Why are Patients Afraid after Undergoing Lumbar Spine Surgery?

Orthopaedic & Spine Center

by Jeffrey R. Carlson, MD

In my role as a fellowship-trained Spine Specialist, I may perform over twenty spine surgeries a week.  With the advent of better surgical techniques, instrumentation, and pain control, the majority of my patients can go home the same day of surgery.  Some of these surgeries are straightforward and take about an hour and some are complex and take several hours to complete.  Even so, patient recovery from similar surgeries can vary.  Some of my patients experience a lot of anxiety about their recovery and much of it has to do with fear of pain.  I have observed that my patients who anticipate a good recovery and keep a positive attitude tend to do well, while those who worry excessively about their surgical recovery tend to take longer to recover and have more pain. So, do normal coping skills help patients do better after spine surgery?  A newly published study seems to confirm just that.

Researchers at the University of North Carolina and Vanderbilt University, working with Physical Therapists, wanted to know if cognitive behavioral therapy could help patients who were afraid of the pain they might experience after spine surgery.  Some of these patients were so fearful of ANY pain that their recovery was hampered greatly.  During the study, it was found that these patients lacked normal coping skills, had lower self-confidence and that they tended to inflate small, everyday issues into large, ominous tragedies, called “catastrophizing”.

When these post-surgical patients were given the emotional support, counseling and resources to more effectively cope with the fear of hurting themselves, they began to experience less pain and more quickly recovered from their surgery.   The researchers quickly confirmed that for these patients, the fear of pain is much worse than the actual surgery and pain during recovery.  Cognitive Behavioral Therapy helped them to address their fears and develop more realistic expectations of their surgical outcomes.

Because these fears can be so debilitating for patients, it is important for them to discuss their anxieties, so that they can be successfully addressed BEFORE surgery.  OSC has a Medical Psychologist, Dr. Cal Robinson, who can help patients learn coping behaviors so that their surgery will be less traumatic emotionally and more of a journey to well-being and healing.  And that is a worth-while goal for anyone facing surgery.