BACK PROBLEMS & THE MIND

[Guest guest]

Here is an article that I wrote for the Sportsci group some months ago which

has a bearing on the letter that I wrote earlier on the same topic.

BACK PROBLEMS & THE MIND

Periodically we have some folk writing in about Dr Sarno's theories of back

pain and the mind. Some religiously believe what he states, but others

rightly point out that back pain may indeed be the result of genuine

anatomical damage.

For those of you who may not have come across Dr Sarno's ideas, here are two

websites that fill in some gaps:

http://www.mindspring.com/~chiropractor/tms.htm

http://www.pleiades-net.com/voices/health1/127_7.html

The foundation of Sarno's work lies in that very important issue of

interaction between mind and body. If we work from a foundation of this

ancient saying, " A healthy mind in a healthy body " , we may make some

progress towards understanding the situation a little better.

If this aphorism is correct, then what about its possible converses: " An

unhealthy mind in an unhealthy body " and " An unhealthy body with an unhealthy

mind " . We will readily note that there are some very unhealthy and

profoundly disabled people with very healthy minds and some very healthy

bodies in people with some very neurotic and unhealthy minds, so these

converses just do not hold universally.

Now, let's return to the original aphorism " A healthy mind in a healthy body "

and see how literally we should take it. Just as we have noted that its two

possible converses do not constitute universal truths, so we will note that

this saying may also have its limitations.

Can we ever state with certainty that someone who has a healthy mind will

always have a healthy body? Let's try an experiment - expose that person to

a highly contagious disease or let that person experience a severe injury and

we will notice an immediate weakness in that belief.

Maybe some folk will say if you can radiate mental health (wholeness) the you

will immediately cure that disease or injury - if that is true, then the

cases of this happening are very few and far between. They are called

" miracles " .

Can we say that someone with a healthy body necessarily will have a healthy

mind? Visit a mental asylum or jail and you will very rapidly discover that

some very disturbed minds are residing in some very healthy bodies.

So, by examining that aphorism in the manner of one of my " Puzzles &

Paradoxes " , we will see that it needs to be applied with some intelligent

circumspection. If we state it thus: " Greatest health is the result of a

healthy mind and a healthy body " , then we can move on towards greater

universal universality.

We may state that interaction between mind and body is such that the one may

affect the other, if, in fact, we are entirely justified in separating mind

and body, as if mind is some ghostlike phantasm which occupies a physical

body and is not the result of bodily processes. In fact, that is why we

sometimes prefer to talk in terms of the mind-body system and why many

Russian scientists talk about the human organism as a single entity.

At this point, some might be tempted to discuss the concept of a soul or

higher level aspect of human consciousness, but that is not what I am

referring to here, solely because science has not yet been able to explore

this territory, even to the most basic level of understanding, proof or

disproof.

So, my comments apply specifically to the mind-body system or entity. The

scientific discipline known as PNI (Psychoneuroimmunology) has already

uncovered powerful interaction between mind and body in terms of biochemical

and electrical changes associated with various disease states, so the

interaction between health of mind and body is already a field being afforded

some very serious research.

Here are some websites for anyone who wishes to delve a little deeper:

http://207.136.91.232/oracle/library/health/psneu.html

http://www.the-scientist.library.upenn.edu/yr1996/august/research_960819.html

http://www.mc.vanderbilt.edu/adl/pathfinders/psychoneuroimmuno/research.html

The Mind-Body Link:

http://mentalhealth.about.com/health/mentalhealth/library/weekly/aa111797.htm?

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PLACEBO EFFECT

Thousands of articles have been written on this topic, but this more recent

one by the author of the book, " The Relaxation Response " and " Beyond the

Relaxation Response " offers another viewpoint.

Benson H & Friedman R Harnessing the power of the placebo effect and

renaming it " remembered wellness " Annu Rev Med 1996;47:193-9

The placebo effect yields beneficial clinical results in 60-90% of diseases

that include angina pectoris, bronchial asthma, herpes simplex, and duodenal

ulcer. Three components bring forth the placebo effect: (a) positive beliefs

and expectations on the part of the patient; ( positive beliefs and

expectations on the part of the physician or health care professional; and

© a good relationship between the two parties.

Because of the heavily negative connotations of the very words " placebo

effect, " the term should be replaced by " remembered wellness. " Remembered

wellness has been one of medicine's most potent assets and it should not be

belittled or ridiculed. Unlike most other treatments, it is safe and

inexpensive and has withstood the test of time.

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NERVOUS SYSTEM - ENTERIC NERVOUS SYSTEM LINKS

Recently there has been a great increase in the amount of research being done

on the digestive system as a neural system in its own right, thereby

suggesting that the old sayings " gut feel " and " I feel sick to the pit of my

stomach " have some scientific basis, after all.

Dr Gershon, a pioneer researcher in this field of neurogastroenterology,

discovered that more than 95% of the body's serotonin is concentrated

in the gut, so he concluded that serotonin was an additional transmitter in

the GI system. This makes one wonder if Prozac and related serotonin

interactive drugs are acting predominantly through the gut or through the

brain. Gerson added that neurotransmitters, growth factors, and many

peptides known in the brain are also found in the gut, suggesting that there

is " a little brain in the gut. "

Another researcher in this field, Dr Camilleri, remarked that " The enteric

nervous system is to a large extent independent, and it is only fine-tuned by

extrinsic nerves that connect it to the brain for motor functions. Like the

more familiar central nervous system (brain and spinal cord) and peripheral

nervous system (nervous tissue outside the brain and spinal cord), the

enteric system includes vast networks of neurons; their supportive glial

cells; and messenger molecules, such as neurotransmitters, neuropeptides, and

growth factors.

It is interesting that some of the earliest research into the enteric nervous

system was conducted by none other than the Russian physiologist, Ivan

Pavlov, who noted in the late 1800s that stimulating a dog's mouth causes its

stomach to secrete digestive acid. It seems as if he was an unsung pioneer

in quite few important fields!

Here is another article in this field:

Furness JB, Kunze W & Clerc N Nutrient tasting and signaling mechanisms in

the gut. II. The intestine as a sensory organ: neural, endocrine, and immune

responses. Am J Physiol 1999 Nov; 2 77(5 Pt 1): G922-8

The lining of the gastrointestinal (GI) tract is the largest vulnerable

surface that faces the external environment. Just as the other large external

surface, the skin, is regarded as a sensory organ, so should the intestinal

mucosa. In fact, the mucosa has three types of detectors: neurons, endocrine

cells, and immune cells. The mucosa is in immediate contact with the

intestinal contents so that nutrients can be efficiently absorbed, and, at

the same time, it protects against the intrusion of harmful entities, such as

toxins and bacteria, that may enter the digestive system with food. Signals

are sent locally to control motility, secretion, tissue defense, and vascular

perfusion; to other digestive organs, for example, to the stomach,

gallbladder, and pancreas; and to the central nervous system, for example to

influence feeding behavior.

The three detecting systems in the intestine are more extensive than those of

any other organ: the enteric nervous system contains on the order of 10(8)

neurons, the gastroenteropancreatic endocrine system uses more than 20

identified hormones, and the gut immune system has 70- 80% of the body's

immune cells. The GI tract has an integrated response to changes in its

luminal contents. When this response is maladjusted or is overwhelmed, the

consequences can be severe, as in cholera intoxication, or debilitating, as

in irritable bowel syndrome.

Thus it is essential to obtain a full understanding of the sensory functions

of the intestine, of how the body reacts to the information, and of how

neural, hormonal, and immune signals interact.

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So what does all this have to do with Back Injury and the Mind?

Well, it means that while there may be definite anatomical and physical

causes of back pain (such as a mechanical fractured bone, herniated disc or

damaged nerves), there may also be mental factors that can cause, worsen or

decrease back pain. However, it would be foolhardy to state that ALL back

problems are the result of an " unhealthy " or unholistic state of mind - try

telling that to all the paraplegics and quadriplegics out there!

Equally well, it is foolhardy to believe anyone who maintain that faulty

posture is the leading cause of back pain and dysfunction, for there is more

than adequate research to show that such a correlation is tenuous at best.

Clinicians and researchers have noted that a significant number of patients

have severe back pain without showing any clear mechanical or physiological

causes - or " poor " posture, for that matter. It is largely this group that

Dr Sarno addresses in his work. Thus, it is important to use modern medical

technological means to make a more accurate diagnosis and to proceed from

that point.

Dr Mel C Siff

Denver, USA

mcsiff@a...