Virtual Surgery On Back Pain: Combining Convensional Therapy and John Sarno

Here’s the previous two posts on my own process in returning to full physical function:

Let me do a brief way-back, from late 2010 / early ’11, where owing to heavy weight lifting, I ended up with intense pain in my right shoulder and arm, accompanied by weakness and some numbness. After some weeks of waiting for it to go away (I had never experienced chronic pain before), I ended up going to a chiropractor for ART. When that did nothing but empty my pocketbook after some sessions (thought it was a rotator cuff issue), I blogged about it and both Dr. kurt harris and Dr. Doug McGuff told me to get a book by John E. Sarno: Healing Back Pain: The Mind-Body Connection. It covers neck, shoulder, arm and a bunch of other pains too (all essentially the same thing).

I kinda dismissed it. You’re telling me this is all in my head? What absurd, woo woo gibberish. Then, I got an MRI and sure enough: cervical herniation. Ha! See? Cause (herniation, “pinched nerve”) —> Effect (pain). Fix the herniation/pinch, pain goes away; healed, all nice & tidy. But there’s a few things I wasn’t aware of:

  1. Very few people get relief from spinal surgery.
  2. Most people over 20 have some level of spinal degeneration (just like hair falls out, wrinkles appear, etc.) and over 50, almost everyone has disc herniations. Kurt Harris, longtime MD radiologist, confirmed this. Dr. Sarno calls these “normal abnormalities.”
  3. Most people in #2 have zero symptoms of pain (also confirmed by Harris).
  4. And if #3 isn’t cause for hmm, something’s not adding up here, Harris also told me that people with crushed vertebrae from an accident 1) have far less general and specific pain than these people with ‘normal abnormalities’, and 2) the pain typically goes away after a few weeks, just like a broken leg.

So I read Sarno and literally, as I’m reading the introduction, I begin to get some relief after a couple months of near constant pain. Over a process of two weeks, it was eventually gone completely. Came back twice, separated by a couple of months each time and I dispensed with it in two weeks and then a week, respectively. Pain free there ever since. Eventually, the weakness and slight numbness went away, too.

Unfortunately, I didn’t learn my lesson because this time, I was convinced that this time, I really had an injury that required addressing and that it was possible to make things worse; so I babied myself, not realizing that was just feeding into whatever was going on in my head.

That said, I think there’s a better way to do Sarno than just approach it from a mind only standpoint. I’ll explain. But first, what is Sarno and this TMS? Here, you can get a very decent overview in this John Stossel 20/20 segment from some years back. (Stossel himself got rid of 2 decades of back pain in one 3-hr. Sarno lecture.)

The very most common error people make when first presented with this information is just how I dismissed it at first. Here’s how I put it in a comment reply under that video:

“But it would be your subconscious tricking the body that it’s in pain???”

This is the most common misunderstanding of Sarno’s work. The pain is not “in your head.” The pain is absolutely, 100% real and physical. It’s caused by oxygen deprivation to muscle, tendon and nerve tissue, and oxygen deprivation causes intense pain—this is why often, someone with a tiny herniation, or nothing at all, will be in far greater (real) pain than the real pain experienced from crushed vertebrae or a broken femur (both of which will heal in weeks and the pain will go away).

Anyway, the pain is real. However, it’s not being caused by whatever structural thing you think you have. It’s real pain being caused by your mind. Once you realize this and that there’s nothing wrong with you (except whatever is going on in your head), you’re on your way. Ironically, most people don’t even need to understand what emotions or stresses or rage might be going on, such that their mind is creating a diversion from that mental pain (your brain thinks it’s doing you a favor) by means of creating physical pain. Simply understanding that’s what it is is enough for most people, including myself…

The pain is real, absolutely physical, but also psychological in origin—not a pimple on your spinal disc (nor stenosis, that virtually everyone has as they age). It is, in fact, a coincidence. Just because you find firemen at fires doesn’t mean they’re typically the cause of fires.

Sarno is pretty damn simple.

  1. First and foremost, realize that your condition is normal and common, normally with zero symptoms, and that there’s nothing wrong with you.
  2. Pushing through the pain rather than baby yourself will not produce greater injury, because there is no injury.
  3. It is completely unnecessary to psychoanalyze yourself to determine why your brain is sending signals to tissues to constrict, thereby causing oxygen deprivation to those tissues, thus enormous pain. Is is sufficient that you understand that’s what’s happening and absolutely accept that as the cause of your pain.

Of course, you get better at it, just as I did each time the shoulder and arm pain returned for me and why, in just a few days (now that I finally decided to go full force with those steps above), I’m completely pain free a very good portion of the time—and have even been doing some sitting at the computer now, for the first time in two weeks exactly—since I picked up the Topo ergonomic standing desk mat.

So, that’s the experience I wish to pass on now, since in my reading, while a lot of people use Sarno and only Sarno, some take pretty long to fully recover—months even. I think you can shorten that by using a number of therapeutic temporary pain relieving techniques: NOT to heal your chronic pain, but to better understand what’s really going on, affirming those three keys to making Sarno work.

So, this is where you get to self experiment, to see what gives you the best relief and you enjoy doing the most. The key is, it needs to be something that increases blood flow to the painful tissues, or dilates their blood vessels directly. Why? Because the real pain is being caused by oxygen deprivation to tissues. Increased general bloodflow or direct dilation brings more oxygen, pain goes away or you get significant temporary relief. Some ideas.

  • Deep massage
  • Focussed meditative or Yoga like relaxation
  • Exercise with an aerobic element (get blood pumping)
  • Heat application
  • Vibration
  • Stretching
  • Chiropractic (with a chiropractor who understands Sarno and can direct therepy towards increased blood flow)
  • Postural stuff (dependent upon where the pain is; e.g., standing a lot for back pain)

There are probably others. Here’s my go-to list in order of effectiveness, enjoyment and ease, for me.

  1. Sunbeam 730-811 Heating Pad plus Massage. Hands down the most effective, easy to use device. I carry one in my backpack. The heat dilates blood vessels, undercutting the oxygen deprivation, and the vibration confuses your local senses, aiding in relaxation. I think the vibration aspect greatly increases the time with relief.
  2. Hot baths and the hot tub. Same thing, only more widespread blood vessel dilation. I also use a couple cups of epsom salts in the bathtub. No idea if the magnesium absorption does anything. Can’t hurt.
  3. Teeter Hang Ups EP 560 Inversion Table. This took a while to implement and may have made things worse initially because I was anything but relaxed; I was more tense. Easing the ankle hold one notch changed that and made it into a focussed relaxation table for me. It’s most effective on the hip pain. It’s probably a combination of stretching and relaxation increasing general blood flow, thus undercutting oxygen deprivation.
  4. VARIDESK PRO combined with a Topo Ergonomic Standing Desk Mat. Probably a number of complex postural, exercise things going on here. It’s really what finally put me over the hump by essentially not sitting for two weeks until later in the evening for TV. Plus, at that level it’s quite fatiguing so sleep (and relaxation) was improved.
  5. Walking. No brainier. Do it more, even if it hurts. Push through the pain.

So, please keep in mind. None of this will work to fix your chronic pain issue unless you see it for what it is. What it is is to demonstrate to you exactly what you have accepted in those three Sarno steps I outlined. Because, once you dial your mind into what’s going on, you’re going to notice that when, for instance, you apply that vibrating heating pad to your right hip and the pain recedes, now your calf, shin, or hamstring aches—or your left hip. Or, now you have a tension headache. Or, you suddenly have angina-like chest pain.

That’s when your self-diagnosis becomes real. You become a “believer,” and it’s all downhill from there. That’s when, actually, the pain becomes amusing; and once you can sincerely laugh at it and yourself, you’ll know you have it nailed.

One last thing: but what about the fact that spinal surgery works for some? For the same reason sugar pills work for some. The placebo effect is well documented and very real. What’s likely happening is that subjects sincerely believe cutting away some tiny part of a vertebrae will give their pimple-pinched nerve more “room,” and it won’t cause pain anymore. This belief, for some, is tantamount to understanding the Sarno process, which minimally requires suspension of disbelief; so bang, no more pain. The downside is, what happens if the pain eventually comes back—which happens for the vast majority of those who’ve had spinal surgery? What happens is they become one of those people you all known, who’ve had 4, 5, 6 and more back surgeries.

So, I’m glad I finally decided that I was once again going to forget about surgery, and go full force with Sarno; and this time, it took 2 days. I’m 100% pain free 95% of the time since yesterday. Took a drive in my X-5 for lunch a bit ago (I was barely leaving the house weeks ago). That’s the seat that causes me the most excruciating pain no matter how I adjust it. Got in and bang! There’s that pain. I smiled, laughed a bit, said something like “nope, you’re not going to get me,” and by the time the light turned green, it was beginning to fad away and soon was a mere shadow.

And, when I got back in the car to return, less shadow still.

This shit works. But hopefully, like me, you’ll find that a combined process, so that 1) you get some temporary relief, and 2) understand the true purpose of that relief (to affirm what’s going on) will greatly accelerate your recovery over a Sarno-only approach.

Richard Nikoley

I'm Richard Nikoley. Free The Animal began in 2003 and as of 2021, contains 5,000 posts. I blog what I wish...from health, diet, and food to travel and lifestyle; to politics, social antagonism, expat-living location and time independent—while you sleep—income. I celebrate the audacity and hubris to live by your own exclusive authority and take your own chances. Read More


  1. Tim Maitski on January 15, 2015 at 17:18

    Glad to hear that it worked for you.

    I read that book years ago and remember watching John Stossel’s video. I’ve never had severe pain but a used it to help with some “pinched” nerves in my neck and shoulder . Never was certain if it was real or not.

    I tried to share the book with my wife who has bad chronic back pain but she pretty much threw the book back at me saying that it wasn’t in her head. It’s tough to get someone to buy onto the theory. But you can tell that every time something is bothering her, her back pain really flares up.

    • Richard Nikoley on January 15, 2015 at 18:38

      Sarno would tell her she’s very wrong.

      The pain is very real.

      But, there’s also people who don’t really want to fix it. Some people enjoy the various dispensations they get when they have pain.

    • Cindy C on January 16, 2015 at 20:24

      This study was in science news recently on pain and the emotions. Many will agree that stress will make their pain worse, but it is harder for them to pin it on their emotions. We can point out how embarrassment can lead to blushing, and nervousness can lead to “butterflies in the stomach”. Dr Sarno books have helped me in the past. The actual study mentioned , I have not read.

    • Richard Nikoley on January 16, 2015 at 08:39

      To clarify, Sarno would say she’s misunderstanding him. He’s not saying it’s all in your head.

      This point is so difficult to get across because people react instantly with rage and then shut off and out. You have to stress: the pain is real. But, your brain is causing it, not a pimple (or whatever other minor injury).

    • John on March 22, 2015 at 05:28

      I don’t get your point, how could someone enjoy back pain?

  2. Janet on January 15, 2015 at 17:36

    I learned first about TMS from you in a January 2014 post. It was just a mention, but at the time I was perplexed by a pain in my hip that made going up stairs very hard. I could only think it was from a time in the previous summer I had stepped off my bike and put my foot down “wrong” and felt a twinge in my hip. It came around a bit, but one evening at a movie with my husband in January I just got up from my chair at the theater and could hardly walk my hip hurt so badly. I wondered WTF was happening. I searched around on the webs, tried ice and heat, ibuprofen, blah, blah. I would have a day here and there where there was no pain, but then back it came. It was the only pain area I had. BUT, after a couple of weeks, I decided I was not going to get on the merry-go-round of doctors, drugs, shots, more blah, blah but find something different as I just could not figure out why all the pain and no real injury I could figure out. Then I saw your mention of TMS and Sarno. I work at a library so checked out the book. I was positive this was “me” and as I read more books on the subject, including The Great Pain Deception (awesome) my pain started to subside. I just saw myself on every page. The book that finally gave me total relief was one by Fred Amir–Rapid Recovery from Back and Neck Pain: A Nine-Step Recovery Plan. I read to the point where he gives some specific commands and “talk” phrases to use. That night, I talked those commands and statements about my pain before I went to bed. I was succinct and said them in a powerful, confident way. 5 times. The next morning my hip pain was GONE and has not returned. I then was able to identify times where my hip area gets a funny feeling in it–not so much pain as a pulsing hot feeling and I tell my subconscious to leave me alone–I ain’t buying it anymore. It stops. I have worked this on knee pain as well. I think the thing I am doing now is stopping and trying to assess what my feelings and moods are at the time I am feeling them. I don’t try and find the reason why but just identify them and validate these feelings. It’s ok to be angry or anxious sometimes. I am a pleaser and perfectionist and emotion stuffer. That’s why I know my issues with pain are probably TMS. I so enjoy your posts on this subject and my thoughts are with you on your healing and I am taking more info from your many smart readers. I am grateful I read your post that day. Have you looked in on all the useful information and the forum at the TMS Wiki website. I got personal responses back from Steve–the author of the Great Pain Deception. Everyone there is so helpful and encouraging and it’s full of resources on TMS.

    • Richard Nikoley on January 16, 2015 at 08:42

      Hey Janet.

      Glad this stuff is helping. Haven’t looked into any online resources yet and anyway, I’m the kind who likes to get up and over it and forget about it and move on. For me, just the act of writing these last three posts has been tremendously thereputic.

      I’m reading Steve’s book now, actually.

  3. wilberfan on January 15, 2015 at 17:40

    Glad you were open minded enough to let some Sarno in. I became aware of him back in 2000 when I had a long bout with back pain. Not everyone is able/willing to accept the *possibility* that his ideas could have some merit. If you ever want to read some more, there’s a great ‘layman’s’ book out there: “The Great Pain Deception” by Steve Ozanich. (There are also some good books by doctors that have been helped by/or studied with Dr. S.)

    • Richard Nikoley on January 15, 2015 at 18:44


      Hey, long time no see.

      Yea, I mentioned Steve’s book in my last post. It’s good work.

  4. Jed on January 15, 2015 at 21:32

    I don’t know if you’re familiar with ‘tapping’, EFT? It can work on pain and you do end up chasing the pain, and it does leave the body. It has to do with moving the stuck energy, often brought about by psychological issues. For example, I tripped in a hole in my backyard, fell, and strained my ankle, but I stayed down on the ground and tapped for about ten minutes, saying, “even though I fell and strained my ankle, I deeply and completely love and accept myself.” After about five minutes the pain started to become a general numbness, and after about ten minutes of tapping, the pain was gone and replaced by numbness. I babied the ankled and it got completely better in days. This works for physical pain as well as emotional issues, and I’d bet it would work on the back to an extent. Since you’ve begun looking at social and emotional reasons and reactions that cause pain, you might try checking out EFT for pain issues.

  5. Dr. Curmudgeon Gee on January 15, 2015 at 22:36

    EFT sounds like a form of bio-feedback to me;

  6. Lars on January 16, 2015 at 03:36

    This pain – oxygenation thing rings true. I have used “conscious breathing” (similar to Buteyko) to remedy my asthma. The same breathing technique and a breathing exercise where you inhale thru your nose and exhale thru a device that restricts air flow during exhalation really helped a lot when i have experienced “chronic” back/shoulder pain that the chiropractor couldn’t budge.

    for more on this and the device

    You can test it with out the device by following this

    or by emulating the device with something like a straw for exhaling. I ussually feel less tense, warm and calm with less pain in about 5-10 minutes.

    The trick for me so far has been to stop the spiral of pain/tension/pain before it’s in full swing.

    Checking out TMS for sure!

  7. james london on January 16, 2015 at 04:33

    “nope, you’re not going to get me” made me smile – I went through the same, telling my subconscious to fuck off when it tries playing sneaky tricks.

    This was about 8 years ago when the Sarno approach worked for me, and very very occasionally I still get random debilitating pain in a foot or something.

    I don’t completely agree that it’s not necessary to analyse why your brain needs to distract you with pain. Eg if you are stressed or angry about something it might not be enough to be mindful without addressing the source of the anger. In my case I had to end a crappy relationship. The pain left before I actually ended the relationship because I told my sub-conscious that I would definitely do it in a few months.

  8. John on January 16, 2015 at 06:44

    I read Sarno’s book a long time ago, but in the beginning, didn’t he incorporate massage therapy into his treatment? I think it certainly makes sense to incorporate some sort of physical component into therapy, especially if it’s not too expensive and carries little or no risk.

    Also, have you ever read the NLP books that Bandler and Grinder wrote? In the fifth chapter of Trance-formations, they talk about a patient they who had hysterical paralysis that they treated with hypnosis. In the example they gave, they moved the paralysis from one arm, to the other, to the legs. Doing this demonstrated to the patient that the cause of pain wasn’t physical (like the heating pad did for you). Bandler and Grinder’s theory was that the paralysis served some sort of subconscious purpose, and sometimes they could come up with a more elegant way for that subconscious part to serve that purpose.

    • Richard Nikoley on January 16, 2015 at 07:42

      John, no haven’t read but what I do think is that any sort of therepy that works to relieve pain and has a mind component to it, such that you clearly see its your brain doing this to you and causing a real physical response, has value. That list above is just my list. I like the heating vibrating pad the best because it’s cheap ($30), I can take it anywhere, requires no appointment, and does its deal in minutes.

  9. Steven Jame on January 16, 2015 at 06:48

    Doctor John E Sarno video is amazing.

  10. John on January 16, 2015 at 08:19

    Maybe I did essentially the same thing to deal with an injury about 5 years ago. While doing squats, I felt a twinge in my lower back, and for several months I had pretty serious localized pain that radiated into my hip and surrounding area. After rolling on a lacrosse ball, trying to stretch, and avoiding squats in the gym (as they seemed the obvious culprit, pain was most acute while doing them). I finally just said fuck it, this isn’t killing me, its just annoying, and went full force on the squats anyway.

    After months of dealing with pretty severe pain, the pain went away. Basically, after ignoring it for a while and doing the very thing that injured me, one day I thought “oh yeah, what happened to that pain I was feeling a while ago?”

    A few years later when I had a cervical herniation, it was a different story. Felt a knife stab in my shoulder while in the gym, walked out with difficulty breathing trying to keep my eyes open. Subsided enough after a couple of hours that I was able to cook dinner at my dad’s house. Everyone was asking me if I was alright because I looked really bad.

    The next morning I woke up at 5 struggling to breathe, tried walking and eventually collapsed on the couch trying to make the pain shooting from my shoulder to my fingertips go away. Orthopedic doctor gave me muscle relaxers, heavy dose advil, and some other anti inflammatory drug. I was surprised when he said it was a herniation, since I had no pain at all in my spine; it was all neck muscles to shoulder to arm to fingers. He explained about the nerves in the area and the pressure etc.

    For months, I couldn’t sleep for more than 2 hours without getting up for 30 minutes in excruciating pain to grind my shoulderblade on the wall, hoping for the pain to drop enough so that I’d pass out from exhaustion for another hour or 2.

    When this happened, I knew it was related to the stress I was under at the time. I was 2 weeks out from taking the bar exam. This totally fucked me; 2 weeks of minimal sleep, constant pain, and inability to focus did not help for 12 hours of testing over 2 days in a city that took 3 hours to drive to with a girlfriend that was also taking the bar and more stressed than I (btw, NEVER share a hotel room with your girlfriend if you’re both taking the bar exam, or even a car to get there, for that matter). I think muscle relaxers affect my vision, too, it was blurry while I was on them.

    Anyway, I go to a physical therapist, once, then decided the place is full of shit. During the consult, after asking why I’m there, they give me a look like I’m crazy and say “yeah you don’t have a herniated disk, how do I know? Hah, well you’d be a lot worse, lets just put it that way.” (This was before the MRI confirmation; I didn’t take the time to go back and show them). Then the therapy involved grabbing rubber bands and doing tricep extensions, etc, with about 1lb resistance. The kind of shit you imagine 90 year olds doing to help them ease the walk from their electronic scooters to the couch.

    Basically, I just went on living, got back in the gym doing real weights as quickly as possible (thought it took a while to get back into squats!), and finally the pain went away.

    I was reading the blog Chaos and Pain a lot back then. The guy is big on thinking for yourself, doing your own thing, and rejecting bullshit (all in the most offensive way possible). He basically called workout regimens advising long recovery periods as bullshit, advocated 2 a day workouts basically full force all the time, and encouraged the philosophy that if you want to be good at something, go 100%, don’t buy “less is more,” and crush it in the gym. To demonstrate efficacy, he wound up setting some world record lifts, deliberately going against conventional training wisdom, with relatively little prep time, then called weightlifting ridiculously easy to get to the top in afterwords. I never followed his regimen (funny, I get hurt while doing a 3 day a week Leangains minimalist routine). I bring that up because that was the only place where I read the equivalent of “you will get hurt in the gym. Everyone who is good trains when he’s hurt. Don’t treat yourself like a pussy, get in there, and do what you have to do to keep going, unless you can’t.”

    I’m only in my mid 30’s. Perhaps someday the pain will return and I’ll regret ignoring everyone around me, and giving up physical therapy to resume heavy lifting as soon as possible. I feel pretty damn good right now.

    • Richard Nikoley on January 16, 2015 at 08:26

      The description of your arm pain sure brings back vivid memories. Oh, man, worst, most persistent pain ever. Yea, blurry vision too. Sometimes I wanted to tear my right deltoid off my arm in ‘if thine eye offends thee, pluck it out’ fashion.

    • John on January 16, 2015 at 09:00

      Yeah your description in blog posts was almost exactly what I felt at times. Sounds like it got you worse, though – I never thought up an exit plan!

  11. mart on January 16, 2015 at 09:35

    is this helpful for all types of pain? I have terrible carpal tunnel pain in hands and forearms. Does anyone have experience of Sarno’s technique working on more than one or two different types of pain?

    • Richard Nikoley on January 16, 2015 at 10:27

      Lots of hits when I Googled ‘sarno carpel tunnel’

  12. Pippy on January 16, 2015 at 11:12

    I would add Pilates training to your list. I bet a Pilates workout, ideally 2x per week for at least a month, with a reputable instructor would bring back pain relief. Either a mat or reformer workout should be equally effective. Pilates training works muscles differently than weight lifting and is a complex set of movements (if done correctly), therefore it can bring blood flow to tissues that might be missed in your normal workout. It will re-train and strengthen the muscles and neuromuscular junctions around your abdomen and spine to better support your back. Before all you guys dismiss Pilates as a girly thing, read up on Joseph Pilates. Men who are too afraid of looking silly in a room full of women are really missing out on an opportunity to improve their health, IMHO.

    P.S. I tried honey at bedtime – got great sleep, vivid dreams, and more energy in the morning. Love the Tiger Nuts! Trying the SBO probiotics as well, but too soon to notice any effects. Thanks for exploring and introducing these ideas.

    • Dr. Curmudgeon Gee on January 16, 2015 at 21:15

      Pilates is good (if you can tolerate the boredom)
      although i like Feldenkrais more tho.

  13. Ulfric Douglas on January 17, 2015 at 09:22

    I would prioritis changing your X5’s seats … for what? I don’t know but I would always recommend OLD Volvo.
    Go to a scrapyard and sit in a lot of driving seats, don’t forget to try old Volvo 240, 740 and 940.

  14. Charlene on January 17, 2015 at 09:44

    Glad you’re finding your way out of pain, Richard. I was wondering if it would help too to activate the vagus nerve parasympathetic nervous system using deep abdominal breathing during pain.

  15. Anna on January 17, 2015 at 11:03

    I use two balls – one tennis ball, and one gym ball.

    The gym ball is now my “chair” at work. Sitting on a gym ball forces me to use various core muscles just to keep sitting. Result: more blood flow.

    The tennis ball is a sort of low-cost massage/naprapathic therapy. Lying on a gym mat, I place the ball between the hurting muscle (basically my butt/thigh region) and the floor and then use my body weight to create the effect.

    This has been quite effective and I can now do things like sleep a whole night through, walking up a stair or get off my bicycle without feeling any pain. I’ve had the pain for three years (it started when I was pregnant) and it cleared in a matter of months once I started with the balls. I have tried many other things that didn’t really help, e.g. naprapathy (would probably work if one could afford two sessions a week for months), stretching, various types of strength exercise, and anti-inflammatory drugs.

  16. Dr. Curmudgeon Gee on January 17, 2015 at 19:52

    i agree one should resume the normal exercise asap.
    but not sure “pushing through the pain” is a good idea tho.

  17. Lisa Truitt on January 19, 2015 at 09:03

    Hi Richard. I wonder if this has implications for other physical problems/illnesses? Can other health problems be caused by the same thing?

  18. Rita on January 19, 2015 at 09:30

    Hey John: I think there’s something to your frequency theory. I read a study that said runners who run more frequently suffer less injury. Ironically – I’ve found that everything hurts when I run twice a week, but when I run 5-6 days a week, no pain.

  19. damndirtyape - on January 19, 2015 at 15:07

    Back pain from disc degeneration is not always psychogenic – I have had a lifetime of facet joint pain at L4/L5 that doesn’t look “too bad” on an MRI, yet causes a slow ache to build and build when I stand to the point where it becomes like a hot knife stabbed in the back.

    This pain is purely mechanical and can be relieved by taking the weight off my spine, or someone can even do it firmly pulling the vertebrae apart with their hands. Pain will go from unbearable to perfectly normal in an instant.

    On the other hand, my wife suffers from a lot TMS type pain and muscle spasms. For her, anti-anxiety/ muscle relaxants do wonders. For me the don’t do a damn thing. Only taking taking weight off the facets works.

    Not everything is “in your head” Her TMS type back pain was initiated by an injury, but like so many things with the body, once it finds an avenue to express tension and anxiety etc, that weak link is strengthened by repeated occurrences and the mental effects they bring out establish pathways that can persist long after the acute injury.

  20. Charlesp on January 20, 2015 at 15:37

    I’ve been using a standing desk for two years and it really helps with postural issues. But there is also a lot of research that standing all day is as bad as sitting. The experts I interviewed for my piece in the Financial Times said 75% standing 25% sitting is the ideal mix. That’s easiest to do with a motorized stand up desk.

  21. Mark on January 20, 2015 at 15:39

    What worked for my back was the book “The Multifidus Back Pain Solution” by Jim Johnson. The book spends most of its time describing how the back works, but the key is that unbalanced multifidus muscles cause back pain in many individuals.

    His recommendation is to use the “bird dog” exercise ( to strengthen the unbalanced muscles.

    Obviously this would not work for cases described by Dr. Sarno, but it worked for me.

  22. Cassandra on January 21, 2015 at 10:36

    Have you thought about trying float therapy? Besides being one of the coolest feelings I’ve ever experienced, it almost completely cured me of 5 years of chronic neck/shoulder pain. I’ve only done 5 sessions, but I’m already looking into getting a float tank installed in my house. There’s a ton of scientific literature on the healing/pain relief/psychological benefits of float tanks. You should check it out.

  23. mountainfit on January 26, 2015 at 09:38

    So let me get this straight, the fact I can no longer feel the lateral aspect of my foot, or most of the S1 nerve distribution, which started 3 weeks pre surgery and showed significant improvement immediately following surgery (therefore probably not a result of surgery itself) was completely a mind issue.

    I agree pain can be caused by psychological stress, and if not caused, worsened. But what you wrote us kinda dangerous, as every case of spinal or nerve root compromise is a case by case basis. Had my doctors actually listened to me, instead of assumed I was seeking drugs (which I never asked for) I’d probably have had surgery 3 weeks earlier and regained 100% function of my nerve. Instead, at best I regained 70% strength and 50% sensory.

    So yeah, when you limb becomes weak, and losses feeling, and an MRI shows a disk fragment that the radiologist puts an exact size onto, fuck the mind over sensibility thing a get into a good surgeon ASAP.

    • Richard Nikoley on January 26, 2015 at 09:50

      No, not what I’m saying. Giving my experience. This jives with the experience of many others.

      Sarno emphasizes over and over that one must be screened by competent folks to rule out ACTUAL injury first and decide if various treatments like surgery are appropriate.

      There are tons of people who fall into the coincidence category, where they have pain chronically, and oh, there’s a small disc herniation.

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