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Booklets after surgery can help educate patients & reduce their fears



Many patients continue to have low back pain after surgery


Low back pain is still one of the most common and expensive medical conditions in existence. The number of people affected by low back pain and the costs related to it is comparable to those for depression and cardiovascular disease. Some patients with low back pain also experience pain that radiates down to the leg, which is called sciatica. When these patients continue to experience pain after attempting various different types of non-surgical treatment, a type of surgery called lumbar discectomy many be recommended. This surgical procedure is generally effective for reducing leg pain, but many patients continue to experience low back pain after surgery. One reason for this lasting pain is that some patients have fears and beliefs that prevent them from moving about and staying active normally. In fact, these patients should be following a rehabilitation program and getting back into physical activities after some time, and this is found to be the best way for them to improve. This is why it's important to educate these patients after surgery and instruct them on how to get active. A booklet called "Your Back Operation" was therefore developed by a team of medical professionals to better educate these patients, and to evaluate how effective it is, a study was conducted.



Two groups of patients given two different booklets


Healthy patients who were scheduled to have lumbar discectomy for the first time were recruited for the study. All candidates were screened to determine if they could be included, and 102 patients were accepted and completed the entire study. These patients were evenly divided into either the control group or the intervention group. The control group received a booklet with general advice on how to recover from surgery, but it did not encourage positive beliefs or give any specific instructions on getting active and back to work. The intervention group was given the "Your Back Operation" booklet instead. This booklet encourages an active lifestyle after surgery and instructs patients to follow an early rehabilitation program led by a physical therapist to help them recover more quickly. It also tells them that returning to work earlier will lead to a faster recovery and better overall results. All patients were given questionnaires with questions about their pain, beliefs, and fears before surgery, immediately afterward and then again two months later.



Both groups experience positive outcomes after reading booklets


Two months after surgery, patients in both groups experienced positive outcomes from the surgery. Compared to their status before surgery, these patients reported less leg and low back pain, as well as less disability when getting around. The only major difference between the two groups was that the intervention group had fewer fears and negative beliefs about their condition after reading the "Your Back Operation" booklet. This shows that while both booklets were effective and well received by patients; the booklet that focused more on getting active was more effective for changing patients' beliefs. Since this is such an important part of the recovery process from surgery, these improved beliefs can make a big difference in helping patients improve more quickly. These booklets are also very inexpensive and can easily be distributed. From these findings, it seems that while any education may be helpful for patients after surgery, the "Your Back Operation" booklet can lead to a better overall mindset that will encourage them to get active and seek out rehabilitation from a physical therapist.



-As reported in the January '16 issue of the Annals of Physical and Rehabilitation Medicine



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