Government stance on our pain

Hey everyone,

I've been interested for a while in our health care system's treatment of chronic conditions. Why is it that when I went to see a doctor for my varicoceles, which were causing me intense physical pain, he recommended me to a surgeon first? Why is it that I only discovered Dr. Sarno and Healing Back Pain through personal research?

The idea of this thread is to talk about the politics of our health. Why is it that we have to go out and find Sarno's research on our own? Why is it that a surgery or medication will be partially (or completely) covered by insurance, but we have to pay completely out of pocket for psychotherapy appointments?

I've been looking into this a lot lately, and I wanted to share some of what I've learned, and get your thoughts on it!

It turns out that there's a complicated process in our health care system for getting treatments accepted by the medical community. As I understand it, there needs to be a body of research evidence for any treatment before it can be recommended by physicians to their patients. From drugs to surgical methods to psychotherapy, if it's covered by your insurance provider, it's been tested scientifically. And most doctors are going to recommend what's covered by insurance.

Every year, some of our tax dollars fund that kind of research. The National Institutes of Health are the major distributors of that funding, and so what they think about medical problems like chronic pain is a big deal. The NIH are a bunch of research institutes run by scientists that want to study various health issues. And they have an Institute that's devoted just to neurological issues in health.

Here's a list of treatments for chronic pain that they've compiled. These are all therapies that have research evidence to support their effectiveness. One thing I noticed was that only Cognitive Behavioral Therapy (CBT) is listed as a psychological treatment. There's actually not much discussion on that entire page about the relationship between the way we think and our experience of pain.

I bring all of this up because at the end of the day, the NIH plays a big role in determining how a doctor decides to treat chronic pain. If the NIH doesn't talk about how mindbody is an important part of chronic pain conditions, then the average doctor probably won't either.

Here at TMSWiki, we recommend everyone go see a doctor to make sure there's no structural problems, and then we talk about going through this treatment. But what if you're like me? You go see a doctor and they actually SEE a physical problem? And you *still* have PPD? Let's say your doctor doesn't know about mindbody disorders, and recommends you for surgery? That kind of sucks.

Has anyone else looked into the wider medical community's acceptance of the mindbody and chronic pain? Has anyone heard of an insurance provider that reimbursed for a mindbody-style treatment of chronic pain?

Thanks for reading, you have earned yourself a bagful of awesome!

 

Hey LaL - I'll take that bag of awesome, double it, and award it back to you! (And it's nice to see you again )

This is an awesome recap of The Problem.

To address your final question, what we need is for one of our practitioners to answer it - after all, they are the ones receiving those reimbursements, right?

Or a member who received insurance coverage for seeing a TMS practitioner? Anyone? (I'm no help - I diagnosed myself and self-treated with the SEP and other resources I found here).

Dr. Hanscom is a back surgeon in Seattle who pre-treats surgical patients with his Back In Control program - in hopes that they will cancel the surgery, which they often do. So... do those patients get insurance coverage for going through the program? How do we ask Dr. Hanscom this question? I've got too many other things on my plate this month so I'm going to let someone else figure that one out!

I am also going to try to remember where I saw an article about serious research that is being done on the power of the placebo effect - and the fact that there ain't no profit in it for Big Pharma.

Thanks for this conversation, LaL - I hope it generates more discussion!

 

I was just this moment thinking about this and Bernie Sanders Presidential bid. If you recall he was part of the senate select committee looking into the issue of chronic pain and interested in what Sarno had to say.


A President Sanders would be good for Mindbody medicine at least. I also noted he was particularly interested in the impact of poverty on health. Now, I appreciate American politics and this forums policies so please don't turn this into a slanging match

I don't give a hoot but would love to see Sanders do well on the basis of hopefully getting research funds directed at mindbody phenomena.

He recently declined Pharma campaign money from the CEO who bumped up the price of a cancer drug....doesn't mean he is anti-Pharma just shrewd enough to understand the optics.
https://www.bostonglobe.com/news/po...gn-donation/FcSKxu1VIr7pubg9cI3CQN/story.html

 

Nice catch, Irish - I didn't recall that, but I WAS listening to Bernie on the Tavis Smiley show this morning and thinking maybe it's time I made a monetary commitment - and I think this just sealed the deal, so thanks for re-posting the video. His question was very appropriate to the topic, and Dr. Sarno's response was, of course, right on.

Now I wish I knew what the committee was actually doing about MBS. I'm so cynical, I have always assumed it was nothing.

 

Hey Jan - good to see you again! ^.^

Irish - thank you for that clip, I had heard that Sarno visited Congress but I never got a chance to see the Committee Hearing. I wonder if there's a more complete version with the other doctors' comments. We were really lucky to have Harken on the Committee at the time that the Institute of Medicine was releasing its National Pain research report. Still, it looks like most of those attending felt that Sarno was going back to the "it's all in your brain" argument.

And I can totally see Bernie being down with Sarno's comments RE lower economic well-being and heightened incidence of pain. (Bernie fan myself, here)

If there's evidence that economic status is correlated with pain, it suggests that the prevalence of chronic conditions in our country is not just a health policy problem. We're talking about a problem in the way we've structured our society. It makes me wonder what kinds of changes we can make environmentally to lower the incidence of pain.

 

Hi LaughALot.

I like the topic of this thread, I too am fascinated as to the how and why tms is not wide spread accepted by the general population.

I think the question really boils down to what do the media do about our pain? I've seen two front page headlines on daily national papers in the last month here.


The first one read: BACK PAIN, 8 GOLDEN RULES , then there was a small artical that went on to say 7out of 10 workers suffer with back pain, and the 8 golden rules supposed to help were just ridiculous, things like sit upright, don't look down, walk 30 mins, basically all the stuff you dr sarno says you shouldn't believe!

Then 3 weeks later, Front page again, same paper BACK PAIN, NEW OPERATION WILL HELP MILLIONS. Then goes on to advertise spinal fusion ops!

Is it just me? or does that seem ridiculous in the week when our national debt has increased to £1.5 trillion whilst we are under austerity cuts and the the prime minister has just been exposed putting his bits in a pigs mouth at an initiation ceremony into politics??!

My point is even if the government does want to help our pain how can we make people believe in TMS being real if the general population think back pain and spinal fusion ops are the norm?

As you quite rightly pointed out the medical system will only endorse the scientifically proven. This obviously leads to doctors only learning about the scientifically proven. Which, in turn leads to doctors only prescribing, yep, the scientifically proven.

I think a lot of family doctors know that stress causes the problems,
To give a great, personal example, I asked my freinds wife, a young family doctor what she would say to me if I came into her office complaining that last night at work, in one 12hr shift I had.
-shoulder/neck freeze lasting 2 hrs
-headache lasting 3 hrs
-lower back 1hr
-symptoms of sprained ankle causing me to limp badly for 5 hrs which completely went after being home for 45 mins.

She looked at me somewhat dumbfounded, I said, you'd think I was a making it up! she replied, " no, I wouldn't" but it was clear to me she wasn't going to say psychosomatic or mindbody so I put and end to her guessing to save any embarrassment, to which she replied:

"Well I do know about that because there was an Indian woman I learnt from, she told me that Indian women do not get depression, they get all over body pain" where they come in and say "I have pain here, here & here" pointing to various locations of pain. She also admired that she feels that most people's problems are related to thier mental wellbeing.

I asked her why she thought that mental health therapy is not then the normal prescription and she stated that most people just won't accept that they have mental Heath issues. This is clearly because there is a stigma attached to it. I thought it funny that she totally agreed that its stress related but couldn't seem to see how there's any other way to treat it other than the way it is.

To me, this non acceptance comes from two things us humans have been conditioned to believe:

1) if you have pain you have stuctuctural damage, hospital and medical care system is the most advanced care we can get, they are doing the best they can and you should not question them....this leads to doubts in TMS treatment. Any doubts and you will struggle to shake it off.

2) Mental Heath issues Are usually portrayed in media and films as a bad thing. Think of the common phrase " he went mental" and you will soon conjure up the thought of that somebody coming off the rails..... there is a stigma attached to it. this means as soon as you get that diag, you fear. If you fear it, your unconscious knows, and will try to prevent you thinking about it.

There you go, fear and doubt. The question is where does this fear and doubt come from?

The truth, I.m.o is that the govenment are not actually here to serve us, they are here to serve them. That is, the decendants of the dynasties and rulers that once blatantly ruled the world. Everybody seems to think that when we had enough of that, we created governments controlled by the people, for the people, but unfortunately very little has changed. Although there is undoubtedly a lot of good people working in education, politics and healthcare, the system was made by, and made for the ruling elite. It's very hard to change things in such a corrupt system.

The big issue to me is how to break the cycle. Do we wait for the gov to start educating our children on this or do we need to take responsibility ourselves? I believe that a healthy body starts with healthy emotions. Children should be learning about this at school but in reality they aren't, well all hear the saying "you shouldn't bottle it up" as a child but how many of us realised the importance of this before TMS.

 

Vote for Joe the Plumber, and when he becomes corrupt vote for a chimpanzee, it will do less harm. Instead of sending your taxes to Washington, mail them to Smith Center, KS., it's the new Brasilia--sorry I'm a bit mental but I haven't had my second cup of coffee yet and the gov inspector has recently come by and forced a change in the ph of the hot-tub increasing the EMG's.

 

In my Mathematics class in school my sarcastic teacher asked a guy (whose Doctors were both parents) what he wanted to be. The guy said he wanted to go into accounting/finance. The teacher shook his head and laughed. Then proceeded to tell him he would become a Doctor.
When University applications started, lo and behold off he went to study Medicine.

Like Law, Medicine is really tough to break into and succeed in if you aren't born to it. Of course many become Doctors but you'll find the vast maj of top medics are from a long line. So there is a sense of entitlement/arrogance from some Doctors that they are a special clique. I trust them 90% of the time and genuinely feel for them in the age of the Internet. Can you imagine what it must be like for family doctors trying to counteract bad advice someone 'read online'?

Along comes Sarno with this whacky insane idea that Doctors have missed the mark on the issue of pain not just by a little bit but by many miles.

People think its too simplistic and easy and it MUST be more complicated. Or the old gem ''people are living longer and degenerating like never before''.



Bear in mind that TMS is not medically validated but this gives insight into the closemindedness of the profession unlike say Physics. They seek out the whacky ideas and TEST them scientifically. A great many Doctors will tell you they know stress is a major factor but lack the framework for really treating it well.
I pester top Pain researchers and saw that Lorimer Mosley is aware of Howard Schubiners work so that is progress.

I hope a tipping point will be reached but look at how many people will lose out. People act out of self-interest at all times, this is why I'm pessimistic about the chances of widespread adoption.

 

I don't see Bernie in this at all,is he here because one would know. This congressman is not Bernie. But I've seen this before.

 

Sanders is around the 9 minute mark. Senator harkin is the main speaker who convinced Sarno to come down and speak.

 

It seems like most professions have a multi-generational component to them. Good book on the subject: Outliers by Malcolm Gladwell. There's a lot in the book, but one aspect of acquiring mastery has to do with socialization. The certain way you're brought up shapes you toward particular ways of working, or gives you a certain set of skills that would be advantageous in a particular line of work.