Two months ago, I stepped into a shower in a hotel room in Baton Rouge, La., and felt a slight twinge in my back. I didn’t pay it much mind. I’ve experienced twinges from time to time, but for more than 25 years, I have been essentially free of back pain.
As you’ve probably guessed, that twinge didn’t go away. Instead, it got worse. It lodged in my lower back, and I could feel the sciatica all the way down to my knee. Within a week, I couldn’t walk more than 100 yards without severe pain.
Among other things, I was embarrassed. In 1987, I wrote an article in New York magazine called “Ah, My Non-Aching Back,†about how I’d found relief through a doctor named John E. Sarno.
By the time I saw Dr. Sarno, I had spent a year in relentless pain, visiting orthopedists and chiropractors, osteopaths and acupuncturists, trying yoga, physical therapy and bed rest, all to no avail.
Dr. Sarno’s treatment was essentially a talking cure. His theory, stated simply, is that back pain develops as a way of unconsciously shifting attention away from uncomfortable feelings such as anger and anxiety. With rare exceptions, Dr. Sarno believes, back pain has no structural basis. Rather, it is almost always a consequence of muscle spasm that prompts pain, which leads to fear, and then more spasm, and eventually creates a vicious cycle of pain. He named the condition tension myositis syndrome.
My prescription was to attend two lectures that Dr. Sarno gave describing the syndrome and the pain cycle, and why there was nothing to worry about except the fear itself.
I attended the talks with several dozen other patients. By the day after the first lecture, my pain was receding. In a couple of weeks, I was out of pain. For all practical purposes, it never returned - until this fall. (If you want a fuller description of T.M.S., you can read my article or one of Dr. Sarno’s books, including “Healing Back Pain†and “Mind Over Back Pain.â€
Over the years, I’ve sent dozens of people to Dr. Sarno, including ones who had suffered from back pain for years, had visible herniated discs on their MRI scans, and in some cases, had gone through multiple surgeries. Nearly all of them had the same experience I did: complete relief.
When my pain resurfaced this fall, I naturally assumed it was T.M.S. again. I wondered what anxiety in my life I might be trying to avoid, and came up with a plausible theory that I won’t burden you by sharing. The problem was, I didn’t get better.
I tried to remind myself that my pain was essentially harmless - much the way any muscle spasm is â€" but it felt like a distinction without a difference. As the days passed, I could feel my fear intensifying. I became preoccupied with my pain, monitoring its every fluctuation. I began restricting my movements in an effort to keep the pain at bay. I was seriously doubting the experience and wisdom that had served me so well for so long.
After about 10 days, I told myself that I simply needed to be reassured that there was nothing wrong with me. Dr. Sarno has retired, so I went to see his successor, Ira G. Rashbaum, at NYU Langone Medical Center. In minutes, he concluded that it was, indeed, T.M.S. “You’re going to be fine,†he reassured me.
The next morning, my pain was just as severe as it had been the previous day. It was time, I decided, to address the fear more directly. By this point, I’d given up my daily 30-minute run on a treadmill. I decided to try to resume walking for three minutes at a time, even if it hurt a lot. Sure enough, the first day was excruciating, and I fought with myself not to quit. I managed to do four three-minute walks, sitting down to rest between each one.
The second day, the pain was still significant, but I felt more confident that I could bear it, and this time I was able to walk 15 minutes altogether. The following day, I got to 20. On the fourth day, I was able to walk the 30 minutes without stopping, and on the fifth, I began to mix walking with light jogging.
Even then, it was excruciating at first. But the longer I ran, the more the pain receded, only to reappear when I tried to walk during the day. The difference now was that the pain no longer prompted much fear. If it disappeared when I ran, there was plainly nothing structurally wrong with me. The spasm, I decided, was just taking its time to subside.
I spend a good percentage of my life giving talks. As luck would have it, there were no talks on my schedule during the three weeks I had been suffering, but several days after resuming my runs, I had one to give.
I felt apprehensive about having to stand up for 90 minutes, and I arranged to have a stool on the stage, just in case. I dreaded having to use it. It’s not exactly inspiring to speak in front of 200 people while sitting on a stool.
As I began my talk, I was mildly aware of some pain, but then I became absorbed in what I was saying. When I finished, I realized I felt fine. That was nearly five weeks ago. I’ve been pain-free ever since.
I’ve told you this story for two reasons.
First, research suggests that one-third to one-half of us suffer from back pain, and I know all too well how preoccupying, depressing and disabling it can be. I’m also convinced we are squandering hundreds of millions of dollars and countless hours seeking well-meaning practitioners who fail to understand the real cause of back pain.
The second reason I’ve shared my story is to point out how much the power of fear - which we generate ourselves â€" can take control of our lives. Had I not taken on my fear and deliberately confronted my pain, I have no doubt I would be even more disabled today than I was at my worst two months ago. Instead, I’m heading into the holidays pain-free and emboldened to take on my fear in whatever guise it next arises.
Tony Schwartz is the chief executive of the Energy Project and the author, most recently, of “Be Excellent at Anything: The Four Keys to Transforming the Way We Work and Live.†Twitter: @tonyschwartz
