Quite some years ago, John Sarno, an orthopedic surgeon wrote book on how chronic widespread pain might be a manifestation of emotional pain – people whose bodies are on overdrive and knotted up with body armour. He called it Tension Myositis and claimed cure rates to disciples who embraced this idea and worked to counteract it. He has written a series of books on this mind-body connection.
http://www.amazon.ca/Healing-Back-Pain-Mind-Body-Connection/dp/0446392308 is just one link.
I was enthusiatic about his theories and bought his books but failed to find hard research harnessing me to push it on patients. Now Dr. Schubiner has come up with a program called affect self-awareness training that has proven to have benefit.
J Gen Intern Med. 2010 Oct;25(10):1064-70.
Sustained pain reduction through affective self-awareness in fibromyalgia: a randomized controlled trial.
Hsu MC, Schubiner H, Lumley MA, Stracks JS, Clauw DJ, Williams DA. abstract here
- A process called Affect Self Awareness involves “written emotional disclosure and emotional awareness exercises”.
- “RESULTS: Adjusting for baseline scores, the intervention group had significantly lower pain severity (p < 0.001), higher self-reported physical function (p < 0.001), and higher tender-point threshold (p = 0.02) at 6 months compared to the control group. From baseline to 6 months, 45.8% of the ASA intervention group had ≥ 30% reduction in pain severity, compared to none of the controls (p < 0.001).” – so a subgroup benefited
- It has been know for some time that prior abuse histories sets a certain subgroup up for chronic pain. This subgroup is potentially genetically setup – they are what is called somatizers – people with migraines, irritable bowel, muscle ache and pains needing chiropractic work, and so on. They also seem to have abnormalities of their stress hormone circuits – their HPA axis. When subjected to childhood stress and later severe stress that I would call the “breaking point”, they succumb to chronic widespread pain. A depression susceptibility completes the picture.
I will write more about the mind -body connection, but the book one needs to get for treatment is called
Unlearn Your Pain
by Schubiner H.
it includes a 28 day manual and a CD with meditation training.