Dr John Sarno - The Mindbody Prescription

[thewza]

I just came across Dr. Sarno's method of treating back pain tonight. For those of you who don't know him, he is a PM&R attending at NYU/Rusk. He believes that most pain is related to the mind.

http://www.healingbackpain.com/

I was wondering if anyone on this forum has had experience working/talking with him. I find his ideas fascinating. I find this idea plausible because of the number of chronic pain patients I have seen with little to no identifiable pathology.

For anyone who knows him - what does he think about the whole interventional spine trend? I would imagine that he is not a fan of these interventional procedures, since he feels that most people's pain can be relieved by reading his book.

I just find the topic really interesting. Any thoughts?

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[Ligament]

I know a lot about Dr. Sarno. I just watched the two video excerpts on his website, so I'm going to comment about him.

There is a lot of truth behind what he says. There is no doubt in my mind that there is a huge influence from cognition and mood on the perception of chronic pain. The brain is "educated" to feel chronic pain in some fashion, so why not attempt to "educate" it to NOT feel pain via lectures as Sarno appears to do.

Hey, I'm a fellowship trained pain physician. There is a lot we do not understand in this field.

I can tell you, however, that as with most things in medicine, NOBODY holds all the answers.

 

[PMandR]

I worked with him when I was an OMS IV. I think I was one of only a handful of students who did because I asked him how many students he's worked with in the past. Anyhow, I also asked him what he thought about the whole interventional pain field and he simply said that a lot of people are making a lot of money from it. My take on his thoughts are that he feels it's unnecessary, frivolous, and aggrandizing 95% of the time. He also appears to feel this way regarding manipulation, orthopedic surgery, NSAIDS, etc.

I've also read his books. You can easily get the gist of his thinking and his treatment methods from his books.

For what it's worth, he's definitely right in a lot of what he says. I don't think anyone will disagree. It's just to what extent is what's debatable.

Nevertheless, I'm still planning on doing a fellowship in pain.

FYI: That website is not his. It's a completely separate company that doesn't have much to do with him. I don't even thinks he receives such great royalties from it.

 

[Polymath]

Dr. Sarno is very very interesting...
He is the reason I applied and interviewed at NYU... but...

when I went there to interview 2 years ago, the 3 attendings who interviewed me (you know, the 3 guys that lock you in that room and gang up on you all at once!) really made it seem like a bad thing that I was inquiring about him and his "theories".... in other words, when I inquired about possibly working with Dr. Sarno, they didn't take that too lightly, they all think he's a quack and have all-but locked him away in some room at NYU...thus, I knew NYU wasn't for me.

 

[rehab_sports_dr]

Regarding the Mind-Body connection:

I agree with the consensus, namely that the brain/mind has a large contribution to low back pain.

However, there is a big distinction between that general broad comment and any specific theory. To paraphrase Dr. Sarno's model, as I understand it, is that there is a syndrome called Tension Myositis Syndrome, where repressed emotional conflict presents itself as low back pain, and by resolving these repressed conflict, we can ameliorate low back pain.

I may be misquoting the theory. Regardless, this model may be true, but it does not have a great literature to support it.

I like to compare low back pain to upper respiratory infections. Most URIs are self-limited and go away on their own, so why bother going to the doctor? The reason people go the doctor is because there is a subset of URIs that are either something more serious or something that won't go away on its own.

Same thing with low back pain. A very significant portion of low back pain is self-limited and the presentation is more a function of how the mind perceives the nociceptive feedback, rather than a primary problem with a peripheral pain generator. For these patients, addressing the perception of pain (whether it be through Sarno's method or another method) may be appropriate.

The danger is in not properly addressing those subsets of patients who have clear peripheral anatomical pain generators. Particularly things like multiple myeloma or metastatic cancer.