Abstract

CONTEXT:

Chronic, nonspecific back pain is a ubiquitous problem that has frustrated both physicians and patients. Some have suggested that it is time for a "paradigm shift" in treating it. One of them is John Sarno, MD, of New York University's Rusk Institute of Rehabilitation, who has argued for this in 4 books and several journal publications. We believe that a mind-body approach is more effective and involves much less risk and expense than conventional approaches in appropriately diagnosed cases.

OBJECTIVE:

To determine if a mind-body treatment program addressing a presumed psychological etiology of persistent back pain merits further research.

DESIGN:

Case series outcome study.

SETTING:

Single physician's office in metropolitan Los Angeles.

PATIENTS:

Fifty-one patients with chronic back pain, diagnosed with tension myositis syndrome, a diagnosis for "functional" back pain and treated in the principal investigator's office in 2002 and 2003.

INTERVENTIONS:

A program of office visits, written educational materials, a structured workbook (guided journal), educational audio CDs, and, in some cases, individual psychotherapy.

MAIN OUTCOME MEASURES:

Pain intensity (visual analog scale scores), quality of life (RAND SF-12), medication usage, and activity level (questionnaires). Follow-up was at least 3 to 12 months after treatment.

RESULTS:

Mean VAS scores decreased 52% for "average" pain (P < .0001), 35% for "worst" pain (P < .0001), and 65% for "least" pain (P < .0001). SF-12 Physical Health scores rose >9 units (P = .005). Medication usage decreased (P = .0008). Activity levels increased (P =.03). Participants aged >47 years and in pain for >3 years benefited most.