Articles

Why Does My Back Hurt?

Michele Lowenthal MS, MHC / mind-body counselor

Back pain is ubiquitous. Nearly everyone experiences it sometime in his or her life. We all know someone who is on Social Security Disability because of back pain. Doctors are inundated with patients in constant pain and generally send them for MRIs to ascertain the cause. Anything seen on the MRI that seems to look abnormal tends to be labeled as the source of the trouble. Many suffers are advised to get cortisone shots or sent to physical therapy for relief. Some undergo multiple surgical interventions while others become dependent on pain medications. Many decide to go for chiropractic adjustments or acupuncture. Then, there is the burgeoning industry devoted exclusively to back pain offering comfort items such as cushions, chairs, mattresses, heating devices, orthotics and more. Most instances of back pain resolve over time. Nevertheless, back pain tends to reappear.

In the 1970's, John Sarno, MD, a Professor of Rehabilitation Medicine at the New York University School of Medicine, began to realize that the location of pain his patients were exhibiting, such as herniated or slipped disks, did not seem to correlate to the diagnoses they had been given. He began talking to his patients about what was going on in their lives and as they confided in him, he started to see a pattern emerge, that possibly their pain might be related to stresses of life. As he shared his findings with his patients, many began to recover. He did not fully understand at the time the physical mechanism of how emotions create pain but he was certain there was a connection. He called the condition TMS, Tension Myositis Syndrome, because he believed the condition affected the muscles. He later came to understand that TMS also could affect tendons and nerves as well the gastrointestinal system, skin and other parts and systems of the body.

In the 1970's, John Sarno, MD, a Professor of Rehabilitation Medicine at the New York University School of Medicine, began to realize that the location of pain his patients were exhibiting, such as herniated or slipped disks, did not seem to correlate to the diagnoses they had been given. He began talking to his patients about what was going on in their lives and as they confided in him, he started to see a pattern emerge, that possibly their pain might be related to stresses of life. As he shared his findings with his patients, many began to recover. He did not fully understand at the time the physical mechanism of how emotions create pain but he was certain there was a connection. He called the condition TMS, Tension Myositis Syndrome, because he believed the condition affected the muscles. He later came to understand that TMS also could affect tendons and nerves as well the gastrointestinal system, skin and other parts and systems of the body.

Our spines tend to change as we age and what looks abnormal in a scan may very well be a "normal abnormality", a term coined by Dr. Sarno. He explains that our hair turning gray is normal as we age. Our spines undergo physical changes as well that may or may not have anything to do with pain.

The true purpose of pain is to keep our emotionally painful thoughts from coming to consciousness. Sometimes we are triggered in the present by an unconscious memory from the past. If this memory or emotion is very difficult to bear, our brain will distract us quickly with the best preoccupation there is-pain. When we are in pain, we become extremely focused on how to get relief from the physical pain and our emotional pain is pushed to the background. The usual emotional culprits are intense anger and fear although there are quite a few other issues that many be in considered such as low self-esteem or psychological trauma. In addition, the person with certain personality traits such as perfectionism and people pleasing tend to be more likely to experience chronic pain... It is important to note that we do not have to change our personality to become pain free- we just need to be aware of the traits that are complicit.

While I believe that physicians, physical therapists, chiropractors and other practitioners are sincere in the treatments they provide and truly want to help their patients, they have unfortunately convinced their patients into believing they have incurable injuries or malformations. Once a patient has a diagnosis, s/he becomes conditioned to having the symptoms of that diagnosis. They become conditioned to pain at certain times of the day and while in certain positions. The patient feels disabled and lives that way. They are told how to lift or not to lift at all, how to bend, sit, what sleep positions to use and not use, and what physical activities to stay away from because they could damage our backs. We are often told our backs are fragile or out of alignment and that is why we are in pain and need treatments to correct this. All of these treatments are temporary because eventually we will experience the pain again and return for more treatments, shots, medications, or surgeries. Unfortunately, the real culprit for the pain is ignored by most professionals. I work with those clients who are able to believe there is an emotional connection to their pain. I require that each client be first examined by a physician to rule out any real physical conditions as not all pain is due to TMS. There may be tumors, fractures or cancers causing pain in a small percentage of cases. My goal is to help the client to understand the stresses and emotions in the present and past that are contributing to the pain. Once the client can allow those repressed feelings to emerge to consciousness and make peace with them, there is no longer any purpose for the pain

Other conditions that fall under the same umbrella as back pain are Fibromyalgia, neck, shoulder, knee, arm and leg pain. Please visit my website, backpaincounseling.com for a more complete listing of TMS conditions

Sarno, J. (1991). Healing back pain: The mind-body connection. New York, NY: Warner Books.