Extensive research has shown that use of psychological techniques to prepare for back surgery can improve the patient's overall experience and enhance the ultimate outcome from back surgery. Importantly, rather than being limited to a passive role, psychological preparation before spine surgery can help empower patients to positively impact their healing and recovery.

The stress of an illness or injury, the impending back surgery, and the recovery process after back surgery can all have a significant impact on a patient's physical, psychological, and social state. Psychological preparation for spine surgery can help patients address potential problems in all three of these areas before they occur to prevent or minimize their impact.

Stresses of Back Surgery

Any kind of surgery creates a serious amount of stress, and surgery for back pain is certainly no exception. The back surgery process and surgical pain are major physical and psychological stressors, extending from the decision to have the operation until the recovery is complete.

See Stress-Related Back Pain


1. Back Surgery Process

Following a back surgery, physical and psychological processes occur that can cause problems which impede healing and recovery, such as:

  • Further breakdown of body tissue
  • Impaired immune function
  • A physical stress reaction (called the "fight or flight" reaction)

Overall, the patient’s physical response to stress in connection with the spine surgery can have harmful effects on one’s body in several ways, including:

  • Increased blood pressure
  • Increased heart rate
  • Increased muscle tension
  • Rapid and shallow breathing
  • Release of stress hormones
  • Reduced blood flow to certain areas of the body
  • Diminished immune system function
  • Slowed tissue healing time

2. Surgical Pain following Back Surgery

Physical pain is also a source of stress, and inadequate pain control after spine surgery can be very demoralizing. Patients who are provided with adequate pain management become active sooner and show significantly less emotional distress when recovering from back surgery.

See Bone Graft Site Pain and Morbidity After Spinal Fusion

Ensuring adequate pain control is an important issue. Research has shown that less than 50% of all surgical patients are provided with adequate pain control following surgery. The government mandated national guidelines for the management of surgical pain in 1992 (through the Agency for Health Care Policy and Research {AHCPR}). The guidelines reviewed an abundance of research showing that poorly controlled pain impairs healing and recovery.


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