Got Back Pain?

Chronic back pain is at epidemic proportions that costs $100 billion annually in the US alone. That’s billion with a capital B folks!  One of my favorite general public articles on the topic was in News Week and was titled “The Great Back Debate.”

In many respects, it was a most ground breaking article. Why? Because it was major “mainstream” publication that attempted to examine truly non-traditional causes of back pain. It made a serous attempt to look at non-physical causes of back pain and non-invasive treatments. Causes that would have been relegated to “non-scientific” status just a few years before that, were being taken seriously by a normally conservative publication. I consider it a must read article for anyone with chronic back pain.

In particular, the article explored the psychological basis for back pain, and did so commendably. Since that article, several reviews on the topic have come out, and continued to support the general conclusions from the News Week article. Some key comments in the article for example:

The answer, Carragee and others believe, has as much to do with the mind as it does with the body. In the HIZ study, the best predictor of pain was not how bad the defect looked but the patient’s psychological distress. Depression and anxiety have long been linked to pain; a recent Canadian study found that people who suffer from severe depression are four times more likely to develop intense or disabling neck or low-back pain. At the Integrative Care Center of New York’s Hospital for Special Surgery, physiatrist Gregory Lutz says he routinely sees men who have two things in common: rip-roaring sciatica and an upcoming wedding date. The problem in their back, possibly a degenerated or herniated disc, probably already existed, says Lutz, but was intensified by the ole premarriage jitters.

Various alternative and traditional treatments are covered with a solid overview of them all, including the work of Dr. Sarno, who has concluded essentially all back problems have their root in deep emotional phenomena. I personally know a few spine and pain specialists who are big fans of Dr. Sarno’s work, even if they would hesitate to admit that in public.

A few years after the News Week Article came out, the Washington Post had an article examining the psychological relationship to back pain in more depth. There is a growing acceptance that Psychological factors/treatments can affect pain, in this case lower back pain. The issue at this point is not “if” psychology plays a roll is chronic pain syndromes, but by how much, is where the debate rests at this point. A conservative “old school” doc might say it plays a minor roll, where as people like Dr. Sarno mentioned above feel it’s actually the primary cause of back pain.

Regardless, people with back pain often look strictly for physical causes and cures and ignore the psychological aspects, which is a big mistake in my view.  It’s now very clear there’s solid  support for treating such pain syndromes with both physical and psychological based therapies. As the article in the Washington Post mentions in the article Psychological Treatments Ease Low Back Pain:

U.S. researchers examined the findings of 22 studies of patients with low back pain conducted between 1982 and 2003 and concluded that psychological treatments not only improve health-related quality of life and lower the risk of depression, they also reduce patients’ experience of pain.

If you have chronic back pain, I highly recommend you read both articles, and consider non-physical causes and treatments for  that pain…

  1. Rob 16 years ago

    I suffered with chronic back pain when I was 25. Two and a half years later I was given a copy of Dr. Sarno’s book, “Healing Back Pain” while reading it I could see that I was a textbook case. I am now 40 and have been free from pain for more than a decade. This book is a must read for anyone with ANY type of chronic pain.

  2. Author
    Will Brink 16 years ago

    Your’s is an experience I have heard many times before, and Dr. Sarno has heard thousands of times before….

  3. Jason 16 years ago

    I currently suffer from backpain and RSI type injuries. I have read a few of Dr. Sarno’s books. While I haven’t seen complete freedom from pain, I have seen a reduction in the symptoms. I plan on seeing a doctor in my area trained by Dr. Sarno for the residual pain. Howard Stern said it changed his life.
    This video from 20/20 interview with Dr. Sarno is worth a look for anyone with backpain to RSI:

  4. Author
    Will Brink 16 years ago

    Good find on the vid. I will use that in the future when talking about Dr. Sarno.

  5. GunNposes 16 years ago

    That’s a great 20/20 video. If John Stossel who is a chronic sceptic can get results from Dr Sarno’s theory, it must be good.

  6. Author
    Will Brink 16 years ago

    The 20/20 bit does not do a very good job of explaining Dr Sarno’s approach, but at least it helps get his info out. “healing Back Pain” and “The Mind-Body Prescription” are the two books recommended.

  7. Ryan 16 years ago

    As stated before I have had 2 L-5 surgeries (July 05 then May 06). Since that time last July 07 it blew out again. Since then 2 more blow outs the latest July 20th yesterday I did get a answer. Fusion surgery to fix but as anyone knows who has had surgery they always say no guarantee. But I was told that whatever pain I can tolerate it will not cause further damage but it could blow out again. I am delaying surgery until Feb. I am going to the gym today. Does anyone have any thoughts to which exercises would be the ones that may cause a blow out to stay away from? I know pain is a guide but just wondered what I should without a doubt stay away from. I just would like to make it to Feb. without another blow out. Oh yeah what the heck is the deal with July? Ha

  8. Jack Robert 15 years ago

    That was a great blog. Most blogs are not even worth reading.

  9. Samson G. 15 years ago

    Are you planning to blog more on this topic. I would like to learn more.

  10. Author
    Will Brink 15 years ago

    Samson, not sure when/if I will blog more on the topic as it’s not an area of focus for me, but that does not mean I wont do so in the future. I recommend you sign up to the blog and therefore will get an alert when new material goes up.
    There are also sources and such you can follow up on to learn more which are linked in the blog above. I would start there perhaps.

  11. Doug 9 years ago

    I had lower back paid for about 20 years. I wasnt depressed, but I was fooled in to thinking that a minor twist in a vertibra called for avoiding back exercise and signing up for the life plan with my chiropractor. The Chiro helped…every week for years. Then I got fed up and headed for the gym. I have been paid free for 5 years now. Got one of those free electrical impedance tests done by a Chiro at a fair. He marvelled that I had no Subluxions. Asked who my Chiropractor was, and I told him my experience with pull ups and dead lifts. He ushered me away real quick. 😉

    • NJJoe 9 years ago

      Chiro’s can be great, and they can suck, just like most things in life. Far too many believe in perpetual treatments for life. They’re not motivated by helping you find an effective “cure”, or better said, proactive approach to health. In my experience a well trained and experienced physical therapist can be worth 10,000 chiropractors. Chiro’s are good for acute injuries/pain, but for anything chronic, you need to find the cause, a treatment, and most importantly, a way to prevent it. Your back just doesn’t “go out of alignment” by itself for no good reason. More often than not it takes a fair amount of research, experimentation, and trial & error to find a resolution.
      I won’t boor you with my experience to a healthy spine, but it involves multiple aspects, from yoga, to stretching, to diet, to self-hypnosis, and the occasional Chiro, all synergistically combined. Once pain becomes chronic, it becomes a repetitive neurological cycle, and can originate in the brain. That cycle needs to be broken.
      I read an interesting study a while back, published around 2000 done in Australia. They went to a mall and asked for volunteers to have MRIs taken of their backs. Subjects were diverse in age, gender, and spinal health. Remarkably, they found those with no back trouble had nearly identical MRI pathologies to those who reported frequent and/or chronic back pain. No differences. What does that tell you? Well first, it tells us why back surgery has such a high failure rate, because they’re “repairing” something that doesn’t need repair. Second, it tells us in most cases we can’t really find the cause through imaging.
      Lastly, from my own experience, I cannot over state how powerful the mind-body connection is when it comes to health, especially any type of chronic pain.
      Kudos for Will for bringing another important, yet not well known subject to our attention.
      Good health to all.

  12. Hal Greenham 9 years ago

    Hey Will great to see your ability to consider the evidence and cast aside traditional and limited ideas about what causes pain. I healed myself about 10 years ago from terrible chronic fatigue and pain which was, at the end of the day a mindbody problem. I now specialise in treating these disorders with body-oriented psychotherapy which is a very satisfying career change I must say.
    I would recommend people check out for more great support resources and recovery stories using Sarno’s theory as the base.
    Or you could also read my story at

  13. Steve 9 years ago

    While I know the author list and books on back pain can be endless, I had to throw out Pete Egoscue’s name and books. I have not read the author’s books mentioned in the articles, but Pete has the same mentality and philosophy.
    I had chest pain that no one could figure out and completely altered my life for 2 years. It flared to my neck, it hurt to breathe, and the best way I can describe it is that the pain radiated through my ribs.
    I had chest x-rays, scanogram of legs for leg-length discrepancy, saw chiros, did physical therapy, massage therapy, met with a doctor of sports medicine, did blood work, and eventually met with a chronic pain specialist. ALL of the aforementioned brought about no relief and a very empty wallet.
    It was with a library card and a Pete Egoscue book that his simple method got me back to where it not only didn’t hurt to put a shirt on overhead and do normal everyday activities (couldn’t clean my house, walk my dogs, sit, lie down you name it, without being in pain), but that I am back to lifting the way I was previously. This pain was so debilitating that I wanted to die – literally. I wasn’t suicidal, but I seriously did not want to be alive because the pain was so bad.
    I just had to post because I hope that no one is ever in the same position I was, but if they are, hopefully they can come across these articles, authors, and books, save a ton of money and time, and get back to enjoying life.
    Thank you so much for posting this, as well as all of your other awesome articles, cutting through all the b.s.!

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