For those interested, I have found some research that not only validates Dr. Sarno's theory, but goes into deeper research on why Sarno's theory works. Before sharing my take on this research, I will give you the relevant excerpts for your own perusal. This is a personal break-through for me. It's exactly what I have been looking for. I hope it is helpful to others.
Association between brain and low back pain
Shin-ichi Konno Miho Sekiguchi
Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Japan
Received 30 August 2016, Revised 24 August 2017, Accepted 2 October 2017, Available online 20 November 2017.
Psychosocial factors such as stress and depression are clearly closely involved in chronic low back pain, but the mechanisms have yet to be clearly elucidated. However, the relationship between psychosocial factors and chronic pain is also being steadily uncovered by recent molecular biological studies. The mesolimbic dopamine system refers to the dopamine pathway with axons extending from the ventral tegmental area to the nucleus accumbens, ventral pallidum, frontal cortex, amygdala, and other areas.
…
The mesolimbic dopamine system functions involuntarily, but if it stops functioning for some reason, the individual becomes hypersensitive to pain. Stress, anxiety, and depression are thought to be causes of dopamine system dysfunction. Dopamine release occurs not just with painful stimuli, but also with expectation of pleasure or reward. Scientific evidence for pleasure-related analgesia has also been obtained. Pain is inhibited by pleasurable sensations. Pleasant smells or images, favorite music, favorite foods and the like have shown clear efficacy in inhibiting pain. Interactions exist between pain and pleasure [16]. The introduction to medical practice of pleasant smells (aromatherapy), images (clean or fresh sensations, beautiful pictorial images), pleasant music and similar sensations are soothing for patients with chronic pain and can exert major effects on treatment effectiveness. In the presence of depression, anxiety, or stress, the dopamine response to painful stimuli is insufficient and as a result, μ-opioids are not produced and the mechanism of pain inhibition does not work.
…
Focusing on research that examines chronic low back pain with the use of fMRI, negative activation of the prefrontal cortex has been demonstrated to decrease with visual attention tasks in patients with chronic low back pain [19]. Other studies have reported that activation of the nucleus accumbens is decreased in low back pain groups and that connectivity of the prefrontal cortex and nucleus accumbens is involved in the chronicity of low back pain [20], [21]. Moreover, in patients with chronic pain including chronic low back pain, since multidisciplinary treatments such as pharmacotherapy and cognitive behavioral therapy have little effect, the predictive power of psychological and genetic factors in chronicity is low, and brain tests are effective [21].
…
Conclusion
Chronic low back pain is associated with [psychological] factors.
References
[1]
Y. Takeyachi, S. Konno, K. Otani, K. Yamauchi, I. Takahashi, Y. Suzukamo, S. Kikuchi
Correlatiion of low back pain with functional status, general health perception, social participation, subjective happiness, and patient satisfaction
Spine, 28 (13) (2003 Jul 1), pp. 1461-1466
View Record in ScopusGoogle Scholar
…
[4]
K. Kato, M. Sekiguchi, T. Nikaido, K. Otochi, Y. Matsuo, T. Igari, Y. Kobayashi, M. Takegami, N. Fukumori, S. Fukuma, S. Kikuchi, S. Fukuhara, S. Konno
Psychosocial stress after a disaster and low back pain related interference with daily living among college students: a cohort study in Fukushima
Spine, 42 (16) (2017 Aug 15), pp. 1255-1260
…
M.N. Baliki, D.R. Chialvo, P.Y. Geha, R.M. Levy, R.N. Harden, T.B. Parrish, A.V. Apkarian
Chronic pain and the emotional brain: specific brain activity associated with spontaneous fluctuations of intensity of chronic back pain
J Neurosci, 26 (47) (2006 Nov 22), pp. 12165-12173
…
K. Otani, S. Kikuchi, S. Yabuki
Characteristic of chronic low back pain patients and the role of psychiatrists – a study of consultation liaison psychiatry
J Spine Res, 1 (3) (2010), p. 439
[in Japanese]
Association between brain and low back pain
Shin-ichi Konno Miho Sekiguchi
Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Japan
Received 30 August 2016, Revised 24 August 2017, Accepted 2 October 2017, Available online 20 November 2017.
Psychosocial factors such as stress and depression are clearly closely involved in chronic low back pain, but the mechanisms have yet to be clearly elucidated. However, the relationship between psychosocial factors and chronic pain is also being steadily uncovered by recent molecular biological studies. The mesolimbic dopamine system refers to the dopamine pathway with axons extending from the ventral tegmental area to the nucleus accumbens, ventral pallidum, frontal cortex, amygdala, and other areas.
…
The mesolimbic dopamine system functions involuntarily, but if it stops functioning for some reason, the individual becomes hypersensitive to pain. Stress, anxiety, and depression are thought to be causes of dopamine system dysfunction. Dopamine release occurs not just with painful stimuli, but also with expectation of pleasure or reward. Scientific evidence for pleasure-related analgesia has also been obtained. Pain is inhibited by pleasurable sensations. Pleasant smells or images, favorite music, favorite foods and the like have shown clear efficacy in inhibiting pain. Interactions exist between pain and pleasure [16]. The introduction to medical practice of pleasant smells (aromatherapy), images (clean or fresh sensations, beautiful pictorial images), pleasant music and similar sensations are soothing for patients with chronic pain and can exert major effects on treatment effectiveness. In the presence of depression, anxiety, or stress, the dopamine response to painful stimuli is insufficient and as a result, μ-opioids are not produced and the mechanism of pain inhibition does not work.
…
Focusing on research that examines chronic low back pain with the use of fMRI, negative activation of the prefrontal cortex has been demonstrated to decrease with visual attention tasks in patients with chronic low back pain [19]. Other studies have reported that activation of the nucleus accumbens is decreased in low back pain groups and that connectivity of the prefrontal cortex and nucleus accumbens is involved in the chronicity of low back pain [20], [21]. Moreover, in patients with chronic pain including chronic low back pain, since multidisciplinary treatments such as pharmacotherapy and cognitive behavioral therapy have little effect, the predictive power of psychological and genetic factors in chronicity is low, and brain tests are effective [21].
…
Conclusion
Chronic low back pain is associated with [psychological] factors.
References
[1]
Y. Takeyachi, S. Konno, K. Otani, K. Yamauchi, I. Takahashi, Y. Suzukamo, S. Kikuchi
Correlatiion of low back pain with functional status, general health perception, social participation, subjective happiness, and patient satisfaction
Spine, 28 (13) (2003 Jul 1), pp. 1461-1466
View Record in ScopusGoogle Scholar
…
[4]
K. Kato, M. Sekiguchi, T. Nikaido, K. Otochi, Y. Matsuo, T. Igari, Y. Kobayashi, M. Takegami, N. Fukumori, S. Fukuma, S. Kikuchi, S. Fukuhara, S. Konno
Psychosocial stress after a disaster and low back pain related interference with daily living among college students: a cohort study in Fukushima
Spine, 42 (16) (2017 Aug 15), pp. 1255-1260
…
M.N. Baliki, D.R. Chialvo, P.Y. Geha, R.M. Levy, R.N. Harden, T.B. Parrish, A.V. Apkarian
Chronic pain and the emotional brain: specific brain activity associated with spontaneous fluctuations of intensity of chronic back pain
J Neurosci, 26 (47) (2006 Nov 22), pp. 12165-12173
…
K. Otani, S. Kikuchi, S. Yabuki
Characteristic of chronic low back pain patients and the role of psychiatrists – a study of consultation liaison psychiatry
J Spine Res, 1 (3) (2010), p. 439
[in Japanese]
