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Why Psychological Evaluations Are Required Before Spinal Cord Stimulator Surgery: Understanding the Role of Mental Health in Pain Management

Living with chronic pain can be exhausting—physically, emotionally, and mentally. If you’re exploring spinal cord stimulation (SCS) as a treatment option, chances are you’ve been through countless appointments, scans, and maybe even surgeries. So when your medical team tells you that a psychological evaluation is required before spinal cord stimulator surgery, it might feel unexpected or even frustrating.

You’re not alone in wondering why. But rest assured, the psychological evaluation isn’t a test you need to pass or fail. Instead, it’s a valuable step in your healing journey designed to ensure you get the best possible outcome from your spinal cord stimulator procedure.

In this blog, we’ll walk you through why psychological evaluations are required before spinal cord stimulator surgery, what the process looks like, and how it benefits your physical and emotional well-being.

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What Is a Spinal Cord Stimulator?

Before diving into the mental health aspect, let’s briefly review what a spinal cord stimulator does. A spinal cord stimulator (SCS) is a device implanted in your body that sends electrical impulses to the spinal cord, helping to reduce chronic pain signals before they reach the brain. It’s often recommended for conditions like:

• Failed back surgery syndrome
• Complex regional pain syndrome (CRPS)
• Nerve damage or neuropathy
• Chronic back or limb pain

This isn’t a quick fix, and because it’s a significant medical procedure, it’s important to ensure you’re emotionally and psychologically ready for the experience.

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Why Psychological Evaluations Are Required Before Spinal Cord Stimulator Surgery

A psychological evaluation is not about questioning your pain—it’s about supporting your whole-person wellness.

Medical experts understand that physical and emotional health are deeply connected. Chronic pain impacts more than your body—it can also affect your mood, motivation, memory, and coping ability. That’s why a mental health screening is standard protocol in the SCS approval process.

1. To Improve the Success Rate of Surgery

Studies consistently show that people with better mental health outcomes—such as low levels of depression and anxiety—respond more positively to spinal cord stimulation. A psychological evaluation can help identify emotional stressors that may affect your response to surgery or device use. It allows your care team to address those issues early, potentially improving your long-term outcome.

2. To Identify Mental Health Conditions That May Affect Recovery

If you’re dealing with untreated trauma, PTSD, depression, or high anxiety, it may be harder to recover or adjust after surgery. Pain perception can be influenced by your emotional state. This evaluation provides a chance to address those mental health needs before moving forward, giving you a stronger foundation.

3. To Assess Expectations and Coping Skills

Spinal cord stimulators can dramatically reduce pain—but they don’t eliminate it entirely. Some people feel disappointed or frustrated after the procedure because their expectations were too high. A licensed therapist can help you form realistic goals and develop strong coping tools to navigate both the trial phase and the permanent implant (if pursued).

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What to Expect During a Psychological Evaluation for SCS

The idea of a “psych evaluation” can feel intimidating, but in reality, the process is supportive and collaborative. The goal is not to deny you care—it’s to give you the best chance at success with your device.

Here’s what you can typically expect:

Step 1: Clinical Interview

You’ll meet with a licensed mental health professional who will ask about your:

• Medical and pain history
• Emotional well-being
• Family and support system
• Previous treatments or surgeries
• Current stressors and daily functioning

This is a safe, confidential space where you’re encouraged to speak openly. There are no “right” or “wrong” answers—just your experience.

Step 2: Standardized Questionnaires

You may be asked to complete assessments that screen for:

• Depression (such as the PHQ-9)
• Anxiety
• Substance use
• PTSD
• Somatic symptom disorders

These are used as tools to understand your emotional state and pain-related distress, not to label you.

Step 3: Review of Results and Recommendations

The therapist will provide feedback to your referring physician and surgical team. If mental health support is recommended, it doesn’t delay your surgery—it often enhances your chances of success. You may be referred for short-term counseling or support to help you prepare emotionally.

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Addressing Common Concerns and Misunderstandings

“Are they trying to say my pain is in my head?”

Absolutely not. Psychological evaluations are not questioning the reality of your pain. In fact, your pain is very real—and your emotional well-being plays a crucial role in how you experience and manage it.

“What if I’m depressed or anxious—will I be denied the surgery?”

Not necessarily. Many people with chronic pain experience depression or anxiety—it’s common and completely valid. The evaluation helps determine whether those symptoms need support before or alongside surgery. You’re more likely to have a successful outcome if these factors are addressed.

“I already have a therapist. Do I still need this evaluation?”

Yes, even if you’re in therapy, a formal pre-surgical evaluation is a required part of the process. However, your current therapist may be part of your care plan moving forward, especially if ongoing support is beneficial.

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The Mind-Body Connection: Mental Health and Chronic Pain

Chronic pain and mental health go hand-in-hand. When pain is persistent, it can lead to:

• Fatigue
• Sleep disturbances
• Mood swings
• Isolation
• Hopelessness

Mental health therapy can help you reclaim your quality of life—before and after SCS surgery. Building emotional resilience, strengthening your support system, and learning how to navigate setbacks are just as important as managing physical pain.

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How Onesta Therapy Co. Can Help You Prepare

At Onesta Therapy Co., we specialize in helping individuals navigate the emotional challenges of chronic pain and medical procedures. Whether you’re seeking a pre-surgical psychological evaluation or simply need support managing the impact of pain on your life, we’re here to walk alongside you.

We believe in compassionate, whole-person care—and that includes your mental health.

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Resources for Support

• American Chronic Pain Association
• Pain Connection – A U.S. Pain Foundation Program
• National Institute of Neurological Disorders and Stroke
• SAMHSA’s Mental Health Support Resources

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Take the Next Step Toward Healing

If you’ve been referred for a psychological evaluation before spinal cord stimulator surgery, or if you simply want emotional support during this chapter of your life, I’m here to help. As a licensed therapist, I understand the unique challenges chronic pain creates—not just in your body, but in your mind and relationships too.

Let’s work together to help you feel stronger, more supported, and fully prepared for this next step.

📞 Book a confidential therapy session today with Jen at Onesta Therapy Co.
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You don’t have to face this alone—your healing matters.

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