Lots of folks that know me—and even some that “know” me only through reading my writings here and elsewhere—know that I have suffered from chronic back and neck pain for over ten years. It began with problems with my neck and jaw in 2007 (but, in retrospect, intermittently even before that), and worsened considerably—including spreading to my low back—after a car accident in 2008. Despite trips to numerous doctors, physical therapists, and chiropractors, I found limited relief, and not even clear diagnoses—some minor disc problems and excessive curvature in my thoracic and lumbar spine, but nothing that clearly explained all of my symptoms. I came to the unhappy conclusion that I was irrevocably “broken,” and resigned myself to a life of more limited personal and professional achievement than that to which I had once aspired. Perhaps worst of all, because I was somewhat depressed (and thus prone to overeating) and afraid of vigorous exercise (because I thought I would injure myself) I regained most of the nearly 80 pounds I had lost in my early twenties, and was moving into middle age with the beginnings of predictable health problems resulting from that weight gain.
Surprisingly, the onset of physical pain did have some positive benefits for my work as a musician and teacher. I began to pay closer attention to the way that I use my body when performing (and doing other activities), and studied ways of using the body more correctly and more efficiently. Because using my body incorrectly caused pain, I became a better player and conductor, even though I didn’t always feel as good as I had before. My teaching improved because I took extra care to steer students toward improved and more efficient approaches to their instruments. To the extent that these changes have led to lasting improvements in my work, I am thankful for the physical ailments that led me to make them. Still, I was unsatisfied with the quality of my life and work, and thus always looking for better answers to the issues I was experiencing.
In 2017, for reasons I do not even begin to recall now, I stumbled across the work of Dr. John Sarno (1923-2017), Professor of Rehabilitation Medicine at New York University. I mentioned his work in a post a few months ago and would like to elaborate just a bit more here. In works such as Healing Back Pain: The Mind-Body Connection, Sarno suggests that most chronic pain is not due to structural causes at all, but is rather an outworking of stress, tension, or even repressed emotions. Thinking back to the early days of my experience with chronic pain, one of the doctors I visited said that my symptoms sounded to him more like the result of stress at work than a real physical problem. I recall being, ironically, very angry at the suggestion, because I believed myself to not be one of “those people” that is overcome by stress to the point of experiencing physical symptoms. Still, we have no problem with attributing minor issues such as headaches, excessive perspiration, elevated heart rate, or even mild bowel or bladder disturbances to stress. It just might make sense that such negative feelings could have other, more serious physical manifestations, especially if those feelings are intense and even buried under a façade of calm (like I preferred to present, and still do). After several years of very limited success managing my symptoms, I was more receptive to the idea of a psychosomatic element in at least some of them, and began to devour books by Sarno and others who followed his model. For the first time in a long time, I saw improvement in my symptoms and overall well-being. Most importantly, I felt well enough to begin an exercise program for the first time in years, and lost all of the weight I had regained, plus another 15 pounds.
I am not suggesting that finding Sarno’s work has been a panacea. While the structural problems with my spine are mild, they really are there. The excessive curvature of my thoracic spine produces a chronically forward head posture, leaving me a bit prone to cervical headaches, TMJ problems, and such. These and other issues might still flare up at particularly stressful moments, but I have learned to not be alarmed at this, and to even anticipate flare-ups at particular times. I’ll also not recommend Sarno without a caveat or two. He is too enamored with the work of Sigmund Freud (1856-1939), and tends to blame too much on negative childhood experiences rather than present stressors. He is often overconfident, demanding an all-or-nothing approach to his theories regarding the causes of chronic pain. More recent authors that have developed these ideas further have taken a more balanced approach between physical and psychological causes. Nevertheless, since Sarno was the one who basically “started it all,” I would begin there.
A couple of additional suggestions before I close for today. The last book by John Sarno is entitled The Divided Mind, and is a collaborative effort between Sarno and several other practitioners in relevant fields, which already begins to remedy some of the excesses of Sarno’s earlier work. I am in the process now of reading a new book entitled Psychophysiologic Disorders: Trauma Informed, Interprofessional Diagnosis and Treatment by David Clarke, Howard Schubiner, Mags Clark-Smith, and Allan Abbass. Not only does this text present the very latest research and observations in this field, but it is heavily footnoted, making it a useful resource for finding further information.
If you find yourself having issues with chronic pain, as I did, by all means seek the best medical care, diagnostic imaging, physical therapy, etc. But if nothing is working and your doctors seem flummoxed, you might at least consider that your symptoms are, at least in part, a stress response of some kind rather than a purely physical phenomenon. Like I said, I was initially insulted at the suggestion, but once I accepted it I found myself on the road to a greatly improved quality of life. 100% resolution of symptoms? No—again, there really are some structural problems that really are there—but I no longer feel debilitated or hopeless, and the resumption of an exercise program has made me the most physically fit I have ever been at age 40. This is, psychologically and physically, a much better place to be.