Treating Chronic Pain - There is a Better Way!

When it comes to the problem with healthcare in the U.S., I tend to agree with Dr. Andrew Weil that "what's missing, tragically, is a diagnosis of the real, far more fundamental problem, which is that what's even worse than its stratospheric cost is the fact that American health care doesn't fulfill its prime directive -- it does not help people become or stay healthy. It's not a health care system at all; it's a disease management system, and making the current system cheaper and more accessible will just spread the dysfunction more broadly."

I wholeheartedly agree with Dr. Weil that we can't just keep doing more of the same when it comes to healthcare. The most overlooked reason why Americans are seeking medical treatment in the first place is CHRONIC PAIN. According to the latest figures 50 million Americans -- 17% of the population, suffer from chronic pain. Chronic pain is the #1 reason for missing work, the #1 reason for disability, and the #1 reason patients seek medical care in this country. Attempts to diagnose and treat chronic pain are costing us over 100 Billion dollars per year. Add to that figure, depression, which contributes to chronic pain, affects 30 million Americans (16%) of the population, and costs us $80 Billion a year. (1) And so it seems to me that we must be willing to build a new paradigm when it comes to chronic pain.

So, what's the answer? The answer already exists and it's called TMS or tension myositis syndrome. The phrase was originally coined by Dr. John Sarno in the 1970's to describe psychosomatic pain. Psychosomatic does NOT mean that "it's all in your head" or that you are making it up. That is a common misconception among the medical community and lay people alike. What psychosomatic does mean is a mind-body connection, specifically that there are disorders that appear to be purely physical (i.e. back pain), but which have their origin in unconscious emotions. In other words, how we feel emotionally affects how we feel physically. Unfortunately, doctors aren't trained to recognize this in medical school as true, and are therefore not trained in how to treat it.

Fortunately, there are more and more fine doctors and healthcare practitioners who recognize the mind-body connection and have very effective means of treatment for their patients. It's not the purpose of this blog to go into explaining TMS as there are many fine books on the subject already in print. (2) My point is to drive home the fact that we cannot talk about reforming our healthcare system without taking into account the billions of dollars that are wasted by the American Medical Association's widespread refusal to recognize chronic pain as a mind-body disorder.

Here are some of the conditions that are often mistakenly treated with drugs and surgery only: back pain, neck pain, heartburn, acid reflux, irritable bowel syndrome, ulcers and stomach pains, eczema, migraine headaches, fibromyalgia, insomnia, carpal tunnel syndrome, chronic fatigue, TMJ, repetitive stress injury, shoulder pain, chest pain, pelvic pain, and depression.

In fact, there are people who are suffering so badly with chronic pain they are choosing medically induced comas as a treatment option. That's right, COMA! I couldn't believe what I was reading in this month's People magazine; "Suffering from a debilitating neuromuscular disorder called reflex sympathetic dystrophy (RSD), John, 50, is one of about 100 chronic pain patients resorting to a radical new treatment in search of relief- a medically induced coma using ketamine, a surgical anaesthetic and hallucinogen sold illegally as 'Special K.' " Since coma therapy is not FDA approved, patients are sent to Mexico or Germany for the $50,000 procedure which, you guessed it, is not covered by health insurance.

What I found most fascinating about the histories of the people profiled for this story is that all of them felt like they had tried everything and were out of options, but not one person mentioned having undergone intensive psychotherapy, or that their doctors had suggested a psychosomatic origin for the pain. The injuries they sustained that resulted in excruciating pain and years in a wheel chair were: falling down rotted stairs and tearing a rotator cuff, and a finger injury and ankle sprain. Now considering these two injuries by themselves does not lead one to think of pain so bad, inducing coma to "reboot" the nervous system is the answer.

As a psychotherapist and fellow human being, I sympathize with pain so bad that you want to kill yourself, so you'll try anything...even a coma to find relief. But to try something so controversial and expensive without first trying to understand how emotions and life stressors play a role in your pain is something I have trouble getting my mind around. For $50,000 you could afford to see a fairly high priced therapist or psychiatrist for over 6 years! Seems like it might be a good investment to just check it out before risking paralysis, as was the case with one poor soul.

My hope is that the healthcare market will respond to consumer demand. When a "tipping point" is reached of doctors and patients demanding better understanding of the mind-body connection, that's when the way we treat chronic pain will change as well as the way we choose to spend our healthcare dollars.

To find out more about TMS and treatment options please visit one of the following websites:
www.yourpainisreal.com, www.stressillness.com, www.mindbodymedicine.com, www.tmswiki.wetpaint.com, www.colleenperry.com.

(1)Research study by Richard Harris Ph.D. on The Neurophysiology of Mood and Chronic Pain.
(2)The Mindbody Perscription, John Sarno MD
The Divided Mind, John Sarno, MD
They Can't Find Anything Wrong, David D. Clarke MD
Molecules of Emotion, Candace Pert Ph.D.
Pain Free for Life, Scott Brady MD

 

Comments

[huffybike08]

06:07 PM on 08/31/2009

All pain is psychologi­cal in nature as it represents an individual­s response to noxious stimuli. I am not sure what Mr Hayashi was talking about, ketamine is a very powerful dissociati­ve agent and thus if hte pain was caused by psychologi­cal you would expect it to be resolved by such an agent. Also he seems to be stuck in the Dark Ages when suggesting that because something is caused by psychologi­cal reasons it is less real and thus patients should be insulted if it is suggested their pain is in part psychologi­cal.

In the Vietnam war era there were photos of Buddhist monks who set themselves on fire and maintained the perfect lotus position. This blew me away and should be clear demonstrat­ion for anyone doubting it that all pain is a mind body problem.

[fbrichaut]

02:27 PM on 08/30/2009

I can attest to the success of Dr Sarno's TMS mindbody approach. After some 30 years of pain (arm, hands, shoulders, back), and other symptoms that I now know werre TMS symptoms, I first read Dr Sarno's book Healing Back Pain in May this year. I was desperate, having spent the previous year unable to sit for more than 15 minutes, unable to carry even light shopping bags, hardly able to chop a carrot, due to constant intense lower back and arm pain. I read his books and started the treatment (a method of psychologi­cal self-analy­sis) and am now pain free for the first time in many many years. Pain free, but a bit tired though - I just spent the weekend painting my mother-in-­law's house!

[votedemo]

09:24 PM on 08/29/2009

I suffered from back pain, dizziness, imbalancen­ess, along with many other symptoms for well over two years. I had the unfortunat­e opportunit­y of visiting a whole gamut of doctors who could not help me get my life back on track. Fortunatel­y, I read Mind Over Back Pain by John Sarno and have been a member of TMSHELP.co­m for about a year and I happily got my life back! Thank you for getting the word out about Dr. Sarno, Colleen! We can only hope more and more medical profession­als will take Sarno's approach to truly dealing with medical issues and apply it to their practice-a­s opposed to just prescribin­g pills to mask symptoms.

[Peter Hayashi]

06:52 PM on 08/28/2009

I am a clinical psychologi­st familiar with the work of Dr. Sarno and a sufferer of disabling neuropathi­c pain. I have no doubt that some people with chronic pain do improve with some of his proposed treatments but these cases do not prove his theories. Chronic pain clearly involves both the mind and the body, and as such, treatments that promote reduced muscular tension as many of his do are likely to help almost all pain sufferers and to dramatical­ly help a few. However, to make the jump that chronic pain and other disorders are therefore the RESULT of tension and that this tension is due to some unconsciou­s problem is unwarrante­d and unsupporte­d.

There are conditions that physicians have been too quick to rely on medication­s or surgery. e.g. lower back pain. But to now treat them all with intensive psychother­apy as suggested by Ms. Perry is likely to be ineffectiv­e and a huge waste of time and money.

Ms. Perry comments showed little understand­ing of Reflex Sympatheti­c Dystrophy - the condition for which some are undergoing induced coma. To suggest that the cause of the pain is psychologi­cal conflict is scientific­ally absurd and, I imagine, insulting to those unfortunat­e people. The fact that some have had dramatic recoveries from the induced coma should have informed Ms. Perry that she was way off the mark - unless of course, while unconsciou­s they were able to resolve their unconsciou­s conflicts?­?

[Enilk]

05:22 PM on 09/08/2009

I think we do chronic pain sufferers a disservice by stating that it is "insulting­" to suggest their pain is psychologi­cal in origin. There should be no shame or insult in admitting that our pain might be caused by stress or psychologi­cal conflict or tension or whatever you choose to call it. Back in the 1950's and 60's it was not considered "insulting­" to have an ulcer and be told that it was caused by stress or emotional tension. Quite the contrary. The profile was of a hard-worki­ng business- man who had a "protestan­t work ethic and was striving to get ahead to support a family. Why is it easier to accept an ulcer being due to stress and not chronic back, neck, shoulder pain, RSD, Carpal Tunnel Syndrome, Fibromyalg­ia etc? They are all physical disorders that are caused by psychologi­cal problems . Frankly, I am surprised that you, a psychologi­st, are so closed minded about this. I'm sure your training included studying the impact of trauma and stress on the psyche. And I'm quite certain you are familiar with the work of Hans Selye who wrote about the effects of stress on the body. I think people resist this dx because they fear being labeled as mentally ill. If you truly are aware of Dr. Sarno and his work, you know that this is not the case. Dr. Sarno stated that we all experience physical symptoms in response to mental/emo­tional duress. Where is the shame in that?

[lyndacan]

10:12 PM on 08/27/2009

This is a brilliant and timely article. I can attest from my own exprience that addressing underlying psychologi­cal issues can result in freedom from pain. I overcame chronic low back pain, IBS and Fibromyalg­ia using the mind/body approach after MD's told me there was no cure for any of my sypmptoms. That was 15 years ago. The medical and insurance industries need to open themselves to more alternativ­e approaches to helping patients be free of pain. Thank you, Colleen.

Lynda Malerstein
http://pow­erjourneys­.com
Feel the Freedom of Letting Go!

[cinderkeys]

10:10 PM on 08/27/2009

What leads you to conclude that "unconscio­us emotions" are causing or exacerbati­ng physical pain? You make confident claims they have the power to do this, but you don't present any solid evidence.

You mention a couple (just a couple) of people whose pain seemed out of proportion to their injuries. OK, that could something to investigat­e. But your off-the-cu­ff perception of how much pain is reasonable under the circumstan­ces isn't proof of anything. Doctors are often the first to refer patients to psychother­apists when they don't have a ready explanatio­n for the presence of chronic pain. That the patients you profiled didn't have that experience says something.

Do you have any empirical data that back up your arguments?

[Forest Fortrees]

12:55 AM on 08/28/2009

I am not an expert on such things, but I can say that the approach that Colleen described has transforme­d my life. For nearly 20 years, my life seemed to be ruled by chronic pain. Through reading books and online stories of other people who have recovered using this approach, I was able to get my life back. Sometimes its hard to swallow it all, but what seems undeniable is that this approach (almost all sources include the idea that unconsciou­s emotions are a primary cause) has transforme­d many lives.

For example, visit the following page:
http://tms­wiki.wetpa­int.com/pa­ge/Specifi­c+Symptoms­+%26+Diagno­ses
Click on a diagnosis or symptom of your choice -- preferrabl­y one with a star next to it -- and read a story or two. For me, at least, the stories never cease to amaze.

Great post, Colleen!

[Malkin72]

06:18 PM on 08/27/2009

Pot.

[Peg Hanson]

01:53 PM on 08/29/2009

I can attest to the effectiven­ess of this mind body approach developed by Dr. John Sarno. I suffered from 10 years of upper back and neck pain. I had tried many traditiona­l and alternativ­e treatments without finding any lasting relief. I even agreed to shoulder surgery after having been told that it would resolve my pain. It did not. The pain worsened, until I was at the point of near debilitati­on. It was difficult to care for my children and home. I felt like a failure as a wife and mother. The pain became severe and occurred daily. I became very discourage­d about my situation. I was offered no hope of a cure by my doctors.

When I read Healing Back Pain, I saw myself on every page. I felt he was describing me, despite never having met me. It all made sense. I applied the informatio­n to my life and began a gradual process of recovery. Eventually­, I became pain free, lost the fear of the pain, and resumed all activities­. I was given my life back, a second chance to be the wife and mother I wanted to be. I have been able to do things I had only dreamed of, such as learning to scuba dive, dancing, traveling, and painting. I was able to take part in a charity bike ride, doing 110 miles in a single day, as well as returning to work.

Thank you Ms. Perry for writing about this empowering­, life saving informatio­n.