Just as we have an epidemic of obesity, diabetes and many other chronic diseases due to lifestyle, there is also an epidemic of chronic pain syndromes. Back pain and long term pain following injury are especially common but there is a wide variety of causes with the end result of a miserable life, inability to work, frayed relationships and premature death. Estimates are that 20-30% of all Americans have some life altering form of chronic pain with one of the results being the opioid epidemic we are experiencing nationwide. As with other forms of chronic disease, economically disadvantaged people are disproportionately effected.

An enormous amount of medical therapy is directed at chronic pain syndromes. It’s well recognized that opiates are ineffective and that most back surgery is wasted, doing more harm than good, but that hasn’t stopped opiate use, surgery or other equally futile drug and interventional attempts to control this plague which costs us hundreds of billions of dollars each year and untold misery

Some chronic pain can be corrected by lifestyle change. A healthy diet and subsequent weight loss can be all that’s necessary to cure diabetic neuropathy, chronic back or knee pain.

Many approaches outside standard medicine are focused on chronic pain which often is the main reason these approaches have been developed and continue to be popular. Chiropractic, acupuncture, reiki and other treatments are helpful for some patients.

As scientists study the brain and nervous system we are starting to appreciate the complexity of the problem: so many things effect input into the centers which experience and control pain sensation. The simple solution of an operation works in limited selected conditions. Opioids and other pain medications are usually good for acute problems but never solve chronic pain syndromes. Another approach is to change how we process input. We know fakirs can train themselves to walk on burning coals and not feel pain or damage their feet. There are ways to reprogram our reaction to nerve inputs and subsequent long term pain. Meditation, hypnosis and various forms of psychotherapy all have been used with some success.

Fifty years ago a professor in NYU Medical School’s Department of Rehabilitation Medicine, John Sarno, MD, correctly predicted the epidemic of chronic pain the country is now experiencing. He hypothesized that chronic pain syndromes were often a result of unrecognized and unresolved psychological issues. As our society was becoming more complex and stressful more and more people would develop chronic pain as the somatic reflection of this psychic angst. Sarno called this “tension myositis syndrome” (TMS) since he felt that psychological problems can lead to nerve cells firing with subsequent muscle spasm and pain.

Sarno spent his career treating patients, writing and speaking about his approach to treating chronic pain. There are a few academic papers looking at results in his patients: 76 % were pain free several years later; 88% of those with CT evidence of a herniated disc were free of pain 1-3 years after seeing Sarno. David Schechter, a former Sarno student and assistant, had 51 patients with an average of nine years of severe chronic back pain; on average these patients had a 54% decrease in pain after he taught them the Sarno approach. These results are significantly better than those of similar studies using other forms of psychological treatment.

There is a small network of physicians who make use of Sarno’s approach including some orthopedic spine surgeons who have recognized the futility of surgery in most patients with chronic back pain. But in general the medical establishment has ignored or denigrated Sarno’s work. Medical training and practice revolve around drugs and procedures. It’s what physicians know and it’s lucrative. Sarno’s method is inexpensive (or free for those who study it themselves.) It’s also complication free. Sarno often commented that he was busy but got no referrals from his colleagues at NYU. His New York Times obituary commented that some NYU physicians who belittled Sarno’s work in public went to see him personally when they developed chronic pain.

Sarno’s best selling 1991 book , HEALING BACK PAIN: THE MIND-BODY CONNECTION, is still in print and is rated a “Best Seller” by Amazon. This and his other books have been translated into many languages and sold millions of copies worldwide. A movie about his life, “All the Rage: Saved by Sarno” features appearances by celebrities who successfully used his approach. Deb and I recently watched it on Amazon Prime and found it very enjoyable and interesting.