Study review time. Today, we’ll look at a study on back pain and emotions. The authors looked at spine surgery patients at Johns Hopkins Hospital in Baltimore, Maryland. They basically asked them questions about how happy and sad they are and how bad their pain was. We all know that being happy is generally a good thing, and being sad is generally a bad thing. But can these two things affect the development after laminectomy or spinal fusion? If so, we should especially focus on making you **happy** before, during, and after surgery. This involves different things than normal surgical care, which can be kinda nerve-wracking and involve emotionally distant surgeons.
The results of this study were mixed. They found that being happy six weeks after surgery made it more likely that you’d have better function later on. Also, they found that being sad six weeks after surgery made it more likely that you’d have chronic pain and disability down the road. Post-operative depression (in other words, being really sad) made it even more likely that you’d do bad later on.
However, PRE-operative happiness, sadness, and depression were not associated with future chronic pain, disability, and function. This surprised the authors. Does it surprise me? No! Well, sort of. My response to the findings of POST-operative sadness depression predicting pain: duh. Of course being sad after surgery is going to predict bad outcomes. People who had a bad surgical experience will experience more pain afterwards and be extra sad. But that doesn’t mean anything, especially not that sadness after surgery caused chronic pain. I’m a little bit surprised that PRE-operative happiness wasn’t associated with better outcomes, as it has been in previous studies. But you have to have pretty strong results to make something statistically significant, and the patients in this study were at a disadvantage because of their relatively serious pre-operative back pain. There is a smidgen of good news from this study though–other things (such as the patient’s gender, race, education, previous back surgeries, etc) were NOT associated with the development of of chronic pain later on. So take heart, you are not at a disadvantage just because of who you are when it comes to having bad outcomes from back surgery. Well, you might be, but that will be the subject of a future research review, and it will probably center around genetics.