Outcomes of a mind-body treatment program for chronic back pain with no distinct structural pathology--a case series of patients diagnosed and treated as tension myositis syndrome.
BACKGROUND
Chronic, nonspecific back pain is a ubiquitous problem that has frustrated both physicians and patients. Some have suggested that it is time for a "paradigm shift" in treating it. One of them is John Sarno, MD, of New York University's Rusk Institute of Rehabilitation, who has argued for this in 4 books and several journal publications. We believe that a mind-body approach is more effective and involves much less risk and expense than conventional approaches in appropriately diagnosed cases.


OBJECTIVE
To determine if a mind-body treatment program addressing a presumed psychological etiology of persistent back pain merits further research.


METHODS
Case series outcome study.


METHODS
Single physician's office in metropolitan Los Angeles.


METHODS
Fifty-one patients with chronic back pain, diagnosed with tension myositis syndrome, a diagnosis for "functional" back pain and treated in the principal investigator's office in 2002 and 2003.


METHODS
A program of office visits, written educational materials, a structured workbook (guided journal), educational audio CDs, and, in some cases, individual psychotherapy.


METHODS
Pain intensity (visual analog scale scores), quality of life (RAND SF-12), medication usage, and activity level (questionnaires). Follow-up was at least 3 to 12 months after treatment.


RESULTS
Mean VAS scores decreased 52% for "average" pain (P < .0001), 35% for "worst" pain (P < .0001), and 65% for "least" pain (P < .0001). SF-12 Physical Health scores rose >9 units (P = .005). Medication usage decreased (P = .0008). Activity levels increased (P =.03). Participants aged >47 years and in pain for >3 years benefited most.
Schechter
David
D
Seligman Medical Institute, Culver City, California, USA.
Smith
Arthur Preston
AP
Beck
Jennifer
J
Roach
Janine
J
Karim
Roksana
R
Azen
Stanley
S
D000328:Adult; D000368:Aged; D001416:Back Pain / Q000175:diagnosis / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D002140:California; D002908:Chronic Disease; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D019222:Mind-Body Relations, Metaphysical; D009220:Myositis / Q000150:complications / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D012107:Research Design; D012648:Self Care; D029181:Spirituality; D013577:Syndrome; D016896:Treatment Outcome