Back pain is extremely common, but there is not great consensus about how it should be treated. Billions are spent on surgery without much evidence that it makes a significant difference. Our guest, Dr. Nortin Hadler, has examined the evidence and finds it lacking when it comes to regional back pain.
Our other guest, Dr. John Sarno, agrees that surgery, drugs or manipulation are not generally helpful. He has a unique approach to back pain. What do his patients think?
Guests: Nortin Hadler, MD, MACP, FACR, FACOEM, is author of Stabbed in the Back: Confronting Back Pain in an Overtreated Society. He is professor of medicine, microbiology and immunology at the University of North Carolina at Chapel Hill and attending rheumatologist at UNC Hospitals. His previous books include Worried Sick: A Prescription for Health in an Overtreated America and The Last Well Person: How to Stay Well Despite the Health Care System. The photo is of Dr. Hadler.
John Sarno, MD, is attending physician at the Howard A. Rusk Institute of rehabilitation medicine at New York University Medical Center and professor of clinical rehabilitation medicine at NYU School of Medicine. His books include: Mind Over Back Pain, Healing Back Pain: the Mind-Body Connection, The Mindbody Prescription: Healing the Body, Healing the Pain and The Divided Mind: The Epidemic of Mindbody Disorders.
Madeline Guven heads Guven Design, a graphic design firm that produces Memopause notepads. She has experience as a patient of Dr. Sarno.
The podcast of this program will be available the Monday after the broadcast date. Podcasts can be downloaded for free for six weeks after the date of broadcast. After that time has passed, digital downloads are available for $2.99. CDs may be purchased at any time after broadcast for $9.99.

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  1. Stephanie C

    I can tell you right now that Dr Sarnos books work! I know many many people who have spent thousands of dollars on drugs and surgery and if there is not pathological reason for the pain its TMS. For those of you who don’t want to accept the diagnosis good for you because when a well respected neurologist told me it was stress and I didn’t want to believe him it cost me 7 years of paralysis.
    When I heard it from Sarno I accepted it but back then I knew nothing about the good doctor. Sarno is not arrogant he has stumbled upon something that has helped millions and he is not a quack he doesn’t need the money if he did he would promote the hilt out of his books. Most of them are from word of mouth.

  2. Fingal M.

    I have read two of Dr. Sarno’s books, and he makes very clear that back pain may be caused by physical pathologies which must be ruled out before beginning his program. He also states that, once he started screening out potential patients who seemed unreceptive to the notion that their pain might be psychological in origin, his success rate went to 90+% (if I recall correctly).
    Nobody who reads his books with any care can come away with the belief that he claims that all back pain can be made to disappear with one office visit, two lectures, and no physical therapy. Just the great majority of it. If he’s even half right, it sounds to me as though his approach would be worth a shot for most people (noting the caveats about ruling out serious underlying pathologies).
    Someone experiencing back pain, who rejects the possibility that psychological factors could be at cause, citing only a feeling of “I don’t think so,” is perfectly free to do so, and may even be proved correct, but is not practicing science.

  3. Sara C

    While the two doctors interviewed contributed a helpful counterbalance to the surgical approach to back pain, I found the show as a whole simplistic. There are many many possible physiological, muscular and dietary influences on back pain other than Sarno’s blanket “It’s all from negative emotions” nostrum. For a few: sugars in the diet cause muscle tension; weak abdominal muscles, whether from surgery or whatever reason, stress the low back; constant sedentary work at a computer causes muscular imbalance which hurts the back indirectly; et cetera et cetera.
    There’s a big middle spectrum between spinal surgery, on the one hand, and “it’s all psychosomatic,” on the other, that needs investigation.
    You might have mentioned massage, breath work, physical therapy and strengthening regimens like Pilates as benign forms of therapy that loosen imbalanced ligaments, tighten the abs., teach you to walk properly and breathe properly

  4. FCS

    Yes, Dr. Sarno has a great point in many cases. I am a Licensed Mental Health Counselor and before I ever became licensed, I applied that same knowledge. A client in a group I ran had severe pain for quite a while caused by lifting his child, or so he thought. He told the story of his narcotic addicted nurse brother who committed suicide. My client appeared to be carrying the burden of that loss to the extent that I saw his pain as his emotional shrine to his brother.
    Once I suggested that to him, he returned without pain the next week and I ran into him 2 years later and still he had no pain. he thanked me for helping him to free himself through recognition. Note: He had many interventions and physical therapy prior to our group meetings.
    We do carry our pain for many reasons physically after the emotional pain becomes strong enough yet we fail to see the connection. I think certain diseases come on because we harbor unspoken emotions and thoughts connected to the loss of a loved one. It is as though if we go where they are, we have now done more than we did for them prior to their death.

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