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shawnsmith
Czech Republic
2048 Posts |
 Posted - 01/07/2011 : 06:36:33
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From recent Johns Hopkins newsletter
Johns Hopkins Health Alerts: Back Pain
** Considering Behavioral Therapy for Back Pain
A reader asks: I started having low back pain a couple of months ago,
and I've had to be reassigned at my job. My doctor wants me to enroll
in behavioral therapy sessions. Shouldn't I first see whether
medication works? Here's what we recommend.
Although most people's low back pain resolves within four to six
weeks, pain that doesn't respond within this period is more likely to
become chronic. That's why it's important to seek effective treatment
as soon as it becomes clear that the pain won't go away easily.
A study in the Archives of Physical Medicine and Rehabilitation looked
at people with back pain that had begun six to 10 weeks earlier. A
total of 67 people were randomized to receive either behavioral
intervention, in which a clinician counseled participants on effective
ways to cope with pain, or a control group in which clinicians
provided support but no specific suggestions. All participants also
received standard care, such as medication and physical therapy.
The study found that people assigned to behavioral intervention were
more likely than those in the control group to be recovered from their
pain after six months (52% versus 31%).
If your doctor is recommending behavioral therapy, it's important to
give it a try. It could very well make the difference between recovery
and living with chronic back pain. |
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Dave
USA
1864 Posts |
Posted - 01/07/2011 : 15:43:38
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Typically this kind of therapy is designed to help one "cope" with pain. The assumption is that the pain is due to some physical or structural cause and we just have to learn to deal with it. The therapy often accompanies physical therapy. This is counterproductive to TMS recovery.
While it is true that in TMS we have to learn to "cope" it is equally important to accept that the pain is purely due to psychological factors and not physical, and to cease physical treatments.
CBT could be helpful in learning how to diffuse anxiety which in turn could ease TMS pain, but this method of treatment is not endorsed by Dr. Sarno. |
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PTosh
Portugal
10 Posts |
Posted - 01/12/2011 : 19:16:35
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| No, this doctor is obviously ignorant about TMS, so I wouldn't follow any of his advice on this matter. If you had a stomach problem, would you seek advice of an orthopedist? Of course not, because he doesn't have the necessary knowledge to deal with stomach problems. In this case is the same, you shouldn't seek advice of someone who doesn't have the knowledge. |
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Hillbilly
USA
385 Posts |
Posted - 01/13/2011 : 11:47:02
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PTosh,
If you think about it objectively, Sarno's entire treatment program is based on CBT principles until a patient fails in his/her attempt to resolve their pain. After that he refers them to expensive, often ineffective psychotherapy.
Cognitive and behavioral changes are first prescribed. Cognitive: you aren't broken; you aren't suffering from some dreaded and unknown disease; your structure isn't causing the pain. Behavioral: resume all activity that you were accustomed to before the onset of your pain.
CBT also helps people learn to relax, meditate, stay "in the now," holistically treating their being and reducing stress, which ultimately is the cause. So, before dismissing this doc b/c he doesn't refer to back pain as TMS and prescribe a Sarno screed, perhaps you should take a look at the outcome study referenced vis-a-vis Sarno's own published studies and realize that this intervention is statistically more effective.
Dave: "The assumption is that the pain is due to some physical or structural cause and we just have to learn to deal with it."
Please explain this. I see no assumptions of anything, and the fact that therapy was prescribed indicates to me that the doc thinks stress is a large factor.
I hate quotations. Tell me what you know.
Ralph Waldo Emerson |
Edited by - Hillbilly on 01/13/2011 13:48:22 |
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tennis tom
USA
4749 Posts |
Posted - 01/13/2011 : 13:02:52
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Well said Hillbilly. All these different methods of psychotherapy leave me confused. In the end it's not the violin but the violinist that does the work. At least, in this article they are on the right track by recommending any form of psychotherapy, rather than some form of invasive bodily procedure or a failed disc surgery. It's a big step in the right direction that stress reduction will help more over a structural approach for many if not most back-pain sufferers.
DR. SARNO'S 12 DAILY REMINDERS:
http://www.tmshelp.com/forum/topic.asp?TOPIC_ID=6415
TAKE THE HOLMES-RAHE STRESS TEST
http://en.wikipedia.org/wiki/Holmes_and_Rahe_stress_scale
Some of my favorite excerpts from _THE DIVIDED MIND_ :
http://www.tmshelp.com/forum/topic.asp?TOPIC_ID=2605
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Edited by - tennis tom on 01/13/2011 13:06:02 |
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suegr98
USA
39 Posts |
Posted - 01/15/2011 : 23:22:34
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Hillbilly good summary of CBT and its potential.
I would add something I did not find in Healing Back Pain (which is the only Sarno I have read so far). I do still have to cope with pain, non-medicinally and non-surgically. My TMS recovery has not been instant or consistent, though I have hope that it will become more consistent with time.
In the past, I have experienced varying levels of cognitive therapy and I believe those experiences are contributing to my ability to effectively deal with TMS now. Ironically cognitive therapy did not help with pain in the past because I did not associate the two. It's the tie-in that really counts!
Btw, I work in a hospital physical rehab setting and cognitive therapy is available but pain meds are vastly preferred. 
take good care,
Sue
http://www.facebook.com/suegr98
http://healingwithfeelings.wordpress.com
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Back Pain: Should You Try Behavioral Therapy?
