Do's & Don't: Placebos & Nocebos

[BruceMC]

There's a store front PT office that I pass each day on the way to the gym with these warnings and admonitions straight out of the lexicon of medical mythology that we all know currently surrounds TMS lower back pain posted prominently in the front window for strollers to take in as they pass:

How much of this stuff is sheer BS and how much is backed up by peer-reviewed double-blind studies published in name scientific and medical journals? I'd warrant that most of it is based on anecdotal evidence repeated so often by PTs to their patients that it has taken on the aura of medical dogma. For example, what proof is there that raising one foot while delivering a talk behind a lectern is going to protect your lower lumbar region from harm? That's just one of dozens of admonitions in these posters that give the general public the mistaken impression that somehow the human back is weak, fragile and subject to damage if preventative measures are not taken morning, noon and night.

Well, needless to say, this particular PT office has closed down and is in the process of being leased to a new owner. But who knows how much harm these warnings have inflicted on the public consciousness has strollers walk down this busy boulevard each day?

Bet our TMS community can call out 20 items of BS listed here. In the meanwhile, avoid swaying and make every effort you can to "Maintain Three Natural Back Curves!" (what are those anyway and how are they somehow 'natural'?)

 

[Walt Oleksy (RIP 2021)]

Great post, Bruce. I try to lift with my knees, not my back.
But mainly, I tell myself my back is not weak.

And never again lift my dog, a big black Lab mix. I got a hernia from that,
not a back ache. I let the vet lift her onto the table to look her over.

 

[Steve Ozanich]

Walt, if only you would have lifted with your knees when you hoisted that 64 pack of beer! But, you would have never learned about MS, or anything about yourself. So your pain helped to heal you, and not vice versa.

I went to my PO box a couple days ago and found your book in there! I can't wait to read it. Thank you, it means a lot to me. I've been writing so much that I haven't been able to read much lately. But I will.

Bruce this poster reminds me of the VOMIT poster I tried to post at "TMS in POP Culture," but it didn't take for some reason. It's not there. Maybe it's pending approval by the high tribunal.

We are often harmed by helpful tips and tricks. They tell us we are weak, and that potential trouble is our only friend.

 

[BruceMC]

Steve, I believe Forest (aka 'High Command') posted the VOMIT brochure elsewhere. In any case, it's on the Forum.

I saw these posters in the window of the PT place nearly every day for the last six months, but the light of the setting sun always interfered with my shots. I kept wondering how much it was damaging to the TMS cause in the public imagination and felt I had to make it available on this Forum. Fortunately, the PT place has gone broke and is shutting down, so I had to get out my Nikon DSLR fast to preserve their lies for posterity. These three placards are just so full of mambo-jumbo it would be a shame if I didn't make them available to a wider public. If I'm at risk of hurting my back while I'm lifting, standing-walking, sleeping, driving, sitting and sleeping, what the heck can I do that doesn't "damage" my back?! Boy, those people at the defunked PT store front were certainly trying desperately to drum up business!

 

[Steve Ozanich]

So, the high cabal didn't block my VOMIT?

One of the most difficult things for people to grasp is that the lifting didn't hurt their back, when their back hurts from the lifting.

Their brain was ready to reduce blood supply, the time had come for the need for a diversion. Just like Walt and his 32 can diversion. The tension had reached a level such that a diversion was waiting, ready to happen. Only a trigger was needed. The lift provides the opportunity, only. You can lift virtually anything you want, in any way you want, if you are relaxed. The spine is strong, despite what the industry wants everyone to believe.

 

[BruceMC]

If I do crushes on an abs machine with 175lbs of weight and it doesn't hurt my back one whit, lifting up a 25lb box of books sure ain't gonna injure my spine. My lower back pain, incidentally, seems totally disconnected from any physical activity I've been engaged in. TMS has a "Mind of Its Own" (so to speak) because it's really in the brain.

 

[af90]

This is gold. I feel like i have some repressed anger towards every physisian or physioterapist that told me to be careful. Thanks for making me realise that, it hasnt crossed my mind ill be oof journalling about it after this post. Example of how the society made me worse:

- i used to get back pain in the process of getting up from bed -> ''you are getting up wrong! You should always roll to the edge of the bed and get you feet on the floor then stand up''
- ''what you sat watching tv for 1 hour! Lets get this straight anything more than 30 min of sitting for you is too much''
-''here is a neck brace and a lower back brace wear them when you are on the pc''
-we had an ''injury prevention'' lecture at work. One of the topics was wrist pain. At the time I was like what is wrist pain? Do people actually get pain in the wrist? I never heard of it. Oh and we got a description of all the ergonomics and these special mouses and all stretches and strengthning exercises. Guess what from not knowing what wrist pain even was, i woke up 10 days later with both of my wrists in pain and that lasted 4 months.. thanks for the lecture guys...

- me: can i cycle to work? Physiterapist: ''NO bike vibrates too much on the roads and that would hurt ur back because of your scoliosis''

- ''stand up every 15 min of pc and do your stretches for one min, you can put an Email reminder every 15 min that works great!'' Thanks now i was thinking about my pain THROUGHOUT the day so i dont miss my stretch every 15 min.

- i was given a mouse pad that had picture of all the stretches one should do. great more reminders needed....

- gp gave me the report by the radiologist for three mri's covering my whole spine. Because it is public healthcare the appoined with the specilist took 2 months. In the mean time i am reading all the scary BS you would read on a typical mri report making it seem like you are about to collapse any moment. And the gp would be like ''oh you have this and that abnormality, i dont know what the specialist is gonna think but we will have to wait for the appointment.'' So the natural response is to be in overall panic for the two months (back then the pain wasnt even that bad but obviously started getting worse and worse the more i look up the terms on the report on the internet. THESE REPORT SHOULD NOT BE GIVEN TO PATIENTS.

Anyway i could come up with probably 20 more example but i wont bore everyone with my rant.

 

[Steve Ozanich]

Dr. Sopher told the radiologists he worked with to be careful how they worded their reports because it damages people (eg VOMIT). People have contacted me crying because their doctor said this or that, etc. But if I tell them it doesn't mean anything they often get better immediately. So belief is the key. If you believe someone your biology will adapt to that guided image.

This is very much at the heart of Dr. Sarno's great message(s). The findings are innocuous, for the most part. But professionals keep pointing to them as the cause. They are not the cause.

As far as damaging statements by therapists and other pain-pros, you're not the first to go on a rant about them. You might be # 999, 999, 999 on here alone. Then of course are the "words of advice" that cripple people. I gave a TMS lecture last year and listed all the things that people have been told by their doctors that harmed them. It was quite a long list but the one the entire room laughed at was, "You have eye pain because your eyes are too close together." 50 ladies laughed hilariously at that, but it's not the dumbest one I've heard.