Attitude and Outcome

The natural way we think affects many areas of our lives, sometimes without us even realizing it. If you’re considering joint surgery, understanding how attitude and outcome are connected can help you prepare.

While there are many factors that influence the success of a joint replacement, like your weight and overall health, it may surprise you that some factors that are within your control are actually within your mind. There’s an incredible connection between your attitude and beliefs, and your overall surgical outcome.

One study found that having unrealistic expectations about pain and function is correlated with poorer results following knee replacement surgery.1 Another study published in Journal of Behavioral Medicine even found that having a negative attitude was associated with an increase in pain behaviors, such as walking with a limp or facial grimacing.2

A negative attitude may even delay your recovery, especially if you decide not to follow your doctor’s post-operative recommendations. If you believe that pain is only an indicator that something is "wrong", and not simply part of the recovery process, then you may become fearful about doing your exercises and moving around—despite the fact that physical activity is so important for a good recovery.3 If your recovery takes longer, you could begin feeling even more socially isolated. It’s possible for the effects of a negative mindset to trickle into many areas of your life.

Post-operative pain is a real and valid concern. Staying in control of your pain through appropriate medication, exercise, sleep, and nutrition is a critical element to your success. But pain is influenced by multiple factors, including physical, cognitive, neurological, and even cultural and social ones.4,5 Many people are unaware what their beliefs about pain really are, or struggle to see how their upbringing, friends, and personal history affect what and how they think. But, be sure to discuss all pain you are experiencing with your doctor. Your doctor should be able to help you understand why you’re feeling a certain pain and provide appropriate guidance for your specific needs. 

The good news is, beliefs can be changed­. You have the power to start thinking differently and focusing on good outcomes.

Optimizing Outcomes: Adopting a "Successful Surgery" Mindset

1. Learn as much as you can about your surgery and associated pain. Going into a procedure knowing as much as possible about what to expect might help ease your fears and help you set realistic goals for yourself. This may help you deal with any apprehension, frustration, and disappointment following your surgery. No question is off limits for your surgeon and medical team, so ask away!

2. Practice mindfulness. Because feeling stressed can exacerbate pain,6 it's important to manage your stress effectively if you want to maintain a positive attitude during your recovery. Many sources suggest that simple activities like meditation, deep breathing, and/or journaling are good stress release habits.7-10

3. Consider chatting with a professional. Some people find that speaking to a counselor can be helpful… whether you have specific topics you want to cover or simply to get an impartial third party opinion on a situation. Consider speaking to a therapist to see if there is anything they recommend to help prepare you, mentally, for your surgery.

4. Beware of negativity. It's also helpful to be aware of the influence of other people you know who've had a similar procedure. If a friend, family member, or colleague had a bad experience with their implant, this doesn't necessarily mean you'll have a bad experience. Feel free to offer them support and listen to their stories, but remember to focus on your own needs. 

5. Celebrate the small wins. One way to help you stay focused on the positive is to celebrate your successes after surgery, however small they may be. Perhaps one exercise in rehab was easier, you learned how to use a new piece of equipment, or you were able to spend more quality time with a loved one. It's easy get overwhelmed by the temporary changes and challenges that a joint replacement procedure brings—so commit to being the type of person who will always look for the silver lining.

References
  1. Dooley, P. and Secretan, C. (2016). Total knee replacement: understanding patient-related factors. BC Medical Journal. 58(9): 514-519.
  2. Shen Johnson, M., et al. (2014). Associations among pain, pain attitudes, and pain behaviors in patients with metastatic breast cancer. J Behav Med. 37(4): 595-606.
  3. Turk, DC. and Wilson, HD (2010). Fear of pain as a prognostic factor in chronic pain: conceptual models, assessment, and treatment implications. Curr Pain Headache Rep. 14(2): 88–95.
  4. 6 factors that affect arthritis pain (2020). Arthritis Foundation. www.arthritis.org/health-wellness/healthy-living/managing-pain/understanding-pain/6-factors-that-affect-arthritis-pain
  5. Linton, SJ. and Shaw, WS (2011). Impact of psychological factors in the experience of pain. Physical Therapy. 91(5): 700–711.
  6. McAllister, Murray J (2014, Nov 24). Stress, Inflammation and Chronic Pain. Institute for Chronic Pain. www.instituteforchronicpain.org/blog/item/152-55stress-inflammation-and-chronic-pain
  7. Ackerman, C. (2020, Feb 4). 23 Amazing Health Benefits of Mindfulness for Body and Brain. Positive Psychology. https://positivepsychology.com/benefits-of-mindfulness/
  8. Jennings, K. (2018, Aug 28). 16 Simple Ways to Relieve Stress and Anxiety. Healthline. www.healthline.com/nutrition/16-ways-relieve-stress-anxiety
  9. Stress Relievers: Tips to Tame Stress (2019, Mar 12). Mayo Clinic. www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress-relievers/art-20047257
  10. Kelly, G. (2019, May 17). 12 Science-backed Ways to Manage Stress. Neurohacker Collective. https://neurohacker.com/12-science-backed-ways-to-manage-stress
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