Back pain

Between Christmas and New Year's it struck again: after months of peace the severe back pain was back. This time it stretched out to about a week, in the cases before I had managed to get better with pain killers after a few days.

But this time I had a secret weapon at my disposal: a book. I had already bought it, in case I needed it.

I had heard about this book on the Internet.. A lot of people were talking about how the book had helped them to combat their back pain (and other kinds of pain like RSI oder in the knee) for good. Some claimed, just by reading it their pain had vanished.

A clear case of esotericism. It can't be. I'm the sciency type, homeopathy or osteopathy are not my thing. But I was ready to give it a try. Pain is nasty, and the one who heals is right.

How did it go? Right after reading the book my pain had subsided a bit. I went to bed and rose the next morning without pain (albeit with quite some tension in the back).

Does that prove that the method promoted in the book is working? Of course not. My back pain has always gone away again in the past, and I did take painkillers for a week. So it may be random luck. And in the medical point of view, it is. But just maybe there is some truth to it, and it has certainly not done any harm.

Dr. Sarno promotes the thesis, that most types of back pain (and many other kinds of pain) have a psychological cause.

Now every victim is about to cry out: „My pain is real, not just imagined“. Unfortunately, society tends to dismiss psychological maladies as “not real”.

But they can rest assured, Dr. Sarno does not claim that the pain is imagined. No, it is real physical pain, caused by real oxygen deprivation of the muscles and other tissue.

The postulated mechanism goes like this:

1. We have repressed emotions and tensions inside us.
2. The brain tries to shield us from those, and to distract us from them.
3. It's using the autonomic nervous system to do that (it controls blood pressure, blood vessel dilation and much more), in order to cause oxygen under-supply to a region of the body on purpose.
4. Those regions then signal back to the brain their pain, and we are distracted by that pain. To quell any misunderstanding: this is about a slight oxygen deprivation. No tissue is dying. Think about a runner who makes it across the finish line with pain in his thighs.

Pretty wild theory, isn't it? It presupposes that “I” and “my brain” are two distinct actors that can have secrets from each other (the brain knows about those repressed emotions, but I am being misled by the brain).

And even if this exact mechanism is not the truth, Dr. Sarno's treatment rests on two necessary conditions:

First, the pain has no actual physical cause, it is being created by a psychological process. Whether it gets caused because repressed emotions are playing a role, as Dr. Sarno proposes, or for whatever other reason, doesn't really matter. At a time, where psychological effects increasingly get into the focus of classical medicine, it is at least a defensible premise. Whether you choose to follow Dr. Sarno's further theses, or not.

And second, this physiological cause must rest upon a psychological deception. Out brain is playing us, and we don't notice. That's the thesis that's much harder to swallow.

But if you accept the possibility of both premises, the treatment method is plausible.

Let's put those questions aside and see what Dr. Sarno's recommended treatment looks like.

1. The first point is the most important one, and Dr. Sarno is elaborating that point multiple times: The first steps are the steps into your doctor's office! No exceptions. Even if Dr. Sarno thinks most back pain is psychologically caused, he does not deny the existence of severe physical problems. If you have a tumor right next to your spine, no psychological mind games will help! The tumor won't go away, jsut because you have read a book.
2. Move actively and normally. Physically everything is fine with you.
3. Be aware that your brain is lying to you. Tell your brain, that you've seen through it, and that it can stop with this charade now.

Mostly, that's it. The brain realizes you won't be deceived anymore, and gives up on those pain tricks.

That's where the experiences of sudden, spontaneous reconvalescence from reading the book come from: you see through the brain's tricks and they lose their effectiveness.

And now we're at the point where a single question looms large, where you either dismiss it all as quackery, or where you try it.

Was Dr. Sarno a quack?

On the one hand, no: he was a professor at NYU's medical center. A classically trained, practising doctor with success in the treatment of patients.

On the other hand, yes: nobody else shared or shares his theories and theses. He is complaining in the book that his papers weren't accepted by medical journals. That is usually a sign of charlatanerie. Nobody, really nobody in medicine seems to accept his theories fully or at least substantially.

And on the last hand, no: He would be a strange quack. Usually quacks are selling expensive pills or even more expensive seminars.

As far as I can tell, Dr. Sarno sold nothing. Except his book. Which you can buy for less than 10 dollars new. That's atypical. He may have been misguided, I'm not able to judge that, but he didn't seem to be a fraud.

In the end my opinion comes down to this:

Listen to your doctor! It's not a good idea to chase miracle cures. But trying this book on top of what your doctir tells you? I can't see anything wrong with that. You're not harming anything. You're not refusing conventional medicine. If it works for you, great. If not, you have lost ten bucks and two hours of your time.

All being said, whether Dr. Sarno was right in his ideas doesn't really matter to you or me.

The one who heals is right.