When painful symptoms or physical discomfort aren't improved (or remain the center of a patient's focus), then quality of life may be a good measure. For example, you may ask your friend if she is sleeping any better after the surgery? Perhaps waking up less often or getting back to sleep faster after waking up?

What about daily activities? Is she able to walk farther with less pain? Can she get in and out of bed, the car, or a chair with greater ease? Has she noticed any difference in her appetite or even elimination patterns (bowel movements)?

Though it's a little more delicate, some patients also report improved sexual activity as a benefit of back surgery. By asking these questions and drawing her out, you may be able to help your friend look at other areas of improvement besides just pain control.