True Pain Management

On my reference list from last week, I included 3 books about dealing with pain. Nortin Hadler MD in Stabbed in the Back and John Sarno MD in Healing Back Pain tread where the medical world has feared to go for the past century. They leave the standard medical approach to back pain (or any pain) behind and propose new perspectives. These books and their authors are bold and honest and real. Back pain is the most over x-rayed, over "surgerized" and over medicated entity in medicine and the path through rarely is found in the way we deal with it in standard medicine. Enter alternative/complementary medicine in the form of massage, chiropractic care, acupuncture, herbs for pain and inflammation; these approaches have been embraced for the last 2 decades and offer a whole new avenue to pursue. It has never been clear who gets better, why they get better if they do or the role of these modalities in prevention. While I favor these approaches to standard medicine, it is more than a little unclear what the prescribed healing remedy is in any given situation.

So, how to manage these "drainers" of energy and "zappers" of life and pleasure. Nortin Hadler MD, John Sarno MD and Pete Egoscue (inventor of the Egoscue Method of therapy -- a yoga based physical therapy that has helped and empowered many people with this challenge) all have confronted the issue of back pain head on. They have different styles and approaches but they all offer very real solutions to this poorly classified and disasterously managed entity which is a national epidemic.

Sarno focuses on emotions and emotional expression. Hadler suggests allowing the body to "naturally heal" with time and non-medical interventions while Egoscue utilizes yoga and postural therapy to correct damaging asymmetries.

At this time, there are no defining studies of what is the best therapy or what approach suits which patient or clinical presentation. However, what these 3 bold pioneers have done is opened up the "black box" and offered very real and helpful solutions for real people with very real pain. It is a conversation that is long overdue. It is a start to addressing and healing the most common affliction in our society. All three offer healthful approaches: yoga, emotional acknowledgment and expression, time and natural healing.

The one thing that is clear is that back pain (as well as so many of the ailments seen in primary care and medicine in general) is NOT straightforward and not just about the body. We have to open up the playing field. We have to to look at the whole life of the client -- not just the body. We have to look at the lifestyle, the life, the emotions as well as the spirit and mind of each individual to develop a plan and a path that is right for them (not a generic recipe that is right for the condition). In short, we must become holistic and integrative if we are going to truly take on this challenge. Even that sells our client short if we do not look at the client first and foremost. Working with back pain is never easy or fun for the sufferer but it is an opportunity to explore life and all its messages to us.