No evidence supporting the use of antidepressants for non-specific low-back pain

Clinical question: 
How effective are antidepressants for patients with non-specific low-back pain?
Bottom line: 
There is no clear evidence that antidepressants are more effective than placebo in the management of patients with non-specific low-back pain, i.e. back pain where there is no identifiable cause. However, there is evidence that antidepressants are effective in other types of chronic pain, e.g. neuropathic pain.
Caveat: 
These findings do not imply that severely depressed patients with back pain should not be treated with antidepressants – they continue to play an important role in the treatment of clinical depression.
Context: 
Low-back pain is a common condition, affecting up to 80% of adults over their lifetime. It is usually benign and self-limiting, and generally resolves within 6 weeks, with or without treatment.
Review CD#: 
CD001703
PEARLS No: 
58
Date: 
April, 2008
Authored by: 
Brian R McAvoy