Conservative treatments are sometimes effective in reducing the pain caused by stenosis and limiting disability related to the condition. Treatment methods include exercise therapy and chiropractic care. For patients who don’t respond to such treatments, surgery may be prescribed. Surgical interventions used for this type of back pain include spinal fusion – the fusing of two or more vertebrae together to eliminate painful motion – or decompression – the removal of bone spurs or disc material to free up the nerve.
The decision of whether or not to have surgery should not be taken lightly. High price tags, risks, recovery time and the fact that surgery might not solve the problem should all be factored into the decision-making process. Knowing what factors may limit the likelihood of a successful surgical intervention can help patients make an informed decision.
Depression has been linked to poorer outcomes in surgery patients in the short-term. A recently published study suggests that it affects long-term recovery as well, making it a significant consideration for both medical professionals and patients.
Participants were 102 lumbar spinal stenosis patients who underwent surgery. Before the procedure, they filled out a survey intended to yield information about their mental status and functional levels (ability to walk, lift and sit). Patients filled out the survey again three months, one year, two years and five years after receiving surgery.
Researchers found that even quite mild symptoms of depression were associated with poorer functional outcomes during each of the follow-up periods. They conclude that psychological screening and support may be an important component of recovery for stenosis patients.
See more on the study at www.thespinejournalonline.com.
Chicken or the Egg?
It may seem logical to assume that the direction of causality runs the opposite way – that is to say, that poorer surgical outcomes are associated with depression, since inability to function well is rather depressing. While this certainly is reasonable, research over the past decade increasingly supports the important role that emotions play in pain intensity, disability levels and the transition from acute to chronic pain.
Patients should pay attention to their psychological and emotional well-being – these may not seem relevant to physical pain, but they could impact the outcome of treatment attempts. This is why a mind-body approach to chronic pain treatment is increasingly believed to be beneficial. And, hey, it never hurts to feel better on the inside. Consider incorporating cognitive behavioral therapy into your treatment regimen; you may be surprised by how useful it can be.