spinal stenosis
When patients want relief from chronic back pain, they often see surgery as the best and most effective treatment possible. When physicians order psychological evaluations before undertaking spine surgery, or before surgically implanting devices such as the pain pump or spinal cord stimulator, patients often get worried. "Does my doctor not believe me?" they wonder. "Does my doctor think I'm crazy?"
Actually, if your doctor has sent you for a pre-surgical psychological evaluation, that is a good sign that you are receiving excellent care!
Research shows that all too often, surgical treatments do not reduce back pain related to bulging or ruptured discs, spinal stenosis, or many other back problems. In fact, research shows that the surgery may even cause complications, and the patient may have more pain than before. Neither you nor your physician would want that. Evaluating psychological risk factors before any surgical treatment for back pain reduces that risk, and is fast becoming the standard of care for best medical practice.
Medicare and many other insurance companies now require pre-surgical psychological evaluation before back surgery for pain, or surgery to implant devices such as spinal cord stimulators or pain pumps. When you are referred for evaluation of psychological risk factors, your physician is assuring that you are receiving the full diagnostic work-up needed to make this important medical decision, so you can have the best treatment possible.
The health psychologist will use psychological tests, interviews, and questionnaires to ask about your thoughts and feelings, your stresses and the ways you cope, and the experiences you have had. That's because stress and emotions are not just "feelings" that happen in our mind. Stress and emotions have direct biochemical effects on your brain and your body.
Stress and emotions are "mind/brain/body" experiences, and they can actually change how your body works. They affect your pain system and other central nervous system processes. Research shows that back surgery is not very effective at reducing pain when excessive stress, depression or anxiety have caused changes to the central nervous system.
Pre-surgical psychological evaluations can improve your chance for success with overcoming your back pain. Surgery is not the only way to help you deal with back pain. If the risk factors show that you won't get better with surgery, then your doctor can help you get other treatment that will give you the good outcomes you want.
So--there's no need to worry! If you have been referred for a pre-surgical psychological evaluation, you can rest assured that your physician wants you to have the best care possible for your pain problems.
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