“Back Pain”

Brian Lynch

This is pretty dangerous territory. Back pain is a problem for many people including doctors. The good news is that nine out of ten people do get over back pain. Besides doing psychotherapy I do, do general medicine and there is a lot of back pain in general medicine. There is just a lot of pain in medicine. 

One reason I do psychotherapy and general medicine is that I do not believe that there is a great difference between the mind and the body. Some people say “Oh the pain is in your head” meaning it is not “real.” Well, where is your head? Where is your brain? Is it not part of your body? 

We now know that our emotional pain and what we call physical pain or “ouch” pain come from much the same places in the brain. Back pain has to do with a lot with the spinal column. Where does the spine start? It starts in the brain. Back pain also has to do a lot with muscle pain.

We have known, for a very long time, that if we take 200 people and take all their X-rays, cat scans, and MRIs we find that we cannot tell who has pain and who does not have pain based on their studies. We find 100 of people that do not have back pain and 100 that do have back pain, but all of them have things out of place on their studies that look like they should have pain and mix all their studies and give them to radiologists to read. The experts cannot tell who has pain and who does not have pain.

Now this is very interesting. One hundred have pain and one hundred do not, but their studies are the same.

This is where people will get upset and I do not want people to get upset. I believe people have pain. They do have pain. Maybe their pain is not caused by what we see in the studies. Maybe the pain is much more complex. Maybe we should think differently?

When people go to surgery for these conditions only about one in three get better, but often not completely better, what is going on? 

In this short space, I want to suggest Dr. John Sarno of Columbia University. After studying many patients he has discovered that the patterns of the pain of many people just do not fit what is seen on their MRIs and x-rays. He, again, is not saying they do not have pain. He is suggesting that since our emotional and other nervous systems are so intertwined, and so connected that we channel our negative emotions into, mostly our muscles, and this usually is in our upper back and upper hips. I think it is a bit more complex than Sarno is suggesting but he is on the right track. He talks mostly of our problems with anger. I think our problems are with a more broad range of feelings such as distress, fear, shame, and disgust but it is a start. I would suggest any of his books such as “The Mindbody Prescription.”