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Susan was sitting expectantly in front of me, hoping for a miracle. As her story unfolded during our preliminary interview, I could see why she thought a miracle was the only possible answer to her problem.
Having suffered excruciating back and leg pain for more than seven years, she had reached a stage where she felt hopeless about her prospects for finding relief or resuming a normal pain-free life. Although she was once a vibrant nurse who had literally run about the halls of her hospital tending to patients, her pain had reduced her to a shell of what she had been. Now, thoroughly debilitated by chronic back pain, she couldn't go to work. She was bedridden seven days a week; her husband even had to carry her downstairs when she wanted to get out of bed.
The pain interrupted her rest, to the extent that she hadn't had a good night's sleep for years. All the activities she once enjoyed were now out of her reach: going to the movies, playing golf, taking vacations, driving, or even riding in the car. Her persistent pain had taken her life away.
As you might expect, Susan had run thegamut in her search for medical help. She had seen physical therapists, orthopedic surgeons, acupuncturists, chiropractors, and various pain specialists. Five years earlier, an MRI (magnetic resonance imaging) scan showed herniated disks in her back, and as a result she had undergone back surgery. But the pain soon returned. Another MRI showed more degenerated disks, so she had another back operation. After that, the pain again got better for a few months-only to return worse than ever.
Then came the epidurals (shots into the thick outer covering of the spinal cord) and nerve blocks (injections of anesthetics into nerves to numb sensation). Again, she experienced more temporary relief-but the pain returned.
Seven months earlier, Susan had been evaluated and treated by experts at a leading national health clinic, who had performed another surgery to implant a spinal cord stimulator in her back, a procedure that was supposed to relieve the pain.
"That helped for about one month," she told me. "But then I lifted something, and bam, my back has hurt worse ever since."
"How are you feeling today?" I asked. "Describe your pain on a scale of one to ten, with ten being the worst pain you can imagine." She sighed before beginning her litany of complaints: "My lower back pain is eight out of ten-there's burning, aching, and sometimes cramping pain. And I have sharp pain in my buttocks going down the back of my leg. That's the main problem. On occasion I also get migraine headaches, and awhile back I was diagnosed with irritable bowel syndrome."
As Susan sat on the verge of tears in my office, my mind started racing. Her complaints were obviously chronic, and she was at her wit's end. She had seen so many physicians, but no one had been able to cure her. Of course, she had received several diagnoses-including degenerative disk disease, herniated disks, and sciatic neuralgia. But none of these diagnoses had led to a cure for her pain.
In any case, countless experts had tried to help her but had fallen short. She had submitted to more surgical procedures, injections, X-rays, MRIs, and other diagnostic tests than most people can even imagine. But conventional medicine had failed Susan. Her back was still riddled with pain-pain that had taken all the "life" out of her life.
BEYOND "BODY" MEDICINE
During fifteen years of traditional medical practice-or what I now call "body" medicine practice-I had seen many patients like Susan. Most physicians don't enjoy seeing chronic pain patients like Susan: They're frustrating to us because it's unclear why they continue to suffer, and it's usually impossible to bring them out of pain by conventional treatments.
In my former body-medicine mode, I would have given her the conventional evaluation, diagnosis, and treatment plan. In other words, I would have increased her dosage of pain pills, recommended a fourth round of physical therapy, and talked to her about a newer generation of medications that might help curb her symptoms a bit. Then I would have sent her on her way to yet another specialist-without giving her any real answers or any hope that a cure was possible.
But now I was able to understand Susan's condition differently. Her chronic back pain, headaches, and irritable bowel syndrome finally made sense to me. I myself had once been in almost the exact condition as Susan; I had also listened to the conventional medical wisdom and failed to find relief from the treatment plans given to me by modern body-medicine experts.
My personal path and research had led me out of pain and into a new understanding of the true cause of Susan's problems. Her back pain was not related to her degenerative disks or heavy lifting; the source of her complaints was deeper and broader and involved her mind and body and spirit. Specifically, I determined that Susan was suffering from symptoms related to Autonomic Overload Syndrome (AOS)- a term I've formulated to describe the physiological process that results in different types of chronic pain. Furthermore, the great news about AOS is that, in most cases, patients like Susan who suffer from this syndrome can become pain-free.
So I spent about forty-five minutes with Susan, probing her physical symptoms, her psychological makeup, her personality traits, and her stresses and pressures in life. We discussed her past medical problems, her family history, and her spiritual history. I asked her about her personal beliefs and spiritual background, because a person's deepest convictions and worldview can become powerful factors in recovery from physical pain.
Early on, I noticed an important feature of her personality that had set her up for chronic pain: her tendency to be a Perfectionist. Susan set extremely high standards for herself and others. Her lists of things to do were never-ending. But even though she put a lot of pressure on herself in her professional and personal life, she usually found that she didn't measure up-and, of course, neither did those around her. Like most Perfectionists, she became irritated and frustrated easily. But you would never have known it, because she had learned quite well how to "stuff," or bury, her dangerous emotions into her subconscious mind.
"I don't consider myself an angry person at all," she said. "Yes, I get frustrated and irritated with people, especially doctors. They think they're always right and they know everything. But of course I don't show it-I'm just a nurse, and you don't tell doctors what you really think!"
Then I gave Susan a physical exam-looking for any dangerous conditions such as cancer or neurological disorders that might explain her pain. I tested her reflexes and her muscle tone. I pressed on her muscles and joints, looking for areas of increased tenderness. I have found that patients with Autonomic Overload Syndrome often have tenderness in several specific muscles and tendons in the back, neck, elbow, shoulder, and thigh.
During the exam, I reviewed the X-rays of her back. It was true that these X-rays didn't look the same as those of a twenty-year-old female. But then again, Susan was in her fifties. Radiologists had interpreted her X-rays as "herniated disks" and "degenerative disks at multiple levels." In fact, the radiologists were correct in their assessments, but her physicians were incorrect in concluding that these findings were abnormal and the cause of Susan's pain.
I explained to Susan that her X-ray findings would be normal in 30 percent of people in their thirties and still normal in 70 percent of people as they get older. That is, an increasing number of people have these conditions without any pain symptoms as they age. Most elderly folks in nursing homes have herniated and degenerative disks, yet nursing home residents actually have a lower incidence of back pain than people in their thirties and forties! In my personal experience with patients, bulging and degenerative disks are normal findings; only rarely are they the cause of chronic back pain. Or as I sometimes tell my patients, "They are common-yes. And normal- almost always."
Finally, we returned to my office to talk. "Susan, I think I can help you," I said. "I believe that all your symptoms-your chronic back pain, migraine headaches, and irritable bowel syndrome-have a common cause and a common solution. I believe you can become pain-free."
At this reassurance, she began to cry. But these were tears of hope. Her husband, Bill, who had joined us for this final, wrap-up part of the exam, consoled her, but he seemed rather skeptical. I understood his doubts because I had been there myself only a short while before. So I went into a little more detail about the scientific and clinical explanation of the treatment I was recommending.
THE REAL SOURCE OF SUSAN'S PROBLEM
I explained to Susan and her husband that she was suffering from a pain-producing condition that I call Autonomic Overload Syndrome. Here's a simple definition:
Autonomic Overload Syndrome (AOS) is a group of chronic pains and other symptoms caused by harmful levels of stress, pressure, and repressed strong negative emotions that have built up in the subconscious mind.
In AOS, subconscious emotions and stresses build up and overstimulate the autonomic nervous system and related mechanisms-which control many automatic bodily functions, such as muscle tone and hormone production. When these systems are turned to an "on" position for long periods, various physical symptoms emerge-many of which involve pain. These AOS symptoms can involve back pain, headaches, irritable bowel syndrome, insomnia, and other complaints.
Probably the easiest way to understand AOS is to think of your mind, body, and nervous system in terms of an automobile. A car engine is built to travel at moderate speeds most of the time and can generally be expected to last many years without problems. But the car will begin to show a lot of wear and tear if we constantly step on the accelerator and keep the speed at a hundred miles per hour for hours at a time.
Similarly, our minds and bodies usually work well if we keep our autonomic nervous system and fight-or-flight stress hormones at moderate levels of activation for short periods of time. Unfortunately, though, the stresses and pressures of modern life activate these stress systems for extended periods. Also, when the pressure builds, strong emotions come into play. Yet these emotions, such as irritation, anger, guilt, fear, and shame, are dangerous and unprofessional to express. So we tend to stuff or repress them to the subconscious recesses of our minds. Unfortunately, though, they are still there inside us, constantly pressing to get out and keeping our stress system turned on.
But I had some good news for Susan and Bill. "I've learned that you can correct these malfunctions of your autonomic nervous system- and eliminate your pain-by pursuing several simple treatment strategies," I said. "These have worked for me, they have worked for others, and they can work for you as well."
SUSAN FINDS A SOLUTION
After I provided her with an individualized version of my 6-week Pain-Free for Life Program, Susan went home with increased hope and a can-do attitude. During the next few weeks, she diligently applied the strategies that I had taught her-and that you will learn about in this book.
Three weeks later I received a letter from Susan-a message that made my day:
"It is true!" she wrote. "I'm better! I can hardly believe it. I can walk without pain-go down the stairs-and sleep through the night! I even turned off my spinal cord stimulator for the first time since it was implanted."
Then came the best part: "Hallelujah! I have so much to be thankful for! I am getting my life back. My husband and I are finally going on a trip-it's the honeymoon we never got to take!" I don't think that I've ever had a patient who shouted "Hallelujah!" after seeing me. And it didn't matter one bit if that shout was on paper.
After re-reading her letter a couple of times, I sat quietly in my office, awaiting my next appointment and musing over how I had arrived at this remarkable juncture in my life. As a victim myself of seemingly incurable upper and lower back pain, I had found not only a way to overcome my own anguish-but also a methodology to treat patients who were at the end of their rope, feeling hopeless that they could ever escape their pain.
THE ANSWER TO "IMPOSSIBLE" PAIN
The proof of the power of our program in overcoming various symptoms of the Autonomic Overload Syndrome lies in the results of the 6-week Pain-Free for Life Treatment Program. This program has helped hundreds of patients suffering from the chronic, "impossible-to-cure" pains of AOS to achieve significant relief within weeks-without drugs or surgery.
In a recent research project we conducted at the Brady Institute, we studied fifty-five patients who had suffered from debilitating and seemingly incurable chronic pain-all of whom I had examined and diagnosed with Autonomic Overload Syndrome. These patients had experienced chronic pain on average for twelve years. We found that more than 80 percent of these subjects experienced 80 to 100 percent pain recovery within four to six weeks of beginning our treatment plan.
Also, with the passage of time, their pain relief continued to hold firm, according to two-month and six-month follow-up surveys. The various AOS pain complaints that we studied and cured included chronic back pain, fibromyalgia, chronic neck and shoulder pain, sciatic nerve pain, migraine headaches, tension headaches, and the painful spasms of irritable bowel syndrome. Significant AOS-related symptoms, such as insomnia and skin conditions like psoriasis, also frequently disappeared.
Here is a sampling of patient comments that lie behind the numbers:
An elderly retiree with chronic lower back pain and herniated disks for ten years reported, "Doc, I was cured in three weeks."
A woman in her early forties, with sciatic pain running down her hip and leg for seven years, wrote: "My sciatic pain is finally gone-I can sit in the movie theater, play tennis, and my husband and I are going to Europe."
An attorney in his thirties with chronic back pain for three years declared after four weeks: "I'm off my medicines, and I'm 80 percent better. And I'm playing golf again."
A twenty-five-year-old female with debilitating fibromyalgia for eight years said, "I've finally got my life back. I'm going back to school without pain for the first time in years. Last week I began to have a migraine headache-and I was able to make it go away within minutes!"
Such results in my practice-and also in the work of other physicians who employ mind-body techniques-have convinced me that traditional medicine is too narrowly focused to help cure millions of patients who suffer with seemingly incurable pain. I call today's traditionally practiced medicine "body" medicine because we physicians have been trained to focus almost exclusively on the physical without giving attention to psychological or spiritual factors that influence the body. While I believe that our current medical practice is the best the world has ever seen, our narrow structural focus often precludes us from solving many common conditions. Consider just a few limitations of today's conventional medicine:
We will soon help the average person to live to be ninety or a hundred ... but millions suffer from chronic back pain-costing billions of dollars each year in health care costs and lost work productivity.
Body medicine can replace knees and hips and transplant kidneys ... but it can't offer lasting relief to millions of people, such as the many patients, the majority of whom are women, who suffer from the debilitating painful muscle condition known as fibromyalgia.
Traditional medicine can block stomach acid with pills ... but it can't cure gastritis or irritable bowel syndrome once and for all, so that pills are no longer necessary.
Conventional medicine can remove brain tumors ... but it can't permanently cure migraine or tension headaches.
Yet all these limitations often fall away when people in chronic pain are examined and treated with a well-designed mind-body-spirit approach. A new and better medicine will emerge only when patients are treated as a whole-with attention paid not just to the body, but to the mind and the spirit as well. Yet it's important to remember that there's really nothing new about this approach. In fact, the seemingly new path I've taken in my practice represents the culmination of landmark pain-related research that has spanned the past century and a half.
Excerpted from Pain free for Life by Scott Brady William Proctor Copyright © 2006 by Scott Brady, MD. Excerpted by permission.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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Posted August 7, 2006
This book is right on target. With so many people under constant pressure it is no wonder that we are overloaded. This book makes the mind-body-spirit connection understandable. Because the author once had chronic back pain, but now lives pain free he tells his first hand experience with Autonomic Overload Syndrome. I figured if it worked for him, the least I could do is try it. This book is filled with hope for a better life.
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