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Excerpted from Mind Over Back Pain by John Sarno, M.D. Copyright 1982 by John Sarno, M.D. Excerpted by permission of Penguin Putnam, Inc.  All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.  HTML and web pages copyright by SpiritSite.com.

"In this book I shall endeavor to show that it is actually tension that causes most back pain."

Dr. John Sarno, 
Mind Over Back Pain,
Part 1

Back pain has reached epidemic proportions in the Western world. It is one of the most common disorders for which people seek medical help. It is also the single largest cause of worker absenteeism in the United States, Sweden, Great Britain and Canada, accounting for billions of dollars each year in medical costs. Perhaps 80 to 90 percent of Americans experience back pain in the neck, shoulder or back during their lifetime. At the least, such pain is temporarily annoying; more often than not, it produces qualitative changes in people's lives. Victims may be unable to participate in leisure-time activities, or worse, they are significantly restricted in their daily work.

Clearly, this is a phenomenon of the twentieth century. Why? And how has this come to pass? At a time when medical science presents us with such impressive accomplishments, why has it been unable to solve this common problem?

This book supports the idea that this great problem exists because the medical community has failed to recognize the major cause of back pain. Medical writings on the back routinely attribute pain to various structural abnormalities of the spine. In this book I shall endeavor to show that it is actually tension that causes most back pain.

I first appreciated the magnitude of the problem of back pain in 1965 when I joined the staff of the Institute of Rehabilitation Medicine at New York University Medical Center as director of outpatient services. For the first time in my medical career I began to see large numbers of patients with neck, shoulder, back and buttock pain. I had received conventional medical training and was under the impression that pain in these locations was due to a variety of structural abnormalities of the spine, most commonly arthritis and disc disorders, or to a vague group of muscle conditions thought to be due to poor posture, weakness, overexertion and the like. I believed that pain in the legs or arms indicated nerve involvement and was a sign of a spinal structural aberration. However, I was not sure how any of these abnormalities actually produced the pain.

The rationale for the treatment I prescribed was equally perplexing. Occasionally I would inject a painful area with a local anesthetic, with mixed results. In almost every case physical therapy was prescribed, consisting of ultrasound treatment to bring heat to the muscles, as well as massage and exercise. No one was sure what these procedures were supposed to do, but they seemed to help in some cases. It was said that the exercise strengthened the abdominal and back muscles and that this somehow supported the spine and prevented pain.

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