ONE DAY ABOUT four years ago I noticed a pain in my back. Sometimes sharp, most times dull, it was pervasive and insistent, lodged deep as an internal organ. It must have crept in before I registered it, because once I did I couldn’t remember not having it. Back pain is like that: It becomes part of you, like the thickness around one’s jawline as one ages, or that thing you did that you regret. If you’ve had it, you know that some days it hurts when you move like that, and some days it hurts when you move, and some days it hurts. If you haven’t, you don’t know what I’m talking about. You don’t know how lucky you are.
My primary care doctor asked a few questions, rapped on my spine, made me touch my toes. She smiled sympathetically. “Here’s a physical therapist I like,” she said, scribbling on a pad. “Your insurance will pay for a few massages, or acupuncture if you’d rather. Or both. Or a chiropractor!”
What, no kitchen sink? I thought, suddenly pissy. No shaman? “But what’s wrong with me?” I demanded.
The doc sat down and took off her glasses. “I must see four, five patients like you a month. Nonspecific back pain. No injury. We don’t know what’s wrong with you. What you do is try this, then try that. And expect success. Because really—why expect failure?” I stared at her. “I’d start with physical therapy,” she offered, opening the door for me. “And let me know.”
I called the physical therapist that afternoon, wincing as I bent for the phone book, trying to expect success but wishing I had a slightly firmer grasp on why I should. Over the next few months that wish intensified, as I pulled on stretchy bands and perched on rubber balls, laboring to heed my spry physical therapist by strengthening my core. “But…the pain is on the right,” I pointed out. “This really doesn’t feel like a core issue.”
“It’s all a core issue!” he sang. “Have you tried yoga?”
One by one I ticked off the fixes; one by one they failed to fix me. It wasn’t all for naught—from the chiropractor I learned never to cross my legs while sitting, and that by the way I had scoliosis and should really see him for weekly adjustments. An acupuncturist cleared up a sinus thing like magic, while a massage therapist taught me that even the most severe back pain will temporarily dim against the screaming torture that is deep-tissue massage.
But countless Aleves, dozens of office chair positions, three lumbar support structures, and about 30,000 core-strengthening Kegels later, I had to concede that on the trial and error scorecard, error was winning. I was done messing around. Time for an orthopedist.
He slid me into an MRI tube and showed me the pictures. “I suppose this might be an injury,” he said vaguely, pointing to a place on the field of gray that looked ever-so-slightly grayer. “We-ell…I did fall on the ice a couple years ago…could that be it?” I ventured. “Must be,” he shrugged, virtually oozing medical certainty, and put me down for a cortisone shot. “Now, you never know with this stuff—might work days, could work years,” he said as the needle toured the interior of my flesh. What I got was two perfect weeks.
When the pain came back, I was standing in the kitchen with my friend George, a kindred sufferer from way back. I felt the familiar stab as I stooped to unload the dishwasher, and immediately he saw it on my face. “Your back again, isn’t it,” he said. I burst into tears.
“Did you ever read that book I gave you? Mind Over Back Pain?” he asked gently. I’d read it: the 1982 volume by New York University school of medicine professor Dr. John Sarno laid out the controversial theory that most chronic back pain isn’t structural at all. Instead it’s a manifestation of tension, like ulcers are, that commonly afflicts Type A personalities with high self-expectations and mouthy inner critics.
In sober medical language the book laid out the underpinnings of tension myositis syndrome: sensible-sounding stuff involving tension-induced changes in circulation leading to blood deprivation and resultant pain to certain areas—usually the upper or lower back. Recognize tension as the source of the pain, and voila!—no more need for the pain to psychosomatically present, no more pain. According to Sarno, 76 percent of his patients were pain-free within weeks of this realization, and remained so three years later.
Even the most severe back pain will temporarily dim against the screaming torture that is deep-tissue massage.
“Come on, George,” I barked, despairing. “All you have to do is believe it’s tension and the pain will magically disappear? Give me a break.” Sure, I fit the personality type—but this was an injury, remember?
Fast-forward four years. Back pain was still my selfish houseguest, only lodged now in my upper back, where it had fiendishly taken to mincing a nerve whenever I moved. When I finally had to call in sick on its account, I trudged back to my primary doc. “I’m afraid there’s just nothing more we can try,” she sighed. “I mean, short of surgery. But since the pain relocated, we know it isn’t an injury.”
We know it isn’t an injury.
I flew home, pulled Mind Over Back Pain off a dusty basement bookshelf, and reread the thing in a sitting.
And at last I…well, I believed.
I am a stress monster, I said aloud. It was the first declaration in all these years of obsessing about my condition that I categorically knew to be true. After all the ball balancing, all the needles—here was a fix I could have faith in. If anyone’s body was going to have to scream at her about unrealistic self-expectations…it was mine.
Say what you will about the woo-woo mind-body connection, or about the fact that despite Sarno’s astonishing anecdotal record his tension myositis syndrome has never been scientifically validated. His book said relief typically comes two to three weeks after this realization, and can be expected to stay.
And that’s exactly what happened. As I write, I’m four months pain-free, and crossing my fingers and—for the record, Mr. Chiropractor—my legs.