Pain can be very difficult to control and sometimes, even after months of treatment, the patient may still suffer from pain. This can have many deleterious effects on one’s life including job, home, and relationships with others. Sometimes this level of back pain support is not enough, and the patient may need help from a trained psychological professional.
Physician referrals to psychologists should not be viewed as a sign that the care provider thinks the patient is crazy or that the patient is making up the problem. They should be viewed that there is an appreciation for how stressful back pain can be and may offer another means for the patient to help control pain.
Psychological treatment may also help patients have a more realistic view of their condition and their planned treatments. Other services a psychological interventionist may be able to provide include pre-surgical psychological screening, general psychological evaluation, and treatments such as biofeedback and hypnotherapy.
Patients facing major spine surgery, those with failed spine surgery syndrome, and those with chronic pain will benefit from psychological support.
Especially those who show signs of depression, anxiety, anger, and pain medication dependence. Each patient completes a pre-surgical psychological evaluation to help us to better understand and tailor their treatment.
This session will explore concerns, expectations about the surgery, the ways in which they have tried to deal with the pain, efforts they have made to improve, use of medications, how spine problems have affected your life, and how others have reacted to their back problems.
The psychologist may also help with pain control (using techniques such as meditation or hypnosis) and may provide techniques to help overcome depression and anxiety related to pain.
- Learn as much as you can about the physical conditions causing your spine pain and limiting your activities.
- Make sure that you have explored other options and that you feel confident that surgery is the best option for your condition
- Discuss your understanding of your physical condition and your surgery with the surgeon, so that you are working together. Come prepared to ask the surgeon any questions you may have.
- Learn about actions you can take to prepare for the surgery such as proper nutrition and exercise.
- Get sufficient sleep.
- Examine your emotions and discuss any negative feelings such as depression, anxiety, stress or anger with a qualified mental health professional. Negative emotions can lead to poor surgery results
- Limit narcotic intake prior to surgery as much as possible. Long-term use of high levels of narcotics makes post-operative pain control more difficult to achieve and is associated with poor surgery results. Discuss any problems you have had with narcotic medications with your physician
- Keep as active as you can prior to surgery. Keep working if possible. Inactivity causes muscle weakness, decreased endurance, and you lose important aspects of your life.
- Learn realistic expectations for the results of spine surgery, including how much pain relief to expect, how much you can expect to improve your abilities to engage in activities, whether you can return to work, etc. Do not set yourself up for disappointment by expecting more of the surgery than it can deliver
- Recognize that surgery only creates the foundation for your recovery and healing. Where the surgery takes you depends on your own efforts to be as healthy as possible.
- Determine what arrangements will be needed for your post-operative care, if necessary. Involve family members in appointments with your physician and in care planning so that they can best understand and promote your healing process.
- Seek balance between activity and rest. Push yourself to gain strength and endurance but be aware of pain, and let it act as your guide. Do not undertake activities (especially during the initial post-op period) that you know will cause a major increase in pain. Do not undertake activities that you know you can only do if you take pain medication.
- Recognize that healing is unlikely to be rapid or easy, and will involve setbacks. Commit yourself to stay positive and pushing for improvement even when it is difficult. Do not blame yourself when your recovery is not going as you expect.
- Make healing your work. Do not feel guilty that you can not do your normal job, or do household tasks, as you recover from the surgery. Accept that you have limitations while you heal.
- Examine what’s important to you and commit yourself to it, while adapting to any limitations you experience.
- If you were taking antidepressant medication before surgery continues taking it for at least 4-6 months post-op even if you are feeling great. Stopping an antidepressant during the post-operative period can cause you to become depressed and negatively affect your recovery.
- Accept help and support from others. Don’t let pride or habit lead you to undertake activities when others would gladly assist you. Don’t forget to give them support, also.
- View surgery not as an end of pain, but as a beginning—a resetting of the foundation for you to regain health and vitality
- Set goals for your recovery, but stay flexible. Some goals may need to be delayed, others may need to be abandoned. View changing your goals as a victory for your ability to adapt.