Dr. Ronald D. Siegel - Back Sense: A Revolutionary Approach to Halting the Cycle of Chronic Back Pain

F OR OUR FAMILIES,

AND OUR PATIENTS

CONTENTS

ACKNOWLEDGMENTS

Many people have made substantial contributions to the creation of this book. We would, first of all, like to thank the researchers and clinicians whose work laid the foundation for the Back Sense program. In particular, wed like to acknowledge Dr. John Sarno, a pioneer in understanding the role of the mind in back pain; and Dr. James Rainville, who has developed practical, proven programs of functional restoration and introduced us to the crucial importance of resuming full physical activity in curing back pain. We would also like to thank Dr. Eugenio Martinez, who has worked with us in perfecting an integrated approach to treatment, and to thank as well the numerous other colleagues who have shared their ideas and encouraged us in our work.

We are very grateful to the many people at the Doubleday Broadway Publishing Group who have helped bring the book to completion, especially to our editor, Patricia Medved, who suggested innumerable improvements to the manuscript; to Gerald Howard, who was the first to see the completed manuscript and eased our first-time-author anxieties; and to Jennifer Griffin, who originally brought us to Broadway Books.

Our agent, Ira Silverberg, and his colleagues at Donadio & Olson, have offered us great assistance and encouragement in seeing the work through from initial inspiration to completed book.

For their astute counsel and aid during several stages of the books evolution, wed like to thank Jennifer Brehl, Mark Dalton, Alan Litner, and Deborah Weisgall.

For their help in reading and refining the manuscript, we would like to thank Dr. Parakrama Ananta, Fred Armstrong, Florie Arons, Dr. Michele Bograd, Shari Duane, Joyce Jansen, Robert Jenne, David Johnson, Dr. Eugenio Martinez, Ellen Matathia, Dr. Andrew Mazur, Dr. James Rainville, Joan Stoddard, and others who prefer to remain anonymous.

We are also especially indebted to our patients, who have taught us so much about the treatment of back pain and have actively helped us to develop this program.

Finally, we cannot say enough to adequately thank our families for their considerable patience, sound advice, and enduring support: Mary Ann Dalton; Christa, Anna, Michael, and Sarah Johnson; Gina Arons; and Alexandra and Julia Siegel.

PART 1

UNDERSTANDING

CHRONIC

BACK PAIN

CHAPTER 1

A NEW APPROACH TO BACK PAIN

BACK PAIN BULLETIN!

If youve been suffering with back pain, we dont need to tell you just how bad it can get. Its an ordeal. You suffer, your family suffers, your friends suffer, your work suffers. Your whole quality of life can take a nosedive. There are millions of other people with the same problem, but that doesnt make it any easier to handle. We know that its hard to believe, but the book you hold in your hands can helpand help a lot. Its about an exciting new approach to understanding and treating chronic back pain that integrates the very best from both traditional and alternative medicine so you can resume your normal life as soon as possible. It is based on an explosion of recent scientific research that leads to a whole new way of understanding and treating back pain that has become a chronic problem (lingered more than a couple of months).

Simply put, the book makes three major points:

1. The cause of most chronic back pain is generally misunderstood by both sufferers and the medical community. It is usually thought to be the result of damaged or defective parts in the back. This is a perfectly natural assumption, but, strange as this seems, it simply isnt true. A great deal of scientific research has been done on chronic back pain, and the findings point in a completely different direction. So what does cause chronic back pain? The evidence tells us that while the problem may start with a physical injury or strain, those things usually heal quickly on their own. Tight muscles cause the pain to last, and stress is to blame for tight musclesstress over pain, worries about the future, disappointments over unsuccessful cures, fears of surgery, anxieties about medical bills, problems at work, unhappiness over strained relationships. The pain is certainly not all in your head. We know that it is completely real. Muscle tension and spasms can cause intense pain.

2. Most current back pain treatment methods dont work very well because they misunderstand the real cause of the pain. Again the research contradicts typical medical practice. If you are like most people, youve taken your back troubles to one or more doctors. You may have been told to rest, take medicine, or attend back school. Perhaps youve tried special cushions, braces, physical therapy, a chiropractor, or even surgery. Youre probably very careful to avoid reinjuring yourself. Some of these measures may have helped to a degree, but they probably havent solved your problem entirely or you wouldnt be reading this book. Conventional treatments miss the real cause of most back troublethey simply dont address the stress and muscle pain problem.

Most treatments also emphasize taking it easy, trying not to hurt yourself, or waiting for the pain to go away before resuming activity. Yet all the research and our experience with patients show that a quick return to unrestricted physical movement is the fastest and surest way to recovery.

3. We have great news about your hurting back! Back Sense describes a new way to treat chronic back pain that is more effective and less expensive than conventional methods and allows you to resume full activity. Its goals are to help you understand the true causes of chronic back pain, reduce your stress, and restore your life. The especially exciting part is that you can heal yourself without special treatments and without having to accept disability and the loss of your favorite pastimes. The methods we describe have already helped thousands of back pain sufferers before you. Theyre safe, toolow risk for almost everyone (well tell you how to make sure theyre right for you).

We know that all of this is very hard to believe if youve been stuck with back pain for months or years. We were also extremely skeptical when we first heard about it. Please take a chance and read on. The news in this book can be your way out of pain.

HAPPY ENDING: ONE PATIENTS TRUE STORY

Up until now we have been talking about chronic back pain in general. Here is the story of one mans struggle with the ailmenthow he suffered and eventually got better. Your own story will be different, but you may find similarities to what youve experienced.

Im in my forties now, married, a professional. I was in my early thirties when the ordeal began. I was in decent shape and enjoyed outdoor sports. While on vacation visiting my brother, I decided to try out his cross-country ski machine. The next day, when my back started to ache, I figured that the machine had overstressed my muscles. Like most of us, I had gotten backaches before. But when I returned home from vacation, the pain was worse. I got a bit anxious when the pain moved into my leg, since I thought that this might indicate a nerve problem.
After a couple of weeks of pain I was starting to worry. Not only was the ache still there, but my toes went numb when I was walking. I went to my doctor, who looked worried herself. She sent me to see an orthopedic surgeon connected with a famous medical school. The surgeon ordered a CAT scan of my lower spine and told me to rest in bed until the results were known.