Monday, March 03, 2008
Best Life Magazine: Back pain strikes nearly 80 percent of all adults, yet its causes are not fully understood.
A growing cadre of doctors and scientists now believes that chronic back pain is a disease of the nervous system, not the spine. This breakthrough has opened the doors to new kinds of treatments that could banish back pain forever.
In its darkest moods, the demon lurking in Marc Sopher's back made it almost impossible for the family doctor to carry on with his daily routine. It would pound his lower back, sending dull throbs of pain up his spine, and then fire sharp bolts of pain down one leg and then the other. At first, Dr. Sopher tried to ignore the pain. He assumed that he'd strained something in his spine, perhaps herniated a disk or pinched a nerve. "I'm a traditionally trained physician," he says. "I started taking some anti-inflammatories and I waited for my back to heal." But the demon wouldn't go away. When holding meetings, he'd have to stand up and stretch his back. When driving, he'd have to stop and get out of the car to ease the tension in his spine. When reading bedtime stories to his kids, he'd have to lie on his stomach. There was no anatomical explanation for the extremity of his pain. "I tried to soldier on the best I could," he says. "I honestly believed I'd be living with pain for the rest of my life."
The majority of people with back pain (estimates run as high as 90 percent) will get better within seven weeks with little or no medical treatment. The body heals itself, the inflammation subsides, and the nerve relaxes. These people go back to work, pledging to avoid the sort of physical triggers that caused the pain in the first place. About 10 percent of patients don't get better. Their pain gets worse and worse: It is chronic. One day, these people find themselves lying supine on the floor, wondering what they did to deserve such agony.
Today, Dr. Sopher, who lives in Exeter, New Hampshire, no longer has back pain. He has slain his demon. When I meet him, he's drenched in sweat, having just run eight miles and played a game of tennis. Later, he'll ride his bike. His short hair is salted with white—Dr. Sopher is 46—and he still has the taut body of a young athlete. But Dr. Sopher wasn't healed by conventional medicine. He didn't undergo surgery or get epidural injections or take painkillers. Instead, Dr. Sopher is one of the thousands of patients suffering from chronic back pain who got better by treating his mind.
He learned to think differently about his pain, and that's when his pain went away. This narrative might sound suspicious—there's no shortage of phony treatments for chronic back pain—but a growing body of scientific evidence supports it. Chronic back pain is now predominantly seen as a disease of the nervous system, not the spine. It's a problem suited for psychologists and neuroscientists, not surgeons. The best treatments are often the least invasive.
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