I'm somewhat of a back pain book connoisseur these days, and am making my way through the Princeton Public Library's back pain collection.
Up til now I've been reading books about how your degenerating, bulging, herniated discs and/or weak muscles are the cause of your chronic back pain, and if you'd only do these 6, 8, or 10 exercises once, twice, or three times every day for the rest of your life, you'd be fine, you big sissy!
But I recently took three books out of the library that (mostly) throws that out the window. Tonight, I want to discuss "Mind Over Back Pain" by John Sarno. It's a relatively slim volume first published in 1982, before the days of MRIs, and it's throws all conventional back pain wisdom out the window. He refutes it all, from the physical 'causes' (he does not believe disk issues or weak muscles to cause chronic back pain) to the typical things docs or others tell you should or shouldn't do, like sleeping on a firm bed, sitting a certain way, lifting objects in certain ways, etc. He talks about why anti-inflammatories don't work (because there is no inflammation) and how you just get stuck in a pain cycle (you have the pain--the doctor tells you your disks are degenerating or bulging--you imagine your back is falling apart--this incites fear--you have more pain)
John's basically saying that your chronic back pain is a physical manifestation of an emotional issue that you haven't dealt with. Once you deal with the emotional issue, your back pain will go away. Your emotional issue causes tension. Tension means less blood flow to a muscle. Less blood flow means lack of oxygen, waste products build up in the muscle, your muscle gets tighter, it starts clenching your nerves, you have pain). So then you go to a doc who scares you with all this medical terminology and gives you muscle relaxants, and you go home and get more tense thinking about it all and how you think your back is weak and fragile, and you have more pain, and you do less, and you have more pain, it never ends.
He also talks about back pain that moves around and varies with intensity can't have a structural cause.
He also talks about the placebo effect, even with believing in his book!
He talks about how it's widely accepted that ulcers are caused by stress--and says back, shoulder, and neck pain can be caused by stress too--it's just not widely accepted because docs keep preaching about structural causes of back pain.
He talks about how when you have treatments done to you (acu, massage, chiropractic) that it alleviates the pain but doesn't cure it--because you haven't dealt with the underlying emotional issue.
Basically, every piece of advice or wisdom I've received about back pain--he has something to say about it. Not surprisingly, he's a controversial figure in the medical world. Wikipedia mostly sums up it.
Oh, and he talks about the hundreds of patients he's cured, on average having had 8 years of chronic back pain. 8 years!
A LOT of this book resonated with me. Let's see: Ibuprofen and Aleeve never really do much for my back pain, which matches the "no inflammation" statement. My back pain alternates from side to side. It varies in intensity a lot. The orthopedic doc actually said that even though I have a bulging disk, my back is actually healthy and that he doesn't know what the cause of my pain is. I know my emotional issues. Acupuncture and chiropractic have helped a lot, but they haven't eliminated my pain.
So I think the book took up residence in my subconscious. Part of his book was about how people say "don't sleep on your stomach". Sleeping on my stomach is my favorite sleeping position. In Feb 2009, the doc at the urgent care place said I should never sleep on my stomach, ever. In the book, John says it really doesn't matter. Sleep on your stomach if you'd like. Well, Sunday night I fell asleep on my back. Monday morning, I woke up and was shocked to find I was on my stomach--for the first time in 13 months. And my back pain was really light! Two nights in a row, I've had intense dreams about my emotional issues. Interesting. He also talked about how people start becoming overly conservative with physical movement, in fear of damaging their back more. He says, go out and do the activities you like doing, ramp up to them. That's what I've been doing with the gym, and if anything, I feel sore after the gym but not in more pain. Sometimes the pain is even less. So we'll see how it goes.
Tonight I had yoga with my acupuncturist. She gave me a lot of good tips for doing supported yoga.
Ok, upcoming posts: the other unconventional back pain books, my trip to Austin/San Antonio, your questions answered, and the pattern giveaway. Stay tuned.