Can a psychologist cure your chronic lower back pain?

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Recently, there have been a number of internet articles regarding chronic lower back pain which can be resolved by a psychologist. Dr. John Sarno, who made headlines with his books on the subject. He charged$1000 for a session and then told you you could come back to any group sessions for free.   He made a fortune with his books that were promoted by his hospital at the time and his theory of TMS (Tension Myositis Syndrome). 12 years ago I had written my own book, Cheating Mother Nature, What You Need to Know to Beat Chronic Pain, and investigated his claims and asked him to comment on the section that included some commentary on his work.  He declined and had no interest in other people's research.   He partly developed his ideas which are based on how stress hormones cause the skeletal system to stiffen, resulting in chronic pain were partly due to his being in the department of physical therapy, where he observed that nobody improved from the physical therapy they performed.

A recent study has been making headlines lately

Recently, another study that was published in JAMA Psychiatry under Dr. Yoni Ashar, Ph.D through Medical News Today made a similar case for psychiatric approaches to chronic lower back pain.  Their approach to the lower back was as follows "Dr. Ashar explained how “guided meditations […] induce a shift from avoidance of bodily sensations to engaging with them with an attitude of curiosity and lightness, knowing that they are safe.” The researchers conducted a randomized controlled study from August 2017 to November 2019. The participants were aged 21–70 years and based in Boulder, CO. All individuals reported experiencing back pain for at least half of the days in the last 6 months. The participants received PRT, placebo, or just their usual care. Those in the PRT group initially received a 1-hour telehealth evaluation and education session with a doctor. They then underwent eight individual 1-hour PRT sessions with a therapist, which took place twice weekly for 4 weeks. Those in the placebo group watched two videos discussing how placebo treatments contribute to the body’s healing response. They also received a saline injection at the site where the pain was most significant and continued ongoing care. The researchers measured the 1-week mean back pain intensity score following treatment. They also used three methods to assess the participants’ pain beliefs and conducted functional MRI (fMRI) scansTrusted Source to measure responses to evoked pain and ongoing pain after resting."

Do we really need counseling and drugs for chronic lower back pain, or is there a better provider to take care of why we hurt?

Chiropractors understand lower back pain well and their patients offer them high praise for their results and their process.   Chiropractors are well aware that there can be a psychological aspect to why they hurt.   On the other hand, they take a primary care multi-faceted approach to treatment that includes a holistic methodology to evaluating, understanding, and treating what hurts with a solid rationale as to why. There is no one approach to chronic lower back pain that works all the time.  Chronic lower back pain can be a foot problem, a core problem, a shoulder problem, an upper back problem and can cause knee and hip and sciatic pain.  The problem has always been the segmented overspecialization of care that can have several specialties evaluating and treating problems without the benefit of understanding the mechanics of why the patient is in pain. This study may offer some guidance for us to better understand the psychological causes that affect the soft tissues of the body, but segmenting care simply raises costs while making management of care more obtuse.   Care by one or two providers is far simpler and better patient-focused. The holistic approach chiropractors routinely use encompasses the psychological, mechanical, and physiological reasons behind why you hurt.  The segmented specialist model used medically raises costs, overuse tests when there is little or no improvement, and relies on pharmaceuticals which are costly and do not solve mechanical problems. For chronic lower back pain, simplicity is best and chiropractors keep it simple.  Book online using this link.