There are many ways to measure success of an operation. Pain relief is one. Many patients are expecting complete pain relief when often there is only partial relief or none at all. Some patients even report more pain after surgery.

Quality of life (QOL) is another measure. If pain relief isn't delivered, then QOL often goes down. Disability goes up as pain levels increase and function goes down.

In a recent study at the Productive Rehabilitation Institute of Dallas for Ergonomics (PRIDE), patients with extreme pain after rehab were more likely to seek further medical care. The risk of post-rehab surgery was 11 times greater in this group compared to patients with mild pain.

The authors of the study pointed out that chronic pain patients with work-related injuries were less likely to return to work after surgery if their pain level was 'extreme.' This was especially true for patients who were disabled for one to two years.

They suggested taking a careful look before doing surgery on anyone with extreme chronic low back pain.