My wife has been a chronic pain sufferer for 30 years. She has held up admirably under excruciating back pain — more than I could have handled. But as the years go by with no relief, I’m starting to worry about her state of mind. I wonder if she’s considering suicide. What can I do to help at this point?

Back pain can be a very disabling problem that alters a person’s life in so many ways. As you have seen first hand, quality of life suffers. Depression is common. Suicide may be tempting. But how often do people with back pain really end their lives because of it? And how does that compare to the number of people who commit suicide who don’t have back pain?

Recently, researchers using hospital discharge records investigated suicide among people with back pain. They collected information from hospital charts for patients with and without musculoskeletal diseases and compared suicide rates. They also looked at differences in age, gender, history of mental illness, method of suicide, and alcohol and other drug abuse at the time of the suicide.

There were over 2300 suicides in patients treated at a hospital for musculoskeletal problems. The data was taken from the required hospital discharge records. Analysis of the data collected showed that men were four times more likely to complete a suicide than women.

Women who committed suicide did so most often in a nonviolent way (e.g., drug overdose). Autopsy reports were used to assess the use of alcohol or other drugs at the time of the death. The reports showed that women with back pain were more likely to be drinking when they died.

Knowing what to look for and recognizing red flag warning signs in your wife’s situation can be very helpful in identifying the risk of suicide. Getting help may begin with a return visit to the physician overseeing her care.

With your concerns about suicide, it may be time for a mental health expert to be a part of her team. Suicide assessment, counseling, and suicide prevention could make the difference for her if she has turned a corner in her own abilities to cope.

If pain control is a problem, then it may be time to try a different approach. There are many pain clinics that specialize in helping people like your wife. Patients who have lived with chronic pain can often gain better control over their symptoms with a change in medication or using other treatment tools now available.