Chronic Pain Relief

MBS Blog  13

The layers of wellness: levels of coping with TMS/MBS

I have spoken to so many people who are frustrated that their TMS symptoms have not gotten better yet.  They have read so many accounts of people who have read Dr. Sarno’s books and immediately gotten better.  They wonder why they haven’t had the same response.  This can lead to increased worrying: worrying about what’s wrong with them, if they really have TMS or not, if they are making themselves sicker by worrying, and this vicious cycle can go on and on.

On the TMS Help Forum and other web sites, there are many excellent suggestions about methods of self-help and books that people have used to vanquish their TMS symptoms.  Most of these are great resources and can be helpful to many.

I was talking about this the other day with a good friend and excellent psychologist, Mark Lumley from Wayne State University.  He and I actually ended up writing a little poem about the layers of work that many people may need to do to get better.  I must warn you, neither of us are poets, so the so-called poem isn’t very poetic.  But we like it because it means something important to us.  Here it is.

Things to do:

Notice what has been hidden;

Understand what has been a mystery.

Speak what has been unspoken;

Confront what has been avoided.

Accept what needs to be accepted;

Forgive what needs to be forgiven.

Change what needs to be changed.

Howard Schubiner, MD and Mark Lumley, Ph.D.

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This is the second part of a blog about back pain.  This blog deals with the MBS approach to understanding back pain.

How can back pain occur in the absence of something wrong with the back?

There is a way to explain this based on new research into how the brain changes over time (neuroplasticity).  One way is to consider what happens in phantom limb syndrome.  In this situation, there is pain in the area of the body that is missing; that has been amputated.  Clearly, there is nothing wrong with the area where the pain is felt, yet there can be severe pain.  In this case, the pain appears to be due to sensitization of nerve fibers that go back to the brain, amplification of pain in the brain and a conditioned response of nerve fibers going back to the body.  The brain and body have in essence learned to have this pain.  The nerve connections have gotten fired after the amputation, but then have gotten “wired” and keep sending pain signals, which are felt to be in the amputated limb.  It is likely that back pain (and other pain syndromes, including headaches, abdominal and pelvic pain, whiplash, fibromyalgia and TMJ pain) is caused in many people by similar nerve pathways. 

What triggers this type of back pain to start and become chronic?

The answer is surprising and even offensive to some people and that is stress and emotional reactions to stressful events.  A classic study showed the Boeing employees over four years and found that psychological stress predicted back pain much more than any other variable, including how much they used their back on their job.  Other studies in Sweden, Holland, and England showed similar findings.  In fact, job satisfaction is the most important factor that appears to determine if someone will develop chronic back pain or return to work after back surgery.  Read more »

Conventional “knowledge” tells us that we were not meant to walk upright and that backs typically degenerate over time which leads to chronic back pain.  If back pain was caused by degeneration of the back and the discs between the vertebrae, then it would make sense that back pain would increase with age.  This is not the case however.  Back pain actually drops a bit after age 65.  We have been told that back pain will occur more often in people who use their backs more often.  However, in studies from around the world, more people have back pain in industrialized, modern societies than in rural, agrarian societies. 

What is the cause of back pain?  There are several serious medical conditions that can cause back pain, such as a vertebral fracture (usually a compression fracture seen in the elderly or those with osteopenia), cancer of the vertebrae (seen in those with metastatic breast, lung or prostate cancer), serious abdominal conditions such as rupture of an abdominal aortic aneurysm, pancreatic cancer, rupture of a duodenal ulcer, or infections such as osteomyelitis, epidural abscess or diskitis.  Fortunately, these conditons are relatively rare and easy to diagnose with modern imaging techniques (X-ray, CT or MRI). 

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MBS Blog –  #9 Mindfulness Meditation

I have been a devoted and passionate teacher of mindfulness meditation for about 15 years.  Many people have misconceptions about meditation.  The most common misperception is that meditation is about relaxing.  Of course, meditation may be relaxing at times, but not always and the intent is not relaxation, but obtaining a better understanding of yourself, and learning to respond to body sensations and thoughts/emotions more deliberately, and learning to live fully in the moments of our lives.  Mindfulness meditation is a form of meditation that asks people to simply pay very close attention to the here and now, to the present moment, to what is happening right now, whatever that may be.  One of the great things about mindfulness is that one can practice it at any moment, no mater what you are doing or what is going on.  That makes it quite useful as a way to cope with the ups and downs of life.

The reason to learn mindfulness meditation techniques for people with Mind Body syndrome is that it can help a great deal in learning to live fully in the present and to learn to let go of some of the things that tend to perpetuate MBS, such as fear, anxiety, sadness, issues from the past, or worries about the future. 

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MBS BLOG # 8

Genetics and Mind Body Syndrome

Everyone knows that genes “controls” our lives.  But how powerful an influence do our genes play in our lives?  Of course, these issues have been debated for many years since the discovery of genes and the classic experiments of Gregor Mendel in 1865 on pea plants genetics.  We wonder not only at the similarities of facial features of children and their parents, but also at their personality quirks that seem to be passed down through genes.  There have been many books that purported to show that genes control everything.  So, when we are told that a certain disease is genetic.  We often assume that we are destined to be affected and that treatment may have little effect.

First, you must realize that there are certain genes that do have powerful effects that will produce diseases if those genes are present.  For example, cystic fibrosis and sickle cell anemia are diseases produced by inherited genes.  If you have those genes, you will get the disease.  However, it is also clear that different people with the same genes can have differing levels of that disease, even in CF and sickle cell.

Other diseases have some contributions from genes, but these contributions are either minor or variable.  For example, breast cancer has been found to have genetic components, but most people with breast cancer do not have the breast cancer gene.  There are genetic contributions to asthma and migraine headaches, but these are relatively small contributions in comparison to the effects of genes on height, ADHD and schizophrenia, which have heritability factors of 0.8-0.9.  The heritability factors of asthma and migraine headaches are in the range of 0.4-0.5, i.e. much smaller effects. Read more »