Scared of Surgery? Fight Fear with Mindfulness Science.

5 min readMay 12, 2016

A major reason for putting off an elective surgery can be summed up in one word: fear. Fear of the unknown. Fear of pain. Fear of recovery. Fear of being vulnerable. For some, this fear can be crippling, causing additional stress and anxiety in the months, weeks, and days leading up to the procedure. What surgery candidates often don’t realize is that this untempered fear or anxiety can actually negatively affect the outcome of surgery.

In saying this, your mind is your biggest ally going into surgery. Your body and mind are very powerful machines — resilient and built for healing. Read on as we discuss the idea of “mindfulness” and share how you can pull the plug on negative thought patterns to set yourself up for success.

What is mindfulness? It’s the practice of bringing one’s attention to the internal and external experiences occurring in the present moment.

Stress and Anxiety Can Negatively Affect Surgery

Not everyone is comfortable blindly surrendering themselves to the “power of their mind”, “law of attraction” or other abstract metaphysical belief systems. For this reason, we will keep our information surrounding mindfulness as scientifically-proven and related to your upcoming surgery as possible. Before we dive in, it’s important to call to attention the negative affect stress and anxiety can have on prehab, surgery results, and post-op recovery.

In a study conducted by the Journal of Arthroplasty, the reported findings were that depression or anxiety in patients is a predictor for complications after joint replacement. In fact, the cost of a total knee replacement for a patient with measurable anxiety or depression was $3420 higher than those without. The reason being, patients going into surgery with anxiety or depression often required additional care, longer rehab, and have more complications in recovery.

Another six-year long study out of Duke University Medical Center compared the results of 86,976 patients who had hip replacement surgery and also had a diagnosis of bipolar disorder, depression, or schizophrenia against 590,689 patients who had hip surgery but did not have a mental illness. The results: Hip replacement patients with mental illness were twice as likely to need revision surgery on their hip replacement; twice as likely to have respiratory failure and pneumonia after surgery; and were twice as likely for their hip to become infected, break, or get dislocated.

It’s important to note that we do not wish to compare a diagnosed mental illness to pre-surgery anxiety. What we do hope to illustrate is the impact that your mental health and state of mind going into an elective surgery t has on your results and the overall success.

Why Practice Mindfulness Before, During and After Surgery?

First and foremost, you will get through an elective surgery, like a joint replacement, and live a richer life because of it. Improving your mindfulness will not just get you focused on positives like a fuller life, but can also reduce anxiety surrounding movement that’s caused by chronic pain. An unfortunate side effect of continuous pain is that even after a joint replacement (or another pain-resolving procedure) lasting anxiety can slow down rehabilitation.

Mindfulness is an incomparable tool to get past the mental struggles caused by pain and reduced mobility.

Employing “mindfulness” also known as “restful alertness” can be described as being present in the moment. Training your mind to stay in the moment and not wander to anxiety and fear-driven thoughts will keep anxiety and stress at bay. As found by researchers with Can J Psychiatry, “mindfulness interventions promote increased tolerance of negative affect and improved well being”.Another study mirrors similar findings, citing that “mindfulness meditation shifts people’s ability to use emotion regulation strategies in a way that enables them to experience emotion selectively, and that the emotions they experience may be processed differently in the brain.” In other words, practicing mindfulness has the ability to improve the way you interpret and overcome negative experiences.

Here’s Why Mindfulness Meditation Matters Before Surgery:

  • Mindfulness teaches you wisdom and how to stop perpetuating the unnecessary suffering that results from trying to escape the discomfort and pain.
  • It’s a proven way to deal with pain and even increase pain tolerance.
  • You’ll have a new set of tools to deal with anxiety and negative experiences.
  • Those going into hip or knee replacement surgery with reduced anxiety or depression have better results and fewer complications.
  • You’ll learn to let go of old pain.
  • Mindfulness will help you better understand the power of your mind and body to heal. This can improve your comfortability with prehab and rehab exercises.
  • Letting go of stress, fear and anxiety will mean better physical and mental health in the future.

How to Employ Mindfulness

On paper, mindfulness meditation is as easy as it gets. Mindfulness meditation is simply focusing on breathing, controlling your thoughts, and refocusing on your breathing if your mind wanders. However, this is much easier said than done. Mindfulness is something that is learned and should be practiced regularly as part of a PreHab health optimization routine.

Here’s how to begin practicing mindfulness meditation:

  1. Find somewhere quiet, free from distractions (e.g. bright lights, sounds, people). Test whether or not you find yourself more restful inside or outdoors.
  2. Take a seat on a chair, bed high pillow, or however you feel comfortable and the most pain-free.
  3. When you’re comfortable, focus on improving your posture. This means straight upper body, dropped natural hands (not clenched), gazing forward.
  4. Set a timer. In the beginning this practice may only be for 10–15 minutes. As you progress and see greater benefits from mediation, you may increase the time.
  5. Focus on breathing in and out. Pay attention to your breathing and as your mind wanders, return focus to inhaling and exhaling.

Remember, do not put too much pressure on yourself or be angry if your mind wanders. It’s completely natural if your mind wanders. The practice lies in reeling yourself back in as your mind wanders and focusing on your breath.

Guided Video Meditation

We’ve teamed up with Oli Doyle, author of Mindfulness Plain and Simple, to bring you a series of guided mindfulness meditations that are designed specifically for those with scheduled surgery. Our goal is that you become more mentally prepared and mindful before your hip or knee replacement. This way, your body is primed, excess fears or anxiety are lifted, and you can focus on recovering to a better you.

Find a calm place and play the video below. You’ll be practicing mindfulness in no time!

Sign-up for PeerWell for full access to our PreHab mindfulness meditations for those preparing for joint replacement surgery. Subscribe to the PeerWell youtube channel for full access.




PeerWell is a digital health company that focuses on helping people throughout their musculoskeletal journey through PreHab and ReHab.