Help For Backpain

Are you a perfectionist?

Do you feel a need to do good for others? Do you care what others think about you?

Did you have a difficult childhood? Kids picked on you? One parent? Parents too strict?

Do you have a lot of stress in your life?

Why on earth am I asking you these questions when you wanted to know more about your chronic or chronic intermittent pain? My guess is that you answered affirmatively to at least one of these and probably more but lets, for the moment, get back to your pain.

Do you have chronic backpain? The kind of pain that can be described as a nasty pain that may shoot down into the buttocks or through the buttocks into the legs? Have you been told that you have herniated discs and that that was the cause of your pain but that the doctor could not help you? Did you know that a study reported in the New England Journal of Medicine [1], showed that only 36% of patients with no history of back pain had normal discs at all levels, 52% of patients with no history of back pain had a bulging disc at one or more levels, that 27% had a disc protrusion and 1% had an extrusion (these are patients with NO history of back pain)? It now appears that most of the time, herniated discs are NOT the cause of your backpain! In fact, in many cases, no physical problem is the cause of your backpain, which explains why most doctors or chiropractors or accupuncturists are unable to effectively help you for anything except temporary relief.

Fortunately for you, Dr. John Sarno, Professor of Rehabilitative Medicine at the NYU School of Medicine has discovered the cause of much of our back pain and the cure of the back pain. He started out in the NYU Rusk Institute of Rehabilitative Medicine taking care of back pain patients and noticed that they had similar personalities or were under a lot of current or old stress! Once he started educating patients that their back pain was due to a psychological cause rather than a physical/structural cause, he started having remarkable cures (approximately 85-90% cure rates) of chronic back pain! He taught them that their back pain was due to the patient's unconscious brain causing the pain as a DISTRACTION so that the patient would not have to think about the things that they did not want to think about. We know that the brain can control the diameter of the blood vessels in order to control blood pressure. It now appears that the brain can control blood flow to muscles, nerves or tendons to also create pain. Modern medicine recognizes and accepts that there is often times a major psychological component to a patient's chronic pain but Dr. Sarno has taken this one step further and has implemented a strategy for obtaining a cure.  He simply realized that by having the patient redirect their attention from a physical cause for their pain to instead a psychological stressor as the cause, the patient can usually easily gain long term pain relief. It is this fact that allows Dr. Sarno to have such a remarkable success rate with his over 11,000 chronic pain patients. I was a patient of Dr. Sarno's in 1987 and will eternally be grateful to him for curing my excrutiating backpain.

Today, I practice back pain relief at several different levels. For the first episode of lower back pain, I teach a stretching exercise, prescribe an NSAID such as Naprosyn and often a muscle relaxer, and suggest a heating/cold pad just as I was taught in medical school and residency.

For the patient with an acute case of muscle spasm, i.e. excrutiating back pain which is virtually crippling, I will inject the spasming muscle(s) with a mixture of the anesthetic Lidocaine and a steroid such as Depomedrol or Kenalog as I was taught in residency. This will often provide fast relief of the spasm.

However, for the patient with chronic back pain or recurrent back pain, I will look to see if there might be an underlying stressor (new or old) that could be contributing to their pain. These patients tend to be perfectionists, goodists in that they seek other's approval by doing good deeds for others, and/or they tend to have had unhappy or stressful childhoods. If the pain has a late onset in life, they will often have a fear of aging and mortality. If the patient has these personality traits and/or believes that their back pain is associated with stress in their lives, then they can be diagnosed with TMS (Tension Myositis Syndrome) and are candidates for permanent relief of their pain through education! Of course, the patient must be open to the possibility that they have TMS. I would never try to convince the patient if they were not interested in this diagnosis.

If you have made it this far, then you too may be ready to be introduced to the remarkable diagnosis of TMS.

[1] Jenson, M. C., et al. "Magnetic resonance imaging of the lumbar spine in people without back pain." New England Journal of Medicine 331 7/14/94: 69-73.