Back Pain…It’s All In My Head?

If you or someone you know suffers from chronic back pain this is a must read

After reading the title 100% of you should be reading this article. Most of us know at least one person who suffers from chronic back pain; many of us know several. Chronic back pain has become an epidemic over the past 30 years. Like many of my colleagues I had attributed this epidemic to our culture’s increasingly sedentary lifestyle. Sitting too much, and moving too little was the culprit. Muscle imbalances, such as tight hip flexors, weak glutes, and overworked hamstrings were responsible for the nation’s pain in the back. In severe cases it was herniated, bulging, and degenerative discs. This was the widely held belief that I maintained until severe back pain knocked on my door.

Over the Summer I began experiencing stiffness in my SI joint on the left side located in my buttocks/hip region. I attributed it to muscle imbalances, and although doubtful in my case, a lack of core strength. My response was to become more diligent in performing flexibility exercises including self-myofascial release (foam rolling), active, dynamic, and static stretching, along with an increased volume of core work. Several weeks went by and my condition worsened. I now was in mild to moderate pain to go along with my stiffness. The pain was also now in my lumbar spine, and my right and left buttocks. I found sitting in my car to be excruciatingly painful, both while driving and upon immediately exiting the car. When getting out of the car I must have looked like a 90-year old man. I experienced similar pain when sitting at my desk, but oddly was fine when driving my SUV. Logically I blamed my body position and the actual seats of my car and desk. I started looking into buying a new car, when all of a sudden I found walking to be extremely painful. I did some research and came to the conclusion that my back pain was being caused by something that was happening in my feet. I blamed my sneakers, and immediately went out and bought new sneakers that provided more stability than my current pair. My relief was minimal, if there was any at all.

On a 0-10 scale my pain ranged from a 4-8 and with each passing day it was more common that the pain was closer to an eight. It got to the point where I would go to work each morning, train my clients and then come home and get into bed for the remainder of the day; just so I would be able to get to work the next morning. Most of my weekends were spent in bed as well. After three weeks of this pattern with no relief in sight I made an appointment to see the orthopedist. The orthopedist had me lie on the table where he performed a series of tests and shared with me his suspicion that my problem was disc related. That didn’t sound good; and my pain that began the day at a four, quickly rose to a seven. The immediate plan was to get an MRI. If the doctor’s suspicions were correct we would start with anti-inflammatory medication and physical therapy. If that didn’t work we would progress to epidural injections, and surgery would be the last resort. However, first I needed the MRI to find out what was wrong with me.

Several days later I went for my MRI. It was a Friday afternoon and the pain that day was around a four. After the MRI, the technician informed me that he could not discuss the results with me, however he could show me the pictures and let me draw my own conclusions. Before bringing me into the room to view the images the technician asked me if I had been doing any heavy squatting. I replied “no, nothing unusual,“ and knew that his question was a bad sign. Looking at the images it was fairly clear that I had one bulging disc at L4/L5, and one completely herniated disc at L5/S1. I walked out of the office with mixed emotions. Initially, I felt some relief that there was something structurally wrong with me; I hadn’t been making it up. Quickly though, those emotions changed to fear and worry. I now believed there was something structurally wrong with me and what would I do if I couldn’t get better. My career would be over if I couldn’t fix this problem. My pain that was a four when I entered the office now rose to an eight. I went home, broke the news to my wife and got into bed, wondering what was I going to do?

Lying in bed a memory came back to me concerning a former client of mine. This particular client at one point was having some issues with their back and a friend of theirs suggested they go see this famous NY doctor. This doctor though had a prerequisite that you read his book prior to your first consultation with him. The friend passed the book along to my client who then gave the book to me. My client requested that I read the book and then summarize it for them. I am a full service trainer. Anyway, I read maybe fifteen pages or so and thought the book was interesting, but my client’s pain went away before I got any further. My client never asked for the book back. It was at that moment while lying in bed pondering my future that I realized I still had this book and in desperation decided to find it and see if there was any hope in it for me.

Over the course of the weekend I read the entire book and my pain went from an eight to a two and remained there for an entire week. I went back to see the doctor, he confirmed what I thought I saw for myself in the MRI and wrote me a prescription for anti-inflammatory medication and physical therapy; which I chose not to fill. The following Sunday I had basketball practice and upon returning home my pain shot up to an 8/9 and I quickly began to panic and have doubts about what I had read in the book. I started to consider filling the prescription the doctor had given me for anti-inflammatory medication and physical therapy. I shared my feelings with my wife, since I had been discussing with her every step of the way my findings while reading the book, and she convinced me to give the book a chance. I am glad I did. It took three weeks of going back and re-reading the suggested chapters in the book over and over again, along with ordering and watching the doctor’s video of a mock lecture, but after those three weeks my pain was a zero. I have now been pain free and back to full activity for two months. Oh, and I’m keeping my car.

So who is this doctor and what is written in this book that simply reading can cure a person who was in bed with pain for several weeks? The doctor’s name is Dr. Sarno. He is a medical doctor who has worked in rehabilitation for over thirty years. After many years of watching people get surgery after receiving conventional diagnoses and experiencing little to no relief he started to believe that the conventional diagnoses were wrong and began a search for the true root of the problem. He started looking into the structure of the back and reviewing the literature from a variety of studies published in renowned research and medical journals. Dr. Sarno found that discs begin degenerating for most people at age twenty, and has concluded that this is part of the natural aging process. In his book, Dr. Sarno cites studies that through MRI’s examined the spines of hundreds of pain free subjects only to find that many of the subjects had degenerative, bulging, and even herniated discs. His conclusion was that alterations in disc matter, in most cases, are normal and are not responsible for back pain. How else could one explain all of these pain free subjects, with structurally “defective” discs yet no back pain? For Dr. Sarno the answer was in the psychological, not the physical.

The pain is real; and yes the pain is physiological. However, the cause is not structural it is psychological. According to Dr. Sarno we all have unconscious rage that we developed from infancy and childhood. The causes of this rage can stem from many sources, but the key is that it is unconscious, not to be confused with subconscious. We are completely unaware of this rage and probably for good reasons. Because this unconscious rage can be painful and even dangerous our brain keeps it in the unconscious mind. However, feelings of stress, anxiety, fear and the like can lead to a surfacing of this rage. In an effort to keep it below the surface the brain causes a physiological response to distract us from these painful thoughts. Dr. Sarno refers to this physiological response as oxygen deprivation, and the result is pain. It is a constriction of sorts of the capillaries that leads to a reduction of oxygenated blood to muscles, connective tissue, and nerves. Dr. Sarno believes that headaches, back pain, shoulder pain, neck pain, tendonitis, bursitis, bone spurs, gastrointestinal ailments and fibromyalgia are all related to this oxygen depravation stemming from the psychological, and he has termed this condition Tension Myositis Syndrome (TMS). Dr. Sarno maintains that certain personalities are more susceptible to this condition than others. Individuals with TMS tend to be conscientious, responsible, ambitious, compulsive, perfectionist, people-pleasers who feel a strong drive to be good or “do good” and be helpful to others. They put tremendous pressure on themselves. The result is chronic pain that is given a diagnosis of being caused by a structural problem. The diagnosis elicits fear that only serves to increase the pain. The individual then begins to make associations between the pain and certain things, like for me my Honda Accord. I believed the car was the source of my pain, so naturally every time I got into the car I experienced pain until I broke the association.

So you’re probably wondering right now, “what is the treatment for TMS?” You want to know what the book tells you to do, what exercises you must perform etc.? The treatment is one word, education. Dr. Sarno has found in his 30 years of treatment that educating the individual on the structure of the spine, the workings of the mind and about unconscious rage, identifying the personality traits of those with TMS, and explaining oxygen deprivation and its effect on the body, is all that is necessary in most cases to rid the body of TMS and thus pain. The education process begins with reading one of his books, attending one of his lectures, and if necessary participation in psychotherapy. According to Dr. Sarno some people find full relief just from reading one of the books. Most find the lectures helpful and a small percentage will need psychotherapy. Now that the video exists attending a live lecture is probably not necessary; at least that was my experience.

Those of you who know me well are probably surprised by my experience. I have to say that I am surprised as well. I tend to be cynical of alternative solutions that deviate from mainstream science. I can only share with you what has happened to me and let you draw your own conclusions. Maybe it is all one big coincidence the timing of my healing and the reading of this book, but I have to say that a great deal of what is written made a lot of sense to me in thinking about myself and others I know suffering from similar ailments. It’s not magic, it’s simply a perspective I share with you that is worth consideration and further exploration. If you suffer from chronic back pain, or any chronic pain for that matter, if you find yourself using the phrase “I threw my back out” then I think it is worth taking a look at this potential solution. The title of the book I read is Healing Back Pain: The Mind-Body Connection by John E. Sarno, M.D. You can find that title amongst others along with the DVD at

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