I wrote End Back Pain Forever  to open up a discussion on back pain and provide insights on effective treatments. I have posted the first two chapters of the book on my blog.

 Chapter 2

You Are Not Alone: The Back Pain Epidemic (Part 2)

As a physician specializing in pain medicine, I know how intimately mind and muscles interact. I can literally see a patient’s mental stress in tense, taut muscles. Early on in my training at Montefiore Medical Center in psychosomatic medicine, which is the study of how the mind and body interact, I could see that the separation of mind and body in medical practice made little sense. This drew me to a newly introduced technology, biofeedback, which enabled me to integrate my medical education with my psychiatric practice at the time.

The term “biofeedback” means measuring a function of the body – for example, temperature of the skin, heart rate, or muscle tension – and providing feedback in terms of sound, light or a meter reading that reflects whether those physiological elements are increasing or decreasing. This is done by attaching a probe to your finger that senses temperature change, a probe to monitor heart rate, or an electrode attached to the muscle that you wish to study that senses electrical activity in that muscle – these electrodes lead into the device that gives you the feedback and makes you more aware of the changes occurring. With that information, you can actually raise the temperature of your skin, lower your heart rate, or lower muscle tension, all of which have been associated with producing relaxation and decreasing various pains.

Thus, if you are attached to a biofeedback device and are asked, for example, about something you dislike, you may see your muscle tension and heart rate go up, while your skin temperature goes down. These changes suggest that you are experiencing stress or tension in your body, and that a part of your nervous system called the sympathetic nervous system is being stimulated. The sympathetic nervous system controls the heart and blood vessels and is generally stimulated when we are anxious or stressed. With practice, patients can be taught and eventually can teach themselves, by trial and error, how to control their physiological responses to emotions, thereby reducing the muscle tension that generates pain.




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