By the time you’ve come to see me, a surgeon, you’ve most likely tried many different treatments from lots of different doctors and other healthcare providers. And, most likely, you are feeling quite frustrated. Treating chronic low back pain is almost like detective work, and the better the communication is between the patient and the physician, the better the expected outcome.
There are several ways you, as a patient, can help your surgeon help you.
- Document the treatments (physical therapy, exercise, pain medications, injections, etc.) you've already tried.
- Write down therapies you have already tried and if they worked.
- Be very specific with what you tried and how long you tried it.
- If you have been on medications, write down the name of the medications and the dosage, and how long you were on it.
Having all of this written out prior to the appointment will help your physician be able to quickly understand and assess your situation, and it will help you remember everything. Your surgeon may decide it's worth it to re-explore some of these treatments.
- Bring any prior imaging studies.
Besides the history and physical exam, the next most important piece of information to a surgeon is the imaging studies. The actual imaging studies are what will be needed, not the reports. Old studies can also be useful to see if there are any progressive changes.
- Ask the physician in person for everything you need during the appointment.
At the end of your consultation, you should not be afraid to request any needs you have, such as medication refills or return-to-work paperwork. It is far easier to close out all these practical problems of chronic low back pain while you have face to face time with your physician rather than ask their staff for these items on their way out of the office or calling back later.
- Keep the peace.
Dealing with chronic low back pain, the healthcare system, and all the paperwork, can be frustrating. It never helps to get angry with your surgeon on the first visit. This may sound obvious, but it happens. Some patients lose perspective and take their anger and frustration out on the surgeon, which will not help the patient and may cause the surgeon to ask them to leave.
Remember, especially if this is the first time you are meeting with a surgeon, they are not to blame for your pain and may actually be able to provide your best chance for some pain relief.
- Have clear expectations of what a spine surgeon can do for you.
- decompress a nerve or
- stabilize a painful motion segment.
Basically, spine surgery can only do two things:
These two conditions comprise a surprisingly small percentage of all the causes of chronic low back pain. Your physician will be looking to see if you have one of these types of anatomic problems that could be alleviated with surgery.
For more information on these conditions see:
Unfortunately, in about 80-90% of cases no anatomic lesion can be found as a cause of the patient's pain. Of course, this does not mean that the patient has no reason for their pain, it just means that the surgeon can’t identify the reason for the pain.
Surgery for low back pain is almost always elective, and your surgeon will guide you to make the right choice.
Understandably, this disappoints many patients, as they may feel their pain has not been validated and surgery cannot provide a clear course of action for pain relief. Being prepared for your consultation with your surgeon will help you get the most out of your time with them.
Don’t be afraid to ask questions and to be open and honest with your surgeon. In the next blog post, I’ll give my perspective on what a patient should expect after the initial surgical consultation.