American College of Physicians and Back Pain

15 Feb American College of Physicians and Back Pain

Yesterday I was in New York to shoot a quick interview with Dr. Mindy Fullilove, author of “Root Shock.” I first met Mindy when I filmed her meeting with Brooklyn community members who were fighting to save their homes in our 2012 documentary Battle for Brooklyn. Mindy’s area of study focuses on the long-term health effects on people displaced via “urban renewal” programs. Her work looks at how both individuals and communities are affected by the trauma that this kind of displacement entails. She found that people carry the trauma in their bodies, and just as we have seen through the data of the ACE Study in 1999, this kind of trauma has long-lasting health effects that lead to greatly increased risk of asthma, diabetes, heart disease, and many other illnesses. While our film All The Rage is largely complete, we hope to include a short interview with Mindy to enlarge the scope of the film.

The previous evening my mother called me with great excitement to let me know that the nightly news had just discussed a major back pain report by The American College of Physicians which found that the best treatment is no treatment at all. The results weren’t surprising to me, and I didn’t think too much of it. In 2011, I filmed a Senate Hearing called in response to the Institute of Medicine’s “Pain in America” report. This report found that none of the treatments currently used in medicine for pain are working, but it didn’t seem to have much of an effect on practice. I didn’t think this study would have much impact either, but when I showed up to shoot with Dr. Fullilove, she argued that it was very important because the American College of Physicians is a very big deal. Mindy came to the premiere of our film in New York and she was excited for us because in many ways the report validates much of what Dr. Sarno has been saying, even if it ignores his contribution.

One of the main reasons Dr. Sarno came to make the connection between emotions and back pain was that none of the treatment methods he had been taught seemed to be effective. He also found that often the physical explanation patients had been given for their pain didn’t make sense either. For example, a person might be told that they had a herniated disc impinging on a specific nerve, but they had pain in several areas unrelated to that nerve. When he looked at his patients’ charts, he found that more than 80% had a history of two or more issues that had a connection to stress and emotions – like colitis, migraines, rashes, hives, and ulcers. When he talked to his patients, he found that most of them were repressive of their emotions. The good news was that when he got them to make the connection between their pain and the stresses in their lives, they tended to rapidly improve. Over the next 40 years, he continued to develop his understanding of this phenomenon, and he had great success treating patients. However, he was increasingly ignored by his colleagues.

While this report doesn’t fully vindicate Dr. Sarno’s focus on emotions as a causative factor in back pain, it does validate his contention that none of the other treatments work. Many of them – like drugs, steroid shots, and surgery – often have side effects. Hopefully, people will begin to look at his work as a possible solution to the problem.

Here are just a handful of the articles that came out about the issue yesterday.

Gina Kolata of the New York Times weighed in here. Last week we posted a piece that links to 4 articles she has written showing that the data regarding disc herniation suggest that there is no direct causal correlation between what shows up on an MRI and physical symptoms. Her last article in 2016 was incredulous about the fact that practice had not changed despite a flood of studies that proved this point.

This article in Vox is interesting because it pointedly states, “Lower back pain is incredibly common — yet doctors don’t really know what causes it.” However, there are an increasing number of people who understand that stress and the repression of emotions are a major causative factor in back pain. This study hints at the idea that things like mindfullness meditation and yoga can help, but it doesn’t fully embrace this idea.

Trailer ALL THE RAGE