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Psych evaluation & pain

LumpyLLumpy Posts: 103
edited 06/11/2012 - 8:43 AM in Chronic Pain
A quick question. I am usually on the neck forum with C5/6 and C6/7 issues with radiating pain in my arms. The NS wants to do a discogram and the insurance wants a psych eval. Apparently that is standard operation proceedure (?). So can anyone enlighten me as to what is involved?



  • Howdy Lumpy,

    I've heard of this with Lumbar issues, not with Cervical? Maybe something new now with any surgery affecting the spine? From what I read on here, it isn't too bad, but I've only heard of it with Lumbar. Sorry, wish I had more info. *hug*

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • hi! :H a psy evaluation can be anything from a conversation with a professional to this and testing. it just depends on what the insurance company wants.. there is really no way to prepare so don't worry about it! i am sure you are as sane as the rest of us spineys! LOL!!! good luck! Jenny :)
  • Dont worry about the test. Its easy and I havn't heard any one that didn't pass it. I took one about 2 month ago.

  • i have never heard of a psyche evaluation with a neurosurgeon. i have one and have had back problems for 10 years and never heard or never had a psych evaluation. What is the purpose of this? i have never heard of anyone who had one. i have had a questionaire that i filled out with pain dr and back dr but it just ask where and what the pain was and what it felt like
    wow-psych evaluation, now that makes me feel crazy
    I have 4 fusions from L5-3, the latest last May '12 where they fixed my disc that broke.They went through my side this time. I take 40 mg of oxycontin 4x a day and 4 fenatyl lollipops 300 micro gms 4x a day.
  • MetalneckMetalneck Island of Misfit toysPosts: 1,378
    Maybe this "insurance company" is Workmans comp related?

    Could be related to STD or LTD - auto?

    What is the cause of your injury?

    The above ins providers want to make sure the pain is real and not "just in our heads" as in false - or faking it for benefits.

    Since you can't "see" pain, they want to make sure we don't have "perception" problems.

    Keep us posted!


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  • My insurance is BC/BS out of Minn. although I live in Tx. Before they would even consider approving my L4-5 360 fusion this was a requirement, just as an MRI, conservative treatment etc. At first I was insulted, hummiliated, angry,etc. But I had to do it.

    As I recall, it consisted of an hour spent filling out a questioneer in regard to pain and how it affects you physically and mentally.

    The 2nd part was spent talking with a pyschologist. I mainly talked about my life and how my spine issues had and were affecting it. It was my 3rd surgery in 4 years. I had some uniquic issues as I was falling, had significantly brisk reflexes and was beginning to have bladder issues.

    I talked about how I was losing the things in my live I had worked so hard to get ~ I am a pediatric Occupational Therapist and I specialize in working with special needs infants. I am very active in my community with fund raisers for Down's Syndrome, March of Dimes, etc. I couldn't do any of these things. I wanted to get better so that I could go back to work and give back to the community.

    She spent some time talking about how there weren't any quarentees that the pain would be relieved. While I pray the pain will go away, I needed this surgery to keep the use of my legs.

    At the end, she analysed my info, came up with that I was "moderately/severely depressed" but a good canidate for surgery.

    Again I was upset! He** yes, I was getting depressed, I was losing the use of my legs and my bladder....but not severely depressed!

    After the pysch eval, I went back to see my surgeon, He said NOTHING about the depression. Said that as we both knew, I was a good canidate for surgery, dictated the letter of medical necessity in front of me.

    Now that I am on the other side of surgery. I am thankful I had it done. It has helped me with insight into how long of a process lumbar fusion is.

    I hope this helps you and others. I wish I could have had someone to talk to as I went through this.
    Feel free to PM me and we can talk more! Best of luck!
  • For SCS recipients to have had to go through this.

    I've heard of others too; Don't take it personally.
    In most cases they are looking for the ability of the person to accept the outcome of the procedure, be it good or bad.

    If they find mental issues that they feel won't allow the person to deal with the outcome, then I guess they have to proceed on a different course.

    I would be extremely surprised if many people actually fail one of these. Most Psychiatrists who administer the testing know what we are dealing with. The depression is related to our condition and not just a general depression, well mine is truly not related to the problems I have now in whole. I have been treated for depression for at least 15 years now. I passed my psych evaluation with no problems at all. My shrink even discussed what he was looking for when he did it. Mostly what I said above. Just looking for realistic expectations and the knowledge that the procedures in question may not work.

    Now if you do the scene from Alice's restaurant where he jumps around screaming, " I want to kill" then you may have a problem? However, if you can jump around like that; you probably aren't one of us anyway!
  • MetalneckMetalneck Island of Misfit toysPosts: 1,378
    You want the truth?? YOU CAN'T HANDLE THE TRUTH!
    (Jack Nicholson - A few good men)

    Maybe I should use that for my psych eval for SSD next month?

    Persevere - or is it post severe?

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  • Thanks for the replies. Jay, yours is especially useful. I have heard of this as a way of evaluating pain tolerance, pain threshold or even what I would call pain's psychological effects.

    I think depression is a natural reaction to what you describe. The idea of a career ending and things slipping out of my hands certainly has been on my mind.

    The part of your post that got my attention what the part about being able to accept whatever outcome. I never really personalized this before, but I'm thinking about it more and more.

    I suspect these evaluations will become more and more common. I know of one major medical group which specializes in all things spinal that requires this eval will every patient that could be a surgical candidate. That might be a little overboard, but I could see it occurring more and more.

    Oh, and if sanity was a question I would be in trouble. All of this workers comp stuff drives me crazy. BTW, my WC is handled by a private insurance company so I get the worst of both worlds.

    This Psych topic intrigues me for some reason.
  • As Jenny said, these evaluations are used across the range of chronic pain and vary at what level and impact they have. Pain changes behaviour the way we speak or our mannerisms, our PM residential evaluated all its potential patients through this process to see how flexible they may be towards future change and it was a simple process of questions and nothing too serious.

    Pain patients have norms that you would expect from someone living in the reality of this lifestyle, keeping a balanced perspective is very difficult and we venture through the peaks and troughs of constant pain.

    It is a fascinating subject and much research on the implication and impact of these traits are on the Net.

    Good luck John.

  • jainsezzjjainsezz Posts: 1
    edited 11/06/2015 - 8:19 AM
    I have chronic pain just about everywhere. I was a reckless kid. I fell out of trees, crashed bikes, dropped things on my feet, was ejected from a car at 50 mph on the interstate (compression fractured T-8, 10, 11, & 12), etc. I'm 44 now & paying the price for all that fun. ;-) I actually had a complete psych eval because my mental coping mechanisms utterly failed me a few years ago. I suppose since my pain has slowly accumulated throughout my life, I just never mentioned it. Sure, I had physical therapy after the casts came off, but I carried on after that. Show choir, theater, marching band.... Anyway, my axis III psych diagnosis is chronic pain. (Depression, anxiety are I & II, btw). It showed up on a psych test when I hadn't really thought about it much & it wasn't a real issue yet. 5 yrs later & chronic pain is the biggest problem in my life. I'm sidelined because I refuse opioids. A failed epidural will make a woman jaded. Ha. Sorry, I just wanted to pop in & explain about a chronic pain diagnosis being listed on a psych eval. Don't sweat evaluations - the more honest you are, the better the diagnosis. Try not to adhere to stigmas about what you may 'have,' because whatever it is has a treatment or a support group. Embrace your diagnosis. Added benefit, your real friends will be exposed. Peace!
  • SavageSavage United StatesPosts: 5,476
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