Spine Health: How Can Antidepressants Relieve Herniated Disc Pain?

Easing the symptoms of a herniated disc is not always easy. In addition to back pain, you may experience severe pain that radiates down your limbs, weakness, numbness, or tingling in the legs or arms, and reduced mobility. These symptoms may cause you to feel fatigued, stressed, and restless. This move from the physical to the emotional and mental is part of the reason doctors sometimes recommend antidepressants for herniated disc pain. But it is so much more. In this guide, we look at how these medications address disc herniation.   

Tricyclic Antidepressants (TCAs)

Your brain determines how you perceive pain by sending and receiving signals from other parts of your body. When certain chemicals in your brain are imbalanced, your perception of pain may change, even heighten. A herniated disc can sometimes impede on the nerves in your spinal column, causing you to experience pain, tingling, weakness, and numbness in the limbs.

Tricyclic Antidepressants (TCAs) are sometimes prescribed for herniated disc pain because they help destabilize the levels of calming neurotransmitters in your brain. These include dopamine, serotonin, and norepinephrine, which help your body naturally fight pain and make you feel happier and calmer. Examples of TCAs used for this purpose include Nortriptyline (Pamelor), and Imipramine (Tofranil). 

Selective Serotonin Reuptake Inhibitors (SSRIs)

Selective Serotonin Reuptake Inhibitors (SSRIs) allow more serotonin to travel across neurons in your brain. Also known as the body’s “feel good” hormone, serotonin is a monoamine transmitter and hormone that influences memory, learning, happiness, body temperature, sleep, bone health, and wound healing. It can also lower your pain perception, allowing you some relief.

Serotonin affects how your body perceives herniated disc pain but does not address the cause of the problem. As such, SSRIs are usually prescribed alongside other treatments. Examples of SSRIs used to treat herniated disc pain include Sertraline (Zoloft), Paroxetine (Paxil), and Fluoxetine (Prozac).

It is important to note that these medications are less effective than TCAs at alleviating pain and do not act on nerve pain. Your specialist will tell you if SSRIs are appropriate for your type of pain. 

Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)

Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs) are very similar to SSRIs, except they act on more than serotonin. These antidepressants increase the levels of both serotonin and norepinephrine in the body by blocking their reabsorption into the brain cells. Also known as noradrenaline, norepinephrine is a neurotransmitter and hormone that influences the body’s fight or flight response and increases your alertness. It can reduce the amount of pain you feel.

Examples of SNRIs that can help with pain include milnacipran (Savella) and duloxetine (Cymbalta), which are often prescribed for fibromyalgia pain, and venlafaxine (Effexor) less commonly.

Norepinephrine and Dopamine Reuptake Inhibitors (NDRIs)

Norepinephrine and Dopamine Reuptake Inhibitors (NDRIs) are atypical antidepressants because they are chemically distinct from the other classes on this list. However, they act similarly, altering your body’s perception of pain and improving your mood and sleep quality. Bupropion (Wellbutrin) is the most commonly prescribed NDRI for herniated disc pain.

Wrapping Up

Medications used to treat disc herniation and its symptoms range from over-the-counter pain relievers to strong muscle relaxants and opioids. A spinal specialist may recommend antidepressants to help alleviate muscle tension and pain caused directly by herniation and to help you sleep better and manage the emotional toll of your symptoms. However, the medical community is still studying the pain-relieving abilities of antidepressants. Always consult your doctor to get a prescription that works for you.

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