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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.

"A reduction in local blood supply resulted in reduced oxygen to the muscles and nerves, which appeared to be the direct cause of muscle and nerve pain."

Dr. John Sarno, Mind Over Back Pain, Part 3

A combination of further patient observation and a search of the medical literature suggested to me that tension affected the circulation of blood to the involved areas and that when muscles and their associated nerves were deprived of their normal supply of blood, the result was pain in the back and/or limbs. Specifically, a reduction in local blood supply resulted in reduced oxygen to the muscles and nerves, which appeared to be the direct cause of muscle and nerve pain.

Later the work of two German scientists, Dr. H.G. Fassbender and Dr. K. Wegner, came to my attention. They obtained biopsies from the muscles of patients with back pain and studied the tissue under the electron microscope. This type of microscope is capable of far greater magnification than the usual type and permits the study of the inside of cells. They found changes in muscle cells that suggested oxygen deprivation. Their work supported the idea that reduced levels of oxygen in involved muscles is the cause of back pain.

What does the medical world think of this diagnosis? First, it is unlikely that most physicians are aware of it. I have written a number of medical papers and chapters for textbooks on the subject, but they have reached a limited medical audience -- primarily physicians and those in other disciplines working in the field of physical medicine and rehabilitation. However, judging by the reaction of doctors in my immediate medical environment, most physicians have either ignored or rejected the concept. Many doctors in my own specialty see the validity of the diagnosis but find it difficult to treat such patients. This is related directly to the fact that the disorder is not purely "physical." Most doctors are uncomfortable with medical conditions that have a psychological basis. However, increasing numbers of doctors in the United States, particularly in the younger generation of physicians, are beginning to appreciate the important role of emotions in health and illness, especially the role of stress in clinical disorders. It is my hope that this book will be an inspiration to learn more about this disorder.

What of the readers with a history of back pain? It is not my intention to diagnose and treat in this book. Thought the syndromes of neck, shoulder, and back pain are not inherently complicated, they require individual attention. I shall describe my experience with a large number of patients over many years in the hope that the reader can extract something helpful from this experience. However, the larger problem will not be solved until there is a change in the general medical perception of the cause of back pain.

Science requires that all new ideas be validated by experimentation and replication. Before new concepts can be generally accepted they must be proven beyond all doubt. It is essential, therefore, that the ideas advanced in this book be subjected to research study. Because of my own successful experience in treating back pain, I am confident that research will bear me out, to the advantage of everyone suffering from the crippling effects of back pain.

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