Years ago, a chiropractor told a friend of mine that he had trouble with his back because one leg was slightly longer (or shorter) than the other one. How many times have you heard that one? The leg was what it was. It wouldn’t change. So my friend received treatments for years.
Others have been told that poor posture, muscular imbalances, tendinitis, bursitis, shin splints, tennis elbow, sciatica, carpal tunnel, osteoarthritis, minor rotor cuff tears, minor cartilage tears and more are all causes for your pain and must be repaired.
The truth be known, chiropractors, physical therapists, orthopedic surgeons, acupuncturists, and various pain specialists make money from your aches and pains. The mystery remains that blaming (or fixing) the pain on a structural abnormality rarely gets a patient back to living a pain-free life.
Ninety percent of all people experience a back pain episode at some point in their lives and sometimes several. Yet, the explanation of structuralism often frightens people even more–right into back surgery.
When my MRI exposed six herniated discs, my primary physician used the standard “scare tactics”, reminding me how fragile I was. “Don’t fall,” he warned repeatedly with great alarm, as if I would fall on purpose.
So I sat in my Lazy Boy, terrified to move, the exact opposite of what I needed to do. Living in constant fear kept my attention focused on the pain, not the recovery.
As pioneer mind-body specialist John Sarno states:
“As long as the patient believes there is something wrong with their back or other joint, the pain will hang around.”
Backs are very strong unless you have some disease like osteoporosis. But any mind body program of integrity will absolutely require detailed tests to ferret out any unhealthy conditions.
If a program doesn’t ask to review your medical history, run in the opposite direction. Current MRI and X-rays were mandatory prior to my acceptance into Dr. Schubiner’s mind-body program.
Dr. Nickolai Bogduk, Professor of Pain Medicine, University of Newcastle and Head, Department of Clinical Research, Royal Newcastle Hospital, Newcastle, New South Wales, Australia writes in his book Clinical And Radiological Anatomy of Lumbar Spine, Fifth Edition):
“Despite technological advances in the diagnosis and treatment of low back pain, and the logarithmic increases in cost of care, we have not seen a commensurate improvement in outcomes.”
In an article titled, “Low Back Pain” published in the New England Journal of Medicine (2001, Dr. Bogduk, who has devoted his career to teaching doctors not to overestimate the importance of biomechanical factors in back pain, writes:
“Degenerative disc disease conveys to patients that they are disintegrating, which they are not. Moreover, disc degeneration, spondylosis and spinal osteoarthritis correlate poorly with pain and may be totally asymptomatic.”
When I’m suffering intense pain and can’t work the mind body program effectively (or closer to the truth, have slacked off on working the program), I half-wish I had gone ahead with the massive surgery recommended by the orthopedic surgeon in 2007 who planned to replace four discs with hardware that resembled small, heavy-duty bed springs, stabilizing it further with a spinal fusion.
Today, just six years later, spinal fusions are found to be ineffective and not recommended. The surgery was scheduled for my birthday. Happy Birthday, Dianne. Out of fear, I cancelled it the next morning. When I’m living in a fantasy, feeling helpless and hopeless about things in general, I wonder if I did the right thing. When I’m in my right mind, I don’t regret it.
The idea of that massive surgery by a surgeon I really didn’t trust or like, scared me enough to research mind body physicians and drive 200 miles once a week to attend Dr. Howard Schubiner’s classes in Southfield, MI. It was there that I learned I was not fragile.
Before all our modernization and lack of activity, such as, sitting at a computer all day, using twitter and ipads, jumping in a car that does everything for you except wash your sheets, men and women were working the fields, lifting heavy equipment and doing strenuous manual labor. Our spines are very strong. And when a major bone, like the femur, breaks, it heals within 6 weeks. The body is amazing. Yet, we sit around with back pain for decades. How can that be?
Aligning with Dr. Bogduk’s quote above, Schubiner presented several studies that showed the backs of many, especially the elderly, are massively degenerated with no pain. Victims don’t even know about the degeneration until they have an MRI for another health reason.
Yet, others have low to mild degeneration and suffer excruciating pain. So why doesn’t degeneration across the board cause pain?
It would appear that structuralism can’t thoroughly or accurately explain pain.
The same can be said about knee pain. At this point, it’s an expectation by the elderly that they must have knee replacements. X-rays show that my knees are bone on bone, but why, when it’s warm outside, can I walk around with hardly any knee pain, and when the weather is cold, I can barely rise from a chair due to pain?
It would seem to have more to do with internal fluids and lubrication than the rubbing of bone on bone? Personally, the inconsistency intrigued me, and one of the reasons I attended a mind body treatment program in 2007.
The same goes for treatment options. I have had some of the most inconsistent physical therapy experiences around. In the 1980’s, after back surgery, I was given a host of exercises to do – all laying on my back to protect the spine. In 2009 a physical therapist had me do basically the same exercises I had done twenty-five years before, but now he had me standing upright at the kitchen counter with no regard for protection of the back or knees or my pain level while standing and doing these exercises.
Moreover, I’ve had several physical therapists, ordering me to do repetitive exercises while the rheumatologist, who diagnosed fibromyalgia, told me I should never do anything repetitive as it exacerbates muscle pain for people who suffer fibro. My point is, even physical therapists and physicians can’t agree on how to treat pain, and the years seem to bring little progress or change.
The idea of either physical therapy or surgery offer some people “hope” that things might improve, but I found it short-lived. In fact, the last time I was in physical therapy for my knee and back pain, one of my heart stents closed up, and I couldn’t get the therapist to take my complaints seriously. He acted as if I didn’t want to do the work. I landed in the hospital having one of my heart stent replaced. Whenever my doctor suggests PT now, I shake my head, “NO!” Why hang on to hope that brings no permanent change? And in my last case, exacerbated other health issues.
Integrated, mind-body physicians rarely send their patients to PT now. Pioneer John Sarno admits that in years past, he sent his patients to PT only because he didn’t know what else to do for them. That is, until he discovered the mind body theory and strategies and 80 percent of his patients have found permanent relief from pain.
According to Scott Brady, M.D., author of Pain Free For Life: (2006), pain is the result of what he calls the Autonomic Overload Syndrome (AOS):
“AOS is a group of chronic pain and other symptoms, caused by harmful levels of stress, pressure and repressed strong negative emotions that have built up in the subconscious mind. These emotions and stresses build up and overstimulate the autonomic nervous system and related mechanisms which control many automatic bodily functions, such as muscle tone and hormone production.”
In other words, we need to stop thinking of the body as a car that only lasts a few years before it breaks down totally and start thinking more about neurology and biochemistry. Dr. Brady says that 80 percent of his patients become 80 to 100 percent pain-free. Over time the cure rate holds firm. Ta-da!
If your pain moves around, it’s a good indication of mind body pain. If the left knee hurts so much that you can hardly walk on it, but two hours later the right knee hurts, and the left knee doesn’t, it’s a good indication of mind-body pain. No one is advocating the pain is false. It hurts and it’s real. In fact, the pain of fibromyalgia pain has been compared to the pain of a fractured bone. What mind body physicians are advocating is that the original cause is something different than what you’ve always been told. Maybe surgery, physical therapy, and drugs only provide temporarily relief because you have not found the root cause of your pain in these therapies.
Anyone who suffers pain knows that there is no secondary gain in having pain. With the AOS (and other similarly named programs), the idea is that your brain is trying to protect you from emotions that seem to threaten your self-image. The brain believes whatever is going on in your life is the scariest thing possible. Pain is an acceptable distraction. It’s common for the brain to choose an old injury for the site of pain because it’s sure you won’t associate it with emotions. You will automatically accept that an old injury might cause pain. Your brain will choose the symptoms that work as the best distraction for you. The brain is trying to be your friend but it’s techniques to protect you actually rob you of life.
We have to stop being embarrassed about admitting that our emotions cause us pain because hiding that fact keeps us from the treatment options that can alleviate our pain. There is nothing wrong with having emotions. Maybe the first step is to spend time in meditation telling yourself that over and over.
When pain hits, you must think psychological. Then ask yourself questions, such as, “What’s going on in my life that might be triggering this kind of pain? What is it that I don’t want to feel, admit, or deal with so I’m having intense physical pain to distract me from the real issues.”
And then, perhaps, it’s time to run an Internet search to see what mind body physicians are available in your area.