuropathic pain. I also take this for my neuropathic pain and it also helps me to sleep better.

We are all different and try to deal with chronic pain, stress and even loss in different ways but for me personally I felt this one little pill I took every morning worked for me. When I went back for my review with my Medicine Man I told him what I had been through and said I felt for me personally it was one drug I would like to continue taking indefinitely if he felt that was safe. He said that every single person will have different views and reactions to different types of antidepressants but if I had found one that I truly felt helped me ‘feel good’ every day no matter what I was going through then he was happy for me to take it indefinitely.

I know there are lots and lots of alternative things to try for any type of depression from Cognitive Behavioural Therapy to Group Therapy and much more but I do feel that some people are nervous of taking medication on a long term basis but if that works for you, then why not.

Try everything that is available to you and when you find something that works for you then stick with it even it is taking a daily dose of medication. Feeling low and depressed is awful and most people in chronic pain must feel that at some stage but life really is to short to feel that way on a daily basis so why not try something just for you to help you feel better on the outside even if the pain on the inside is still there.

Some great websites and organisations that can help with chronic pain and depression are Away With Pain.

BLB Solicitors have a long list with links to UK support and help with depression from pain. The NHS also has details on Cognitive Behavioural Therapy in the UK and how to find a therapist.




On ITV Tonight Britain on Painkillers: The Silent Epidemic.

A quarter of a million people are struggling with opioids in the UK. There are many risks involved with taking them for long-term use. They say they are of no use for long-term pain and they think that exercise, meditation and tai chi are a good option or soothing alternative to get through your pain.

Over the past decade in Britain, prescriptions for these drugs have gone through the roof – up 80% in England alone. We’re now among the biggest consumers of opioids in Europe.

And the tragedy and irony is that while the drugs are super-effective for acute emergency pain, in 90% of long-term chronic pain cases, they don’t even work.

Pain specialists are also trying to get to grips with the fact we’ve practically sleepwalked into a public health crisis: GPs under pressure to help their patients deal with pain and patients sometimes too in distress to find other strategies rather than popping the pills.

According to the British Pain Society, approximately 8 million adults in the UK  report chronic pain that is moderate to severely disabling[1]. Back pain alone accounts for 40% of sickness absence in the NHS[2] and overall it costs £10 billion for the UK economy[3].  The UK has some of the best pain services in the world and the multidisciplinary British Pain Society is at the forefront of informing the public and professionals of what is available.

However, the British Pain Society believes more research is essential to allow pain services to offer the latest effective and safest treatments.  Unfortunately, pain research is not a priority for major UK funders.

So how have we got here and how do we step back from the brink?

Is it time to radically rethink how we manage pain?

I’ve been on Tramadol for over 15 years so a rethink of how I can cope with my pain would be amazing.


With the advent of technology we can easily look up what our health problem is, and nine times out of ten Google can find you an answer. However is that the correct way to understand your health problem?

What about forums and discussion groups which are also readily available online. When I tapped in forums and support groups for back pain the first one that popped up was Spine Health which seemed to have both a discussion board and a forum. However, on a closer look at the link, their discussion group is the same as their forum. This also applied to a number of other sites on back pain including Health Boards and Pain Doctor but neither of these two were as up to date as Spine Health. They say that ‘Since our forum members are an international group, there’s always someone around. If you’re online at 3 a.m., your question about sciatica pain or a running injury may come from half a world away,’  so picking a forum that is up to date is essential if you are using it as a way of finding something out about your pain.

Forums are a great way of getting emotional support, a place where you can share your situation and story, a place where people who are suffering from the same condition as you understand how you feel and a place where you can ask questions about your condition and find out the treatments that are available for it.

Google told me it had About 7,350,000 results so trying to go through that amount would take some time. I guess the way we used to find out by reading a book on the subject is just as good but not as personal as a forum or discussion group. Personally, I do think that if you find the correct group or forum it can really help you understand your problem and is a great way of connecting with people from all over the world who suffer from the same condition as you.




Buying a health subscription for someone who is suffering can be a lovely Christmas gift. It was my friends birthday recently and she has just been diagnosed with Fibromyalgia so I bought her the Fibromyalgia Magazine as a gift, she was thrilled and thanked me for thinking of her. The best thing is that not only can someone benefit from the magazine but also the charity benefits from you buying the subscription so it’s a win-win situation 🙂

My top five health magazine subscriptions, which make great Christmas gifts are :

BackCare have a magazine called Talkback which you can buy as a subscription or you can join BackCare for an annual membership and you will be sent the magazine which comes out every four months plus 12 monthly E-Newsletters.

Talkback is a full-colour glossy magazine produced quarterly which includes the following editorial content:

  • Back product testing and the latest gadgets
  • Health and Excercise
  • Exercises and tips on preventing back pain
  • Patient centred approaches to treatment
  • Research News
  • BackCare Professionals Section
  • Readers Letters
  • Interview with Back Pain Celebrities

The Fibromyalgia Magazine deals with the areas that matter to our readers:

  • Medical Research News
  • Campaigning
  • Lobbying
  • Awareness Raising
  • Legal Advice
  • Benefits Advice
  • Worldwide news
  • News from local support groups and charities
  • Treatment Advice
  • Pharmaceutical News
  • Alternative Therapies
  • Pain Management
  • On line directory of all support groups and phone friends
  • A nationwide directory of FM resources
  • Opinion and Entertainment from our unrivalled team of columnists


Arthritis Inspire Magazine –  Inspire magazine is a quarterly members magazine for members packed with features, news, tips and information. Another Arthritis Uk Magazine is Arthritis Digest

Arthritis Digest magazine is published six times a year and summarises the latest research in the arthritis arena making it essential reading for anyone affected by the painful condition.

Informative, upbeat and packed full of news and reviews about drugs, pain relief, superfoods, products and services, each issue has a star celebrity interview and true stories.

Arthritis Digest magazine informs readers and encourages them to learn, try new ideas and explore their options.

The ME Association produce a quarterly magazine, ME Essential, required reading for any ME sufferer. Members of the ME Association receive a quarterly magazine – ME Essential – delivered

straight to their door. It features exclusive interviews, keeps them up-to-date with medical and scientific developments and includes stories about how people cope with the disease.

Finally, a magazine with lots on health is the Well Being Magazine – it has articles, reviews, health and fitness, beauty, travel, food and drink.


Dr. Sandro LaRocca is an orthopedic spine surgeon in NJ practicing minimally invasive spine, neck, and back surgery since 2001. New Jersey Neck & Back Institute, P.C. 3131 Princeton Pike Building 6, Suite 106 Lawrenceville, NJ 08648
Dr. Sandro LaRocca is an orthopedic spine surgeon in NJ practicing minimally invasive spine, neck, and back surgery since 2001.
New Jersey Neck & Back Institute, P.C.
3131 Princeton Pike
Building 6, Suite 106
Lawrenceville, NJ 08648

Following on from my recent posts on The doctor who gave up drugs. A recent article in the Huffington Post  Contributor platform, written by Dr.Sandro LaRocca, M.D. a spinal surgeon in New Jersey with extensive experience in minimally invasive back, neck & spine surgery pointed out that “people need to be told the truth about their pain relief options and encouraged to seek a surgical consultation and evaluation for lower back pain far earlier than is the norm by their physician. What we surgeons have known intuitively and anecdotally for years, published research now confirms. While waiting for the medical community to stop arguing amongst themselves there are certain things you can do and ways you can empower yourself or a loved one in the grip of chronic lower back pain.

A new study recently published in the journal Spine showed a correlation between chronic lower back pain (cLBP) and illicit drug use. The study, by Anna Shmagel of University of Minnesota, Minneapolis and several other brilliant researchers will be very affirming for anyone who has seen someone battling chronic pain and developing a secondary problem of addiction to prescription opioids. This is a scenario so prevalent that a massive surge in opioid addiction in the last 20 years has created an addiction crisis unlike anything our country has seen and overdose has surpassed car accidents as the leading cause of death in people under the age of 30. There is no new news here, only the reinforced message that pain management is fraught with risk and the once standard of care in prescriptions as pain management must be re-thought.

What was fascinating to me about the study however, was that the correlation in illicit drug use was not limited to prescription or illicit opioids – it held true for marijuana, cocaine and methamphetamine. The study was confirmed this in all directions – those with pain reported more drug use, those with addiction history reported pain, those with opioid prescriptions were more likely to abuse other drugs, and vice versa. This research was basically confirming what most physicians and surgeons are learning about the pathology of addiction and how it intersects with overall health as well how we conduct our healing. But I want to point out another conclusion I believe we can draw:

This recent study about cLBP and illicit drug abuse is one more reason that we need to change our national conversation on back surgery and how we see surgery as a solution for chronic pain. I’ve been an orthopaedic surgeon for over 20 years and performed thousands of neck and spinal operations, including reconstruction after trauma in the emergency room, scoliosis and degenerative conditions of the aging spine. When I entered surgical residency, back surgery for chronic low back pain was a risky proposition with a mediocre prognosis. Surgery was reserved for injuries and only the most severe cases of chronic pain. But in the decades that I have been practicing the techniques, technologies, recovery time and most importantly the positive outcomes have made several types of surgeries early options that were last resorts only a few years ago.

I would argue that in fact we have come so far in achieving positive outcomes with surgery that a pain management plan should be developed only AFTER surgery is ruled out. The pain management practitioner should encourage a thorough imaging review by a surgeon, ideally more than one opinion should be obtained. With the ease of emailing MRI’s and CT Scans to a physician this can be done remotely, and additional opinions obtained without any geographic or travel challenges.

Decisions can be made on simple data – when I review an MRI I can inform the patient what the outcomes are for patients with similar diagnoses and their prognosis – in full transparency. The trouble used to be with cases where a patient had a 50 or 60% chance of relief – that gave everyone pause and usually the smallest hesitation would dissuade a patient from surgery. Even with a great pain management plan, a majority of these patients need surgery after a few years when their condition deteriorates with aging or other spinal degenerations. With this new revelation about the risks of drug use those patients now have additional factors that weigh their decisions towards surgery. Addiction is as lethal as cancer – and we must eliminate its risks in the exact same way. There is a new urgency to back surgery.

My experience is that there is an enormous amount of people who are candidates for surgery with excellent chances of relief and are stuck on the treadmill of pain management limbo because of this overarching myth that surgery should only be a last resort. Instead of navigating the treachery of opioid prescriptions or, god forbid, the self-medicating that the other illicit drug use revealed in the study indicate, a surgical option must be evaluated promptly. That “no man’s land” of chronic lower back pain is a very dangerous place with potentially deadly side effects”.

I don’t know about you and many of my fellow chronic back pain sufferers but what Dr. Sandro LaRocca is saying makes perfect sense to me. Maybe more articles like this might change the mindset of doctors and consultants on how to treat a patient suffering from chronic low back pain which have previously been poo pooed away from a possible surgery intervention.