Pain Management: A MindBody Approach
Recently I read an article in the Integrative Practitioner online site written by Sharon Utberg, DC. She cites the work of Dr. Sarno who helped many, many patients eliminate pain in their back, neck and shoulder – not through injections, exercise, drugs or surgery – but through connecting the pain they felt with the underlying emotional pain.
“Interested in exploring why the mind chooses to mask emotional turmoil with physical symptoms and pain? Contemplating how positive and negative stress generates unconscious anger accumulating to unconscious rage that leads to physical symptoms of pain? Is one reaction to pressure physical symptoms as a response to our inner feelings?
If any of those questions resonate with you when confronting patients with pain, especially neuro-musculoskeletal pain, then the MindBody work of John E. Sarno, M.D. will be of interest to you. As far back as the 1970’s, Dr. Sarno began to doubt the validity of conventional diagnosis and treatment for back, neck and shoulder pain. He coined the term—Tension Myositis Syndrome (TMS) to describe a “painful but harmless change of state in muscles”. Dr. Sarno discusses this syndrome at length in his 1998 book, Mindbody Prescription. He described TMS as a, “psychologically induced manifestation of pain primarily used as an avoidance technique or strategy to turn attention away from suppressed feelings or emotions.”
Based on Dr. Sarno’s theory, emotions stimulate the brain to produce the physical symptoms. Because the pain is caused by repressed, unconscious feelings, acknowledging and accepting this psychological basis for the pain quickly resolves the symptoms. His first book, Healing Back Pain, came out in 1991, and made Dr. Sarno a pioneer in the field of mindbody medicine for the treatment of pain.
As a Professor of Rehabilitation Medicine at New York University School of Medicine and attending physician at the Rusk Institute of Rehabilitation Medicine at New York University Medical Center, Dr. Sarno was a respected voice for some very new treatment ideas. The notion of successfully treating many disorders of the back, neck and limbs without drugs, physical therapy or surgery was revolutionary.
In his extensive years of private practice, Dr. Sarno found certain personality characteristics common in people with TMS. These included hardworking, responsible, perfectionist, compulsive and conscientious personality types. He also found that when the patients were able to acknowledge, agree and accept the emotional role in their conditions that very often the symptoms disappeared.
Another interesting physical commonality in patients with TMS was the tenderness to palpation in three distinct muscle groups regardless of the primary pain condition. The upper trapezius muscles, the lower lumbar paravertebral muscles and the gluteal muscles were consistently tight and painful to touch. This finding lead Dr. Sarno to consider the central nervous system as the originator of the pain rather than any localized structural abnormality at the location of the patient’s primary complaint.
One of the most interesting aspects of Dr. Sarno’s work is that with nothing more than one consultation visit and two additional educational meetings, 80-85% of the patient’s were symptom free. If pain persisted, additional psychological counseling and exploration was recommended. The effectiveness of the treatment seems to be predominately due to the awareness of the patient of the psychological component of their pain disorder. The patient takes control of the source of their pain using knowledge as the key to break free. This appears to be a very powerful mindbody approach and one to consider when looking for answers to help manage our patient’s pain.
For more information on Dr. Sarno’s work go to: Healing Back Pain
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