Every time someone tells me their back’s been giving them trouble, I lower my voice before launching into my spiel: “I swear I’m not woo-woo, but … ”
LetLet me go back a little. ForFor over a decade, I experienced a near constant throbbing sensation in my left piriformis (a small muscle deep in my butt) for more than a year. It was treated with ultrasound, physical therapy and other methods. Botox injections. AtOne point I considered surgery to remove the muscle in half to relieve the pressure on the sciatic nerve.
Then, in 2011, I picked up a library copy of the 1991 best seller “Healing Back Pain: The Mind-Body Connection.” ItAccording to some, the brain causes pain in the neck, shoulders, back, and butt to distract from repressed anxiety, anger, or feelings of inferiority. This is done by decreasing blood flow to the nerves and muscles.
The book’s author, Dr. John SarnoHe was a rehabilitation physician at New York UniversityHe is a bit of an evangelist and promotes a method that is based on anecdotes from his practices and passionate testimonials from patients. Howard SternOr Larry David, who described his recovery from back pain as “the closest thing that I’ve ever had in my lifeTo a religious experience.”
According to Dr. SarnoRepressed emotions are the root cause of most chronic pain. By undergoing psychotherapy or journaling about them, he said, you could drag them out of your unconscious — and cure yourself without drugs, surgery or special exercises. I chose journaling, and began writing pages-long lists about everything that angered me, insecure, or worried me.
I loved the neat logic of Dr. Sarno’s theory: emotional pain causes physical pain. And I liked the reassurance it gave me that even though my pain didn’t stem from a wonky gait or my sleeping position, it was real. I didn’tLike that, no one in the medical profession seemed to be on their side. Dr. Sarno, or that he didn’t have any studies to back his program.
But I couldn’t deny it worked for me. After exorcising a diary’s worth of negative feelings over four months, I was — in spite of my incredulousness — cured.
I didn’t think much about Dr. SarnoAfter that, continue on until MayI was in physical therapy again for a pain in my inner leg. MyPhysical therapist gave me a few exercises that I had to do every day. TheI was worried all the time IfPhysical therapy failed again. Would I have to go back and exhaustively record my woes? Did Dr. Sarno’s claims even hold water?
PainIt is often in the brain that things begin.
“The idea is now mainstream that a substantial proportion of people can be helped by rethinking the causes of their pain,” said Tor WagerProfessor of Neuroscience at Dartmouth CollegeThe director of its CognitiveAnd Affective Neuroscience Lab. “But that’s different than the idea that your unresolved relationship with your mother is manifesting as pain.”
Dr. Wager said most scientists now believe that pain isn’t always something that starts in the body and is sensed by the brain; it can be a disease in and of itself.
Approximately 85 percent of back pain and 78 percent of headaches don’t have an identifiable trigger, yet few scientists would say that all or even most chronic pain is purely psychological. “ThereThere are also psychological and biological reasons for suffering. In most people, it’s some confluence of the three,” said Daniel ClauwProfessor of medicine, anesthesiology and psychiatry at The UniversityThis is MichiganThe director of its Chronic Pain & Fatigue Research Center. “I’m sorry, there are a bunch of people for whom Sarno’s method isn’t going to work.”
TodayA similar approach can be found here Dr. Sarno’s method is emotional awareness and expression theory, in which patients identify and express emotions they’ve been avoiding. It’s not only been shown to significantly lower pain in people with fibromyalgia and chronic musculoskeletal pain, it’s also considered a best practice for treating chronic pain (along with massage and cognitive behavioral therapy) by the DepartmentThis is HealthAnd Human Services.
PainIt can take on a whole new life.
ButHow can the brain cause chronic, unresolved pain? Dr. Sarno’s theory that our brain uses pain to distract us from negative emotions by cutting off blood flow to the muscles is not backed up by science, according to Dr. Wager.
Instead of blood flow, scientists now look to the nervous system to understand chronic pain that isn’t caused by nerve or tissue damage. BasicallyYour brain circuitry may malfunction, causing pain to persist, amplify, and even create.
Dr. Wager said we don’t fully understand the mechanisms of this, but “we do know that stressors can promote inflammation in the spinal cord and brain, which is linked to greater pain sensations.” EarlyChronic pain can also be linked to adversity like child abuse, economic hardship and violence.
Six TipsFor Treating Chronic Pain
ComplicatingThings go further: PainYou can get more pain ForAn injury could increase the volume of your pain response to future traumas. StressThis can cause pain to persist even after an injury has been treated. AndIf your back aches and you begin to imagine how it could get worse, this fear can magnify your pain. This can lead you to avoid doing physical activity which will make the pain worse. ExpertsThis is the pain cycle.
Here, Dr. Sarno’s notion of the brain triggering pain was partially right. ResearchStudies have shown that catastrophizing may turn acute pain into chronic, and increase activity in brain regions related to anticipation and attention to pain. ThisThis is why clinicians are now treating pain disorders in a similar way to anxiety disorders. They encourage patients to exercise to overcome their fear of moving. WhereasA patient who is socially anxious might make small steps towards talking to strangers. For example, a patient suffering from back pain might start jogging and cycling.
YouYou can find the on switch.
TheBottom line according to Dr. Howard Schubiner, a protégé of Dr. Sarno, is that “all pain is real, and all pain is generated by the brain.” Today Dr. SchubinerThe director of the Mind Body Medicine ProgramIn Southfield, Mich., and a professor of clinical medicine at the Michigan State University CollegeThis is Human Medicine.
“Whether pain is triggered by stress or physical injury, the brain generates the sensations,” he said. “And — this is a mind-blowing concept — it’s not just reflecting what it feels, it’s deciding whether to turn pain on or off.”
SoThis reasoning states that all pain is both in the body and in the brain. WhichThat is why my adductor stopped throbbing in pain. July after eight weeks of physical therapy, I didn’t expend too much mental energy trying to figure out what had worked: the exercises themselves, my physical therapist giving me the go-ahead to keep exercising, the once-a-week opportunity to talk with her about my recent move and the other stressors potentially contributing to my pain or (most likely) all of the above.
InThe end. Dr. SarnoHe was right about exercise helping, not hindering, recovery, and about the link between physical and emotional pain. ButNot all chronic pain is psychological. Dr. Sarno’s FreudianThe only treatment that works is not the best. AndFew scientists would believe that our brain uses pain to distract from negative emotions (and certainly not by cutting off blood flow).
I still think of Dr. Sarno as a savior, and I continue to recommend his books to friends and family; some have read them — and had success — while others have politely declined. Yes, Dr. SarnoIt is likely that we have simplified and exaggerated the psychological roots of pain. ButHe helped me see that both my mind and my body are responsible to my physical suffering. And that we’re not powerless to change it.
Source: NY Times