BMJ: Antidepressants are used to assess the effects of pain in back pain and osteoarthritis

Back pain, clinically manifested as low back pain or neck pain, can be accompanied by or not accompanied by nerve root symptoms, and osteoarthritis seriously affects the quality of life of patients.
, worldwide, the prevalence of back pain and neck pain is 7.3% and 5.0%, respectively, while osteoarthritis-related hip and knee symptoms are about 12%.
2016, the U.S. spent about $214.5 billion on pain treatment for back pain and osteoarthritis, with back pain accounting for the majority of spending.
clinicians often use antidepressants to treat pain, especially chronic pain.
recently conducted a systematic review and meta-analysis to examine the efficacy of antidepressants for low back pain and osteoarthritis pain.
researchers collected Medline as of May 12, 2020, Research data from Embase, Cochrane Central Register of Controlled Trials, CINAHL, International Pharmaceutical Abstracts, ClinicalTrials.gov, and the World Health Organization's International Clinical Trials Registration Platform, which compares any antidepressant with a placebo (active or inert) for patients with low back or neck pain, striatum nerve pain, hip or knee osteoarthritis, were included in this meta-control study.
of the study was the pain and disability score (0-100,0 for no pain or disability, and 100 for severe pain or disability).
study included 33 trials with a total of 5,318 participants.
There is moderate-quality evidence that 3-13 weeks of treatment with serotonin-dethyroidine reuptake inhibitors (SNRIs) can reduce back pain (average difference -5.30), and low-quality evidence that 3-13 weeks of SNRIs treatment can reduce osteoarthritis pain (-9.72).
very low quality evidence suggests that SNRIs treatment for 2 weeks or less can reduce scissal nerve pain (-18.60).
there is evidence of low to very low quality evidence that 2 weeks or less of treatment with triceps antidepressants (TCA) does not relieve stetrain nerve pain (-7.55), but 3-13 weeks (-15.95) and 3-12 months (-27.0) can relieve stevical nerve pain.
medium quality evidence suggests that SNRIs treatment for 3-13 weeks reduces disability due to back pain (-3.55) and osteoarthritis-caused disability (-5.10) after 2 weeks or less of treatment.
TCAS and other antidepressants do not relieve pain or disability caused by back pain.
study concluded that 5-serotonin-dephetamine reuptake inhibitors used to reduce back pain were not significant, but they may have some therapeutic effect on osteoarthritis pain.
5-serotonin-dethyrene reuptake inhibitors and tricycline antidepressants may be effective in steage nerve pain, but the quality of the evidence is low.