Comparison of Pain, Functioning, Coping, and Psychological Distress in Patients with Chronic Low Back Pain Evaluated for Spinal Cord Stimulator Implant or Behavioral Pain Management

Abstract

Pre-SCS patients possibly underreport psychological symptoms perhaps to gain SCS approval for SCS. Separate norms and cutoffs for pre-SCS psychological evaluations may be needed to better identify risks of unsuccessful outcomes. Validity scales for measures of psychological distress also could be developed to detect biased reporting. Alternatively, referring clinicians may have referred patients for BPM who were more psychologically distressed and perceived as more in need of psychosocial intervention than those referred for pre-SCS evaluations. Further investigation of clinical referral decisions and assessment bias is warranted to clarify the meaning of these differences and how they apply to patient outcomes.