Jun 15, 2009

Carpal Tunnel Syndrome and Dr. John Sarno's Mindbody Medicine

Whether you have Carpal Tunnel Syndrome, tendonitis or repetitive strain injury, there are a million people out there who will give you advice about how to deal with your pain. But before you continue to treat your wrist pain, I highly recommend you check out Dr. John Sarno's book The Divided Mind: The Epidemic of Mindbody Disorders. Dr. Sarno argues that many of the conditions often associated with fibromyalgia, carpal tunnel syndrome or back pain are actually caused by various forms of emotional repression. I know it may sound Freudian at first, but there's a lot of evidence to back up his claims. Here's his theory.

Scientists and doctors are starting to come around to the fact that the mind and body are not separate entities but part of the same system. And when you think about it, this mind/body connection makes a lot of sense. If your brain can process cues from your body - registering pain, fatigue, and temperature changes - why can't your body be affected by your mind? For example, you've probably noticed that your muscles tense up when you're feeling nervous. When you're embarrassed, you might blush. Both of these situations are widely accepted examples of purely emotional reactions being displayed as physical (bodily) phenomena.

Dr. Sarno spent years treating patients with chronic back pain. After a while he began to notice common personality types among his patients. Many of them were perfectionists and chronic do-gooders. They tried hard to please others, and when they failed they often blamed themselves harshly. To make a long story short, Sarno hypothesized that many of these people were repressing feelings of anger and frustration that were harmful to their good self-image. When he made them aware of these feelings, many of his patients experienced immediate relief from their painful symptoms.

This does not mean that their symptoms were imaginary. In all of his writings, Sarno adamantly makes a distinction between real physical pain which is caused by emotions, and "psychosomatic" pain that is merely imagined, or "all in your head." Studies of most of the patients he diagnosed with this condition, which he called "Tension Myositis Syndrome" or TMS, showed one common physical characteristic: decreased blood flow to the areas where they experienced pain. His theory is that this decrease was the mind's attempt to distract the patient from emotions that they did not want to recognize. He also noticed that the decrease occurred in areas of the body where the patient might reasonably expect to feel pain, generally in an area there had been a lot of buzz about in the media. For a long time it was back pain. Then, when Carpal Tunnel Syndrome became a widespread source of attention, more and more people started showing up with pain in their wrists. Coincidence?

Again, this does not mean that these people's pain was "all in their heads." It was very, very real, and was caused by decreased blood flow to their wrists. Other independent studies have shown that decreased blood flow can cause both pain and temporary structural damage to muscle fibers. This study on "Overuse Syndrome," which was cited in the Google blog's entry on carpal tunnel syndrome, is one such example. In keeping with this, Sarno noticed that most of his patients found relief from treatments that increased circulation, such as heat and massage, and none had lasting structural damage once the source of their problem was addressed.

Now I'm not a sucker for self-help books, but I really think there may be some truth to this. What finally sold me was that a group of high achieving Harvard students managed to heal their carpal tunnel syndrome just by following the suggestions in his book. They started a website to document this amazing event, called Harvard RSI Action. It's very worth a read.

I'll be posting more on this later, but for now I highly suggest you keep an open mind to these theories, especially if you've experienced other symptoms associated with TMS, such as back pain, leg pain or stomach problems. Here's an interview with Sarno, just to give you a quick idea of where he's coming from.


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  4. If my CTS are emotional, how is it possible when i`ve never heard of CTS before i actually got it? Until further proof, i believe this is nonsence.

  5. I agree that chronic pain has a lot to do with the brain. I believe Acupuncture when done properly treats the brain to rewire these set patterns. In the Melbourne acupuncture clinic where I work alongside a psychologist and we get great results with chronic pain. From a Chinese medicine perspective, carpal tunnel syndrome runs along an energy channel that's related to anxiety. In treating carpal tunnel with acupuncture we can also help anxiety disorders.

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