Why Does ADHD Cause Back Pain: Unraveling the Connection
Why Does ADHD Cause Back Pain
ADHD, or Attention Deficit Hyperactivity Disorder, is a neurodevelopmental disorder that affects both children and adults. While it's primarily associated with symptoms like inattention, hyperactivity, and impulsivity, an increasing body of research is uncovering an intriguing connection between ADHD and chronic pain, particularly back pain. But why does ADHD cause back pain? This blog delves into the complex relationship between these two conditions, shedding light on the underlying mechanisms and potential treatment strategies.
ADHD and Co-morbid Conditions: A Closer Look
ADHD rarely exists in isolation. It's often accompanied by other mental and physical health conditions, including anxiety, depression, learning disabilities, and obsessive-compulsive disorder (OCD). However, one co-morbidity that might not immediately spring to mind is chronic pain. Surprisingly, research indicates that around a quarter of chronic pain patients also have ADHD.
Why Does ADHD Cause Back Pain
ADHD and Chronic Pain: The Connection
The relationship between ADHD and chronic pain has been a subject of study for quite some time. One of the most distinctive symptoms of ADHD is difficulty with attention and focus. When people are focused on something, they tend to feel less pain. This is why we often try to distract children when they're in pain. Conversely, when someone has chronic pain, their attention span can suffer.
Both ADHD and chronic pain can lead to:
Distractibility
Sleep Issues
Difficulties sustaining or dividing attention
Difficulty finishing tasks
Inability to inhibit irrelevant stimuli
Emotional dysregulation
Despite these overlaps, the exact reason why ADHD and chronic pain are connected remains unclear.
Theories Behind the ADHD-Chronic Pain Connection
Several theories have been proposed to explain why people with ADHD might be more susceptible to chronic pain. One theory revolves around neuroinflammation, which refers to inflammation in the brain. This condition is observed in both people with ADHD and chronic pain. Other possibilities include reduced or insufficient dopamine transmission and differences in brain structure seen in both conditions.
Current Treatments for ADHD and Chronic Pain
Treating both ADHD and chronic pain can be complex and often involves a combination of therapies. Current treatment strategies for ADHD include:
Counseling or therapy for associated social, emotional, and other trauma
ADHD Coaching to support daily functioning and work/school success
Stimulant medication to support or improve brain function, and enable the success of therapy and/or coaching
On the other hand, managing chronic pain often focuses on alleviating the severity of symptoms, with treatments such as:
Counseling or therapy for associated social, emotional, and other trauma
Physical therapy
Chiropractic care
Antidepressant medication
Opioids and other pain medication
Alternative medicine such somatic therapy, massage, and acupuncture
The Implications of the ADHD-Chronic Pain Connection
Understanding the link between ADHD and chronic pain could have profound implications for the treatment of both conditions. If neuroinflammation is indeed causing or worsening symptoms, then reducing inflammation could become a new treatment strategy for people with ADHD and chronic pain. Furthermore, since both conditions share common features like impulsivity, restlessness, and problems with focus and attention, it's not surprising that they often co-occur. This presents a unique challenge for clinicians who must treat both conditions simultaneously. A comprehensive approach is essential for managing patients with overlapping symptoms.
ADHD, Chronic Pain, and Neuropathic Pain
Studies have found that adults with ADHD have higher rates of musculoskeletal pain, arthritis, back or neck pain, headache, chronic pain, neuropathic pain, and fibromyalgia compared to adults without ADHD. The risk of undertreated pain may occur if adults with ADHD are primarily treated in specialty mental health care. Additionally, ADHD is associated with an increased risk for substance use disorders, warranting further studies of prescription opioid outcomes in ADHD.
Link Between ADHD and Central Sensitization in Chronic Pain
Chronic back pain is a common health complaint among university students, especially medical students. A subset of chronic back pain patients display increased pain sensitivity, a process termed central sensitization. Central sensitization is also associated with cognitive dysfunction, involving attention, memory, and learning, which are key features of adult ADHD. Research has suggested that ADHD is associated with elevated central sensitization in patients with chronic back pain, supporting the hypothesis that central sensitization mediates the effect of ADHD on back pain.
ADHD Medications and Chronic Pain
First-line medications for ADHD are stimulants, which have mild analgesic effects and may be an adjunct for pain relief in some patients. In addition, some patients with depression find that stimulants act as an adjunct for depression, while others may experience exacerbated depression. Fatigue is a common comorbidity encountered in patients with pain, and stimulants may help improve their energy levels. Moreover, the anorexiant effects of stimulants can be beneficial for some patients with pain, as obesity and weight gain are commonly encountered among this population.
Conclusion: A Complex, Multifaceted Relationship
The relationship between ADHD and chronic pain is complex and multifaceted, involving both neurological and psychological factors. While we still have much to learn about why ADHD causes back pain, the current body of research suggests that neurological inflammation, altered brain structure, and a heightened response to pain are all likely contributors. Understanding this intricate connection can open up new avenues for treatment, potentially improving the lives of millions of people living with these co-morbid conditions.
Check out our other posts and our book recommendations to learn more!
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Sources:
Ibrahim, M.E. and Hefny, M.A. (2022). Central Sensitization and Adult Attention Deficit Hyperactivity Disorder in Medical Students with Chronic Back pain: a cross-sectional Study. Egyptian Rheumatology and Rehabilitation, 49(1).
Kasahara, S., Kato, Y., Takahashi, M., Ko Matsudaira, Sato, N., Niwa, S., Toshimitsu Momose and Uchida, K. (2023). Case report: Remission of chronic low back pain and oral dysesthesia comorbid with attention deficit/hyperactivity disorder by treatment with atomoxetine and pramipexole. Frontiers in pain research.
J.N. (2022). Most Adults with ADHD Report Experiencing Common, Noncancer Pain Conditions. [online] Clinical Pain Advisor.
