Outcomes of a mind-body treatment program for chronic back pain with no distinct structural pathology--a case series of patients diagnosed and treated as tension myositis syndrome
Schechter, D.; Smith, A.Preston.; Beck, J.; Roach, J.; Karim, R.; Azen, S.
Alternative Therapies in Health and Medicine 13(5): 26-35
2007
ISSN/ISBN: 1078-6791 PMID: 17900039 Document Number: 614165
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. To determine if a mind-body treatment program addressing a presumed psychological etiology of persistent back pain merits further research. Case series outcome study. Single physician's office in metropolitan Los Angeles. 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. A program of office visits, written educational materials, a structured workbook (guided journal), educational audio CDs, and, in some cases, individual psychotherapy. 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. 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.