I went to a special spine center for help with my chronic low back pain. I had to take three written tests that took over an hour to complete. My back was killing me after sitting that long. I found out later the tests were checking to see if I am depressed or not. Why didn't they just ask me? I could have told them straight out -- yes, I am depressed!

The health care delivery system is taking a new approach to treatment these days. The focus is increasingly on what's called evidence-based medicine. The idea is to show proof that the treatment used for a condition such as back pain is effective. Why spend time and money on something that may feel good at the moment but doesn't really make any difference in the long-run?

One way to assess the effects of treatment is through the use of surveys taken before and after treatment. Various factors known to be part of the chronic back pain picture can be measured. These might include patient satisfaction, symptoms, function, disability, and psychologic state.

Depression and anxiety are common features of chronic pain patients. Many people know they are depressed while others do not. Measuring change in mood can be difficult without a survey of some type to identify change. Most change occurs slowly enough that the patient isn't really aware of how much he or she has improved. When asked directly, the answer might not be the same as when tested formally.

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