How I Cured My Back Pain

Disclaimer: I’m not a doctor. If your back hurts, go see one. If they tell you they can’t find anything wrong with you, but you know your back still hurts like the dickens, consider what happened to me:


 

I was twenty-five years old when I threw my back out. I was working on boats at the time. On this particular job, I was leading a fleet of several dozen boats for the annual Richard Bertram Summer Cruise, which is when new boat owners follow one another through the Bahamas for a week. As the fleet captain, I led planning and weather sessions over spread-out charts to show the other captains where we would head and what to be cautious of. I fixed broken air conditioners, stopped one boat from sinking, and most importantly — I set up the margarita machine in every port of call.

The margarita machine was this massive cooled ice swirler thingamabob that we stored in the lazarette of our lead yacht. It took two people to pick up the margarita machine. Unfortunately, only one person could fit in the lazarette. I was young, dumb, with more muscles than sense, so I would go in, crouch down, pick up this machine that weighed more than I did, and waddle out with it, hunched over.

The third or fourth time I did this, I heard a pop in my back, and I went down like someone who’d had eight margaritas. I’d never felt pain like this before, not with broken bones, nothing. I spent the rest of the cruise crying, stooped over, staggering around, laying out on the deck, putting fenders under my lower back, anything to make it stop. Everything I tried made it worse. I couldn’t sleep. I could barely see through the agony.

And so began my decade of debilitating and chronic back pain.

Episodes could come on from turning my head too fast. From a long road trip. From sitting on a wooden stool for half an hour. From seemingly anything. A few times, the pain got so bad that I couldn’t get out of bed. I couldn’t move. Any attempt to stir caused paralyzing and torturous pain. Once, my wife had to wrestle me out of bed, me muffling my screams, as she helped me to the bathroom. I had at least three episodes like this a year. Some of these episodes lasted weeks or even months.

Three years ago, I was out here in Colorado for the holidays with a friend who happened to be a doctor. (A chief medical examiner in Manhattan, no less.) Never shy about asking him for advice on my ailments, I told him about my back pain (I was having an episode at the time). He said something that really pissed me off. My doctor friend told me all of my pain was in my head.

If you are like I was back then, you aren’t reading this sentence. You’ve already laughed and walked away. That’s what I did. Fortunately, this was a dear friend, and he was persistent. (He is also the smartest person I’ve ever known in person, which made his advice hard to ignore.) With this mixture of caring and brilliance, he wore me down. It took a year, but I started listening. I did some research. I discovered that quite a few really smart people agree with this theory.

One of the foremost is Dr. John Sarno at NYU, author of The Mindbody Prescription. Again, if you’re like me, you’ve already walked away just after reading the title to that book. Maybe like me you are an avowed skeptic, a rationalist, someone who does not believe in what can’t be proven. I am all of these things. Which gets in the way of me understanding some of the very real and bizarre things in the cosmos, like quantum mechanics. The world is not entirely rational. Take the placebo effect.

You’ve heard of the placebo effect, I’m sure. It’s our mind’s ability to affect the efficacy of medical treatment. It is most common in studies of chronic pain, but it shows up often enough (and is real enough) that every drug trial has to take the placebo effect into account. The effect is so powerful that one of the early researchers to study the placebo stumbled upon its powers almost by accident and could barely believe what he was seeing.

His name was Henry Beecher, and he was a medic in WWII. Running out of morphine in the field — and with more soldiers in need of treatment —Henry resorted with desperation to something he’d read about once: the power of lying to his patients. He gave them saline injections (salt water), and told them it was morphine. Many of his patients relaxed and felt no pain, even as Beecher removed their limbs and performed invasive surgery. I repeat: He cut off limbs after giving soldiers a shot of saltwater!

I was thinking about Beecher one day while lying in bed with my back “out.” I also thought about what my friend had told me in Colorado the previous year. He told me he too had suffered from back pain for over a decade. He tried everything. Finally, he cured his recurring chronic back pain after meeting with Dr. John Sarno at NYU, who convinced him that it was all in his head.

Here’s the cool thing about curing my back pain (and probably, curing yours): I didn’t have to go to a seminar, buy a book, or spend a single penny to get better. I just read study after study on this issue until I let go of my skepticism and doubt. I told myself that my back wasn’t physically injured. I told myself that the pain was in my head.

And then I got out of bed.

It was hard at first. I staggered around a bit. I was still pissed at my friend for belittling what I knew to be a very real physical injury with a very specific margarita-machine cause. I was still pissed at what I felt to be victim-blaming. What I felt to be callous and cruel dispassion. A waving away of what had plagued me for over ten years. But I was sick of the pain, and I had read enough bizarre historical accounts to begin to doubt my pigheadedness. And just like that . . . the pain went away.

There are quite a few theories as to what’s going on with chronic back pain. They don’t all agree. They might all be wrong! But they all get one thing right: For most sufferers of chronic pain, there is no physical cause. People go in and get scans, which show nothing. Doctors aren’t sure what to do, so they prescribe pain meds. But the actual locus of the pain is where all pain signals both begin and end: in the brain. (This doesn’t mean backs can’t be injured, just that the vast majority of cases reveal no physical injury to explain the pain.)

If you think that’s wonky, keep in mind that amputees often feel their ghost limbs itching. The itch isn’t on the skin, it’s in the brain. That signal just points back to the location of the itch, where some stimuli caused the initial firing. But signals can fire without any stimuli at all. When you dream, you are “seeing” with your eyes closed, often in color, and often with sound. The world we experience is pieced together by our brains, and we don’t do a very good job of it. We get a lot wrong. Including not knowing that we get any of it wrong.

An excellent overview of psychosomatic pain in the British Journal of Psychiatry suggests that recurring chronic pain often has a real and legitimate origin (such as my margarita-machine injury) but that subsequent incidences are simply a case of fearing re-injury. Many studies link anxiety and stress to chronic back pain. Other researchers have found that back pain plagues those who think of their backs as fragile and easily injured. Those who think of their backs as okay and resilient to injury avoid pain. The miracle is that those in the former group can simply decide to join the latter group. That’s what my friend did. That’s what I chose to do.

I tackled my back pain in several ways. First, I told myself that the pain was far worse than any real injury. This lowered my anxiety about the pain. The first day I tried this, the results were astounding. No medicine. No gadgets. Just a restructuring of my thoughts. “The pain is worse than anything going on in my spine,” I told myself. “I don’t have a slipped disc. I don’t need surgery. My body is protecting me from something that isn’t even amiss.”

My second attack was to reduce the stressors in my life. I stopped worrying so much about . . . everything. I reduced my workload. No more 18-hour days, 7 days a week. I set up an auto-responder on my email account and stopped trying to reply to every single thing. I spent less time staring at my computer and more time with family, more time taking pictures and breathing deeply.

I stumbled upon this study out of Northwestern University, where researchers were able to PREDICT with 85% accuracy which patients would develop debilitating back pain from an initial sensation of injury. 85% prediction rate! The indicator was crosstalk between two areas of the brain that deal with emotions and motivational behavior. One of these is the nucleus accumbens, which instructs the rest of the brain on how to interpret and respond to the outside world. Just as we can have auditory and visual hallucinations, so too can we get our perceptions of pain wrong.

What is likely occurring is a nasty feedback loop. The emotional response triggers a protective pain response, which heightens the emotional response, over and over. Breaking this loop requires calming the emotional response. This often happens by way of placebo, which is why thousands of people swear to thousands of varying (and often contradictory) cures for back pain. Inversion, heat, cold, compression, elevation, acupuncture, massage, yoga, etc. Anything convincing enough to believe that the pain should be going away often works.

Once that feedback loop is severed, you feel better. But the more you suffer from the pain, the more heightened and attuned your emotional response becomes for future attacks. This is what happened to me and what has happened to so many others. And it isn’t just back pain. Various pain fads have swept populations like viruses. Carpal tunnel outbreaks have been found to have psychosomatic origins. All it takes is the conviction that part of our bodies are fragile, to fear that pain, and then to have a slight or even imagined twinge. And then it’s on like Donkey Kong.

To understand how this happens, watch Lorimer Mosely’s TED talk. He’s got the science behind what’s going on when we feel pain. Every time, no matter what’s happening, the sensation of pain is in your head. And the majority of times, there’s nothing at all wrong with your back:

The last thing I did to completely cure myself of debilitating back pain was to exercise more intelligently. I strengthened all the little muscles that are easy to ignore. I stretched more. Because the fewer twinges I had, the fewer times I had to convince myself nothing was wrong. And along the way, I convinced myself that I was making my back stronger. Which makes me invulnerable to lower back pain. Because it’s all in my head.


 

More reading, if you want:

That crazy Northwestern study

The British Journal of Psychiatry

Everyday Health.com

Prevention.com

Psychology Today

Spine-Health.com

COMMENTS (46)

I didn’t run away from this post. :) I completely believe in this as well as other therapies.

Since working in the psychic arena, I’ve heard of instances where people’s physical pain, obsessions, fears, have been eliminated after undergoing past life regression therapy. Everything is there hidden deeply in our minds which are incredibly powerful and direct our bodies in ways we don’t realize.

There are many paths to the same result. I’m so happy you found yours.

I cured my RSI of two years with this (the mindbody prescription by Dr John Sarno, specifically) but stuff like this (past life whatever) is why it’s not more popular in mainstream medicine and why people (like me) have a really hard time buying it at first. It took almost having surgery for me to even look into it.

Psychosomatic pain is in no way woo-woo or mystical or spiritual. Our minds and bodies are connected, and our autonomic nervous system is responsible for a lot of maladies. “Breaking the loop” is simply using our conscious mind to influence our unconscious.

It’s science. Not magic.

Thanks for this Hugh.

I have a similar story. I injured my neck landing on a jump into Kosovo in 99 (used to be airborne infantry). I sucked it up for the duration of the mission but man it was agonizing. Ever since I ‘tweak’ it every year or two doing simple things (shoulder checking on my motorcycle is a common one) and go through it all again.

Exercise and reminding myself that pain is the mind killer eventually did the trick. I also don’t subscribe to any of the feng-shui crystal healing mumbo jumbo… but if you can convince yourself that the problem is a fault in the three pounds of meat computer in your skull then you can get past it.

Glad to hear you overcame it. And thanks for your service.

No problem. I couldn’t have planned my service any better. 96-00, airborne infantry, and stationed in Italy for the entire time. That was Clinton years and other than a week in Kosovo and a couple of other near call-outs it was very quiet. I got out at just the right time.

My brother in law was Army SF and served in Kosovo around the same time. He worked across the entire Clinton Theater and then in Iraq during the first war there. I wonder how close your paths crossed?

Small world. Not too likely we ran into each other, We didn’t have much to do with SF. We jumped in as a show of force after the air-war wrapped up, October 99.

Thank you so much for this post. The ideas behind this make so much sense, and I look forward to trying out this new way of looking at pain.

Many of my clients suffer from back issues. The best treatment is mental awareness and attention to strengthening exercises that unite the main musculatures in single hingeing movements. Right on, Hugh!

Thanks for this post Hugh! I really didn’t think I could become a bigger fan of your work, until just now, as I saw your world enter into my world of expertise. I’m a clinical psychologist with a specific interest in pain management. I work fulltime with chronic pain patients attempting to decrease their suffering and increase their overall level of function through the means you just discussed.
I have truly enjoyed your work over the past several years. Your Wool series helped me balance (and helped escape) the cognitive demands of writing my dissertation, and your subsequent work has provided a much needed reprieve from the challenging work I do. You are gifted, and I hope that you continue your work!
As far as your physical pain goes, I wish you the best, and it sounds like your friend has armed you with a powerful tool (wisdom). If you would ever care to have a more in depth discussion, feel free to contact me.
~Dr. Miles

Thanks, Vincent. I really appreciate that.

Holy heck! Blew out my back 20+ years ago moving a washing machine out of my truck, into the house, and down the basement stairs (young & stupid). And have been minutes away from relieving myself in the bed only to have the wife arrive home just in time to drag me to the bathroom. Same problem of absolute nothing I can pin it on and BLAM! out goes the back and me walking around hunched over for days.

So I’m going to suck it up and give this a shot — and perhaps stop recommending my favorite back belt to others. I have to get on an airplane tomorrow so here’s hoping for some early success…

Thanks, Hugh.

Great post, amazing information. Yoga works this way in reverse. As the consciousness is drawn inward to the breath and the details of the body, the false signals begin to ease. The last section of your article about exercising intelligently is the same process as meditation. It’s so important for writers to break up their long bouts of intense focus with intelligent movement and stretching.

An important distinction to make is that pain perception is at best peripherally a function of conscious thought. What matters far more is conditioning, which often relies upon our conscious thought to be created, but not during activation.

Dr. Moseley is being a tad ingenuous in his presentation when he talks about people experiencing pain that doesn’t have a source and not experiencing pain that does. None of those experiments have consistent results. This is because unconscious thought processes are involved. Highly suggestible people will be more inclined to feel pain from the helmet or on someone else’s body. Some will merely feel obligated to agree. Derren Brown, mentions this propensity when he talks about hypnotism and suggestion. Magicians seek out people who are suggestible and agreeable to work with as volunteers.

The placebo effect is some combination of the impact of suggestibility and feeling of obligation to play along or other forms of self-delusion. There’s a reason the gold standard in clinical analysis is the double-blind study. The placebo effect is very much a social artifact.

I would be careful about dismissing chronic pain treatments that involve activating sensory neurons in the region from which the pain comes. In Dr. Moseley’s Ted presentation, he mentions slow, unmyelinated nerves that carry pain sensation to the spine. This is a very low priority sensory channel whose input could easily be getting lost in the large quantity of gray matter that processes incoming signals in the spine. This theorized phenomenon of regular sensation blocking chronic pain is known as the gate theory of pain.

Back in 2008, there was a big deal going on about a product, Kinesio tape, that volleyball player Kerri Walsh was using for shoulder pain. The makers of Kinesio tape did a study which suggested that their “technique” was better than what I remember being an awful job of a sham treatment. I’m not sure if the study was double-blind and it isn’t available where I first read it. But, the sham, such as it was, wasn’t effective. What stuck out to me was that the sham treatment did not cover the area of injury. This suggested some evidence that the tape creating tension in the region of pain had a real palliative effect beyond the placebo effect.

At the end of this long, winding path, I think I’ve gained insight from your story, Hugh. I’m not convinced that we can consciously affect our sensation of pain, but we can take steps to avoid conditioned triggers which are the product of the frontal cortex deciding a situation is bad and informing the nucleus accumbens which tags the memories of the experience. By making your core stronger, reducing your basal anxiety level, reducing your anxiety about your back, and maybe reducing your quantity of sitting time, you made it less likely that you will have a back twinge that will trigger an all-out protective response by your back muscles and leave you miserable for a period of time. Further, the longer you avoid a recurrence, the more the conditioning should fade and make it even less likely you will have another back episode. At least, those are my thoughts.

I would like to add that it’s probably very helpful that you aren’t reinforcing the chain of associated traumatic back pain events in your memory by obsessing over them. That way natural conditioning extinction can occur. I guess this means I agree more than I first thought, just maybe not about the specific mechanisms at play.

Yep, I’ve had a similar experience. I was cleaning up one morning, and for no reason I can tell, I had a sudden back pain. It became progressively worse throughout the day. It improved slowly over the next few days, then I bent over to pull the blanket over my daughter one night, and was in complete agony. I was completely unable to get up out of bed, with my back spasaming painfully every few minutes.

I did eventually try ice, which helped me a little, and it wasn’t long after that that I realised it was mostly in my head. As I tensed up, expecting to feel pain, it caused it! When I worked on consciously relaxing, the pain was barely there. A few days later, it was completely gone, and I haven’t had an issue since.

Oh dear, I thought, but then I read, “My body is protecting me from something that isn’t even amiss,” and it reminded me of a respected theory about why we sometimes feel anxious for no discernible reason. The anxiety may prevent us from doing something, or even just thinking about something scary, and may thus protect us from feeling REAL fear if a current scenario (unconsciously) reminds of an earlier situation which it somehow resembles, where for some reason or other we WERE very afraid. Great article.

Thank you for sharing this, Hugh. And I’m delighted you managed to get that back pain under control and shooed it off.

I’d like to mention something that could help all readers here in reaching that inner belief that the body is just fine. It’s a modality called Emotional Freedom Techniques (EFT). It involves tapping on meridian points almost like acupuncture and saying words to focus on the issue at hand. It’s not entirely clear how it actually does work, but even if it’s just an elaborate way to bring on the placebo effect, it’s usually faster than trying to convince your brain on your own.

Full disclaimer: I use EFT regularly as therapist and coach in real life (and under a different name). I have used it for myself to reduce the pain from a broken clavicle so I could sleep when the pain meds ran out. I’ve used it to shift many, many beliefs. It’s a huge help and easy to use once you learn it. And there are EFT practicioners almost everywhere.

Interesting. I’ll pass along to my husband. He does have two herniated discs, but even he says that he definitely sees a stress connection to when his back goes out (which, luckily, hasn’t happened in a while).

I had an arm injury myself, and got “frozen shoulder” from it. I don’t think they really understand why it happens (and I think it has a hormonal factor), but the doctor said part of the reason is you hurt yourself and then overprotect your arm.

I never believed in chiropractors, working in constuction most of my life i have had bouts of backs pain, mostly for legitimate reasons. Yet the odd time an insurance company would send me to a chiropractor things got worse. I decided to sleep on a hard floor instead and the pains went away. There have been a dozen people over the years i know who go to chiropractors, and swear by them, but they can never tell me what is actually wrong with them, and they can’t tell me why the chiropractor doesn’t ‘fix’ them.
Muscle has memory, perhaps nerves do too? One hard shock to the system and the nerve keeps remembering it, so you still feel pain even though the danger is long gone.

What’s the old joke about chiropractors? How many of them does it take to screw in a lightbulb? Only one, but the lightbulb has to go back 25 times for adjustments to the screw-in process… (or something like that…) :-)

Hugh, funny you wrote this now. I did the same thing at a young age. At least I can claim a girl was involved, though. At 22, I was carrying a new TV set up the stairs to my girlfriend’s apartment when I hurt my back the first time (We’ve been married 24 years now, yes she was worth it). Since then, I’ve had back problems, often debilitating like yours. Right now, I’m in month 2 of the longest stretch of pain I’ve ever dealt with. Not intense, just stubborn. And I have often wondered if some of it was only in my mind. I’m going to check out some of your links. And get back to a regular exercise routine, which all of us who spend vast amounts of time on our butts could use. Thanks for posting this and have a Merry Christmas.

I was 27 years old, jogging three miles a day, in the best shape of my life, and decided to play tennis with a Russian colleague (who was a brilliant engineer but terrible tennis player). My lower back became so sore that I had to stop and go home. The pain in my back and right leg continued to get worse over the next few days. By the time I got to a doctor, my right leg had gone numb. I could not move my foot or feel pin pricks on it. The doctor admitted me to the hospital. The regular x-ray showed nothing. The myelogram was inconclusive. It took an MRI to reveal a herniated disk, at which point I had back surgery. The neurosurgeon who performed the surgery said that I had the worst herniated disk he’d ever seen, and that depending on the extent of the nerve damage, I might never regain full use of my leg. It took many years to fully recover from that, and even today (30 years later) I still have the occasional pain or numbness. My doctor told me that pain was your body’s way of telling you something is wrong. Maybe a lot of pain is in your head, but in my experience, you ignore it at your peril.

This couldn’t have been more timely. My partner has been struggling with back pain for going on four months now. He has been x-rayed, gone through physical therapy, tried massage, etc. There’s no identifiable (yet?) source of his pain, but it persists and is downright debilitating. I’ve forwarded this post to him. He is also a hardcore skeptic, so I don’t expect he’ll react well at first.

Meanwhile, I’m on day 34 of a cluster headache. Similarly, no remedy (traditional or not) has thus far “cured” the problem. So I’ll be delving into this material for my sake as well.

In other words, thank you!

The only problem with saying “it’s all in your head” is that the person hearing it assumes you are discounting their pain as a fantasy. The pain and their suffering is real, but it’s generated incorrectly by the brain as there is no source of injury, hence ‘in the head’.
I’ve had chronic pain issues in my leg for years after an injury to the muscle and it’s simply a matter of reminding myself that I’m not injured anymore where I feel the pain to get it to quickly subside.
Unfortunately for my neck and upper back, doctors have now discovered I have a degenerating disk combined with spinal stenosis compressing the nerves. That’s real and the pain it causes is real. However I do find it useful to use my mental tricks to convince myself it’s not ‘that bad’ and minimize the way the pain affects my day to day life.
The brain is a wonderful thing when it does what we want and an annoying SOB when it doesn’t.

I mentioned this in the post. It’s a hard thing to hear, and it can be taken as cruelty. But how else can you relay the truth? Sometimes it hurts.

I’ve assisted a family member through the Mayo Clinic’s pain rehabilitation program, and everything you’ve said here rings true with what they do there. I pushed my sister into the program in a wheelchair, as much debilitated by her medicine as her pain. Two weeks later, when she left, she was free of painkillers and literally dancing. (Although physically weak since she’d been in bed for a decade.) Just about every day I saw someone graduating the program, who had come in done with life, sure they could never even hold a job (or a child) again, and leave, for all practical purposes, cured.

The summary of their program could easily be “it’s all in your head” but more accurately (and less off-putting) it might be better put as “the cure for your pain is in your head, not in a bottle”.

The first thing they do is get you off your painkillers, cold turkey. (Or as quickly as is medically responsible.) But a large part of the program is breaking people out of their habits that reinforce the idea that they’re in pain. Lay in bed all day doing nothing and of course you’re going to think about your pain all day. They break you out of the habit of dwelling on the pain and using it as an excuse.

They also talk a lot of science about pain, (and painkillers, which are a nasty class of drugs, and can increase sensitivity to pain after extended use) and get family members involved in the program to help their loved ones transition to living without debilitating pain. (That’s why I was there.) It’s a fabulous program, with the highest rate of success of any pain management program in the world. They’re tightly involved in chronic pain research and have been building (and improving) the program for decades, using the research and results of decades of longitudinal studies on pain and recovery. More science than I’ve ever seen on the table in a hospital.

So if you don’t feel like you’re able to do it yourself, the doctors in Minnesota have decades experience helping people through it. It’s a tough program, and some people do wash out (from what I saw, mostly the ones who doubted it would work) but I’ve seen it do amazing things first-hand.

Brilliant. Great to know about.

I had exactly the same experience, and found exactly the same cure in Sarno’s book, “Healing Back Pain”.

I, too, initially injured my back thinking I was superman, and trying to life a refrigerator all by myself. After the initial incident, I experienced over ten years of excruciating back pain that nothing could cure. A friend told me about Sarno’s book, but I didn’t believe him, and it took me year before I bothered to order it (from Amazon) and give it a try. During the first reading of the book, my pain went away, then came back in a different place, all in the space of 20 minutes. After reading the entire book, and taking up his recommendations to stop all therapy, and talk to my body, I went through several weeks of watching my body go through a lot of really weird things, with the pain coming and going and moving around, until it was entirely gone. And it’s stayed gone for over a dozen years now. I didn’t need to do any special exercises or be careful about lifting things or moving about. I didn’t need chiropractic anymore, ever. The only thing I needed was to allow myself to feel the things I was using my back pain to cover up.

It’s a really miraculous book, and I’d recommend it to anyone with back pain. It may not work for everyone, but it can work for a whole lot of people. Glad it worked for you, Hugh.

This is exactly what happened to me. When I bring this up, I hear all kinds of other remedies. Acupuncture. Surgery. Reflexology. But the fact that I know at least four people who suffered from pain like this for over ten years, and all of us were cured without spending a penny on any kind of treatment, suggests that people claiming the cure has to be some other expensive remedy are succumbing to the placebo effect. And they could achieve the same results for free if they wished.

A couple of things to mention about Sarno’s theory that struck me hard. First, I had heard about mind-body-emotion pain connections before, and assumed that meant that the brain was causing the pain as some kind of self-punishment. Sarno pointed out an entirely different motive – the brain was trying to protect us from severe emotional pain, by creating a distracting pain in the physical body. As long as we were in physical pain, we didn’t have to feel or think about the emotional pain. And so the key to getting rid of the physical pain was to tell ourselves that we were willing to feel and deal with the emotional pain, so that the body could stop creating this physical pain as a distraction.

Second, Sarno says that the physical back pain we feel is real physical pain. It isn’t “all in the head”. It begins in the head, but what actually happens is that the brain sends signals to the muscles in the lower back or elsewhere to contract and tense, and this limits the blood flow in that area of the body, which causes actual physical pain to manifest. When this is done over time, chronic pain results. And it’s why some physical treatments such as massage or chiropractic can temporarily help by bringing blood to the region and helping us relax. But it comes back again when the brain resumes its distracting pattern of inducing physical pain in the back.

The real key for me was in recognizing and accepting and actually allowing myself to feel the intense emotional pain and stress I had been under for all this time, and to deal with those problems directly, first by feeling them, and then acting on those emotions. I had to change my life around big time, which you could say is what I had been resisting all that time by having to focus on all that distracting physical back pain. That wasn’t easy, but it was very important for me to do, and being relieved of the back pain was just the beginning, not the end, of the process.

Yup, I agree that the anxiety and stress cause real issues in the muscles of the back, which cause more pain.

You get a lot of response when you talk about chronic pain – and the back.

For me, I do have a scan showing a bulging disk – but I have been addressing both physically and mentally. I knew from studies that back surgery has virtually zero long-term benefit – likely for many of the reasons you state here. For even if the original injury is repaired the brain remembers. The chiropractor didn’t help, but yoga helps some as does exercising smart and using my inversion table (which I freely lend out). Choosing not to have the pain is a more difficult step, particularly when you can look at that scan. Occasionally I can feel the slip and pinpoint the beginning of that episode, but I know the result and the cure. If it just flares up with no physical cause that can be traced to stress and dealt with mentally. Working out the right muscles, as you say, gives me the confidence to avoid those altogether (as does moving to a much better job).

One thing Sarno points out in his book is that there’s no real correlation between disc wear and tear, herniated disks, and even seemingly “serious and real” back problems supposedly requiring surgery, and pain. Some people with those conditions have pain, some don’t. Some people have pain without them. There’s no widespread study which finds a correlation. In general, he suggests that only about 5% of back pain cases actually have a physical problem in the back and discs and muscles. There’s usually something one could point to that’s physical in nature, but there’ no proof at all that those troubled discs are the actual source of the pain, since a great many people with such conditions have no pain. And studies show that surgery and other interventions are incredibly ineffective at producing consistent results. For most people, it tends to become a crutch that allows them to objective their pain and believe that it’s caused from the outside. And there’s a whole lot of money to be made off that belief. Because it seems like about 95% of patients think they are in that 5% with real physical problems, rather than brain and emotion-based problems.

I’m currently in physical therapy for pelvic pain. My therapist has also been educating me on the latest findings regarding pain. At her instruction, I’ve been reading various materials and I’ve watched the Lorimer Mosely TED talk. It’s all pretty interesting stuff.

I gather that medical science used to posit that there were nerves dedicated to carrying pain impulses. Whereas now, it is believed that the nerves simply carry information – something’s touching you there, that’s warm, that’s cold, that generates pressure, etc. – and the brain then interprets the information based on all your past sensations of touch and temperature and pressure (and injury).

So, to that extent, all pain is created by the brain. But sometimes it creates pain accurately (there really is injury present), and sometimes it creates pain inaccurately (perhaps there once was injury, but this time there isn’t).

However, depending on the nature of the pain, many people may make the most complete recovery when they have the guidance of a physical therapist who knows how to work with the neurological system as well as the musculo-skeletal system. I know I wouldn’t have been able to just “think” myself out of my current pain. I am making wonderful progress, but some of the techniques are more sophisticated than mere positive thinking. I would urge folks who give the positive thinking a try and don’t get anywhere with it to seek out a physical therapist who is up on the latest research on pain and who incorporates it into his or her practice.

I felt exactly the same way. I was seeing all sorts of medical experts, and chiropractors, and even the touchy-feely types out of desperation, and I never imagined it would be remotely possible to “think” my way out of this. It had persisted for over a decade and was often debillitating. Imagine my surprise to find out that I really could cure it purely using my mind, in the space of a few weeks. I bet you can’t, because I couldn’t either. And there’s certainly no guarantees. But I will tell you that it’s not just possible, but real, and certainly worth giving it a try. I recommend getting Sarno’s book, and just reading it. You can get it on Kindle for under six bucks:

http://www.amazon.com/Healing-Back-Pain-Mind-Body-Connection-ebook/dp/B000FA5SGG/ref=sr_1_1?s=books&ie=UTF8&qid=1419288468&sr=1-1&keywords=sarno+healing+back+pain

And btw, it’s not about “positive thinking”, which doesn’t work. You’d have to read it to know what he’s talking about.

Hey Hugh,

That is so awesome you are telling others about Dr. Sarno. I’ve been experiencing the effects of finally accepting the TMS (Tension Myositis Syndrome) he teaches about as the cause of my back pain, and have had great results. The pain is real, and is caused my mild oxygen deprivation to the muscles and nerves. I’ve had back pain since my twenties, and I just turned 40. If you ever read a book about it, you ought to give “The Great Pain Deception” a try. The author builds on what Sarno teaches, and helped me better understand what to do to get better, even more so than Sarno.

I’ve been following your blog for a while, and have really enjoyed it. Your words are one of many that helped me decide to become an indie author. I’ll be putting my first book out in January. It’s a YA Sci-fi romance :) Today, I’ve been trying to figure out how to turn my Microsoft word page count to a book page count, including font size and line spacing, so I can prepare it for ebook and print. What craziness!

I’ve had episodes of agonising back pain for years. Am going to read that book, but what’s really made a difference is bell-ringing (I live in Oxford, which is full of bells.) The stretching and pulling is amazingly good exercise for backs. I’m only a beginner campanologist, but for bad backs – and for writer’s butt and blues syndrome – there’s nothing like coming to grips with three quarters of a ton of ancient bell.

I’ll be in the bell-tower come Christmas morning, making a joyful sound to ring out over the city.

Merry Christmas!

Hugh, thanks for this. I’ve been having back pain that’s been keeping me away from taekwondo for a while. I overstressed a muscle back there over a period of days, then regular life bending and moving started making it worse. Had to sit back for a few days until it got better.

Then I started doing TKD again. I thought I was better, but later that night I was in terrible pain. That was probably a legitimate re-straining, since I really thought I was better. It’s been a couple of months now, though, and this thing just isn’t going away. I’m going to give your advice a try. I never lie to myself (hah!) but it’s worth a shot. :D

Well I watched the TedTalks video and decided to try this out on my knees. About 15 years ago I jumped off a runaway horse and gave them a big shock – had to take it easy for a couple of weeks because of the knee pain. And ever since then, mostly whenever I get too inactive (ie every winter), my knees started to hella hurt whenever I used them. Just getting up off the toilet was excruciating.

But that was a week ago – and today they’re feeling so good I had to actually *remind* myself when I was going up the stairs that last week, going up stairs hurt. Love this stuff. I’m trying to be a bit objective, but I’m really psyched that it’s working.

Great post, thanks Hugh!

Easy for you to say, you are an author. You have the determination to stick to a task, like writing a book, long enough to actually complete the darn thing.
Leave it to the author to suggest that anything we put our minds to can be accomplished.
End Sarcasm. ;-)

I support your posting fully, I only wish I had better success with convincing loved ones in my community around me to believe in it too and let their mind work in their favour.

I also wish I had better success at sticking to my writing.

Thanks for the reminder.

Happy New Year.

– Dale

Great post Hugh- I am going to give this a shot, I have about 5 areas on my body that have been chronic pain centers for decades. What can it hurt?

“Mind over matter” ain’t no bullshtt.

And if you find yourself with free time, this course might be of interest:

https://www.coursera.org/course/chronicpain