"This really is a pioneering book which I found of immense value and interest, not only because it basically solved my 3-year-old lower back problem but also because of the way in which it questions long-held medical views on chronic pain, particularly back pain. "Dr John Sarno's approach to chronic pain may sound outlandish at first, but do read his clear and logical arguments and his description of TMS (Tension Myositis Syndrome) before making up your mind. Particularly if you've been diagnosed with a lower-back problem causing chronic pain, and are considering invasive treatment such as surgery, you absolutely first have to read this classic. "On reading the book it again struck me how strange the human mind is, and how little we know about it. TMS, too, is a very strange disorder. Can it really be that the subconscious mind wants to protect the individual from painful subconscious feelings, and can actually create, via the central nervous system, a physical disorder (TMS) so that the physical pain will distract you from becoming aware of those feelings, thereby avoiding psychological pain? I am a rational person and this at first sounded preposterous to me, but this book made me think twice. One can debate Dr Sarno's Freudian approach and argue about the exact nature of the process leading to psychologically induced pain, but he does seem to be onto something here even if it's only to say that many if not most lower-back pain problems are stress-related and not structural. "Anyway I would like to add my voice to those who have been helped by the book. I am 63 years old and for the past three years experienced episodes of lower-back pain which gradually increased in duration as well as intensity. I initially took the orthodox path, consulting physiotherapists, my GP, trying muscle relaxants and anti-inflammatory ointments, strengthening core muscles with exercises, getting X-rays, seeing an orthopedist and getting expensive MRI scannings. The latter apparently showed a worn vertebral disc from which disc material was bulging out and putting pressure on a nerve. "The next step was an epidural injection with steroids. Rather despondent after the injection didn't seem to help much I began to search the internet for other approaches, and came across an article in Men's Health magazine on TMS, which though identified by Dr Sarno is not recognised by the medical establishment. Subsequently I checked out the many positive reviews of this book on Amazon and bought it. "The first thing I noticed while busy with the book was that, believe it or not, the sharpest pains seemed to diminish, in line with Dr Sarno's "knowledge therapy" - the information itself deprives the subconscious from its mechanism causing chronic pain. Yes, it sounds unreal and far-fetched; but that's because we live in an age where, for decades, doctors have convinced us, and created a mindset, that the subconscious mind and the body are separate and do not really influence each other. "Reading it though did not remove all of the pain, so thereafter I read The Mindbody Workbook by Dr David Schechter, containing a practical daily program based on Dr Sarno's ideas. About halfway into the book I found that the condition of my back had improved to such an extent that I didn't need to complete it. "It's been a few months now since reading Sarno's book and my back is still improving. I can walk without pain, no longer have to do core muscle exercises and can sit for many hours. Yes, I can't "prove" that my recovery is due to Dr Sarno's ideas because it could have been part of natural recovery or even the epidural injection, but I don't think so. After having read Healing Back Pain twice I am very much clued up on TMS and regard that as the syndrome that plagued me. For instance, I have a perfectionist type of personality, which is particularly susceptible to TMS. The symptoms of TMS closely resemble that which I experienced, and all kinds of little things have convinced me that TMS was my problem rather than the rather shaky diagnosis of disc bulging, which according to Dr Sarno is usually not the cause of chronic pain, as it has been demonstrated that many people with this condition do in fact not experience pain. "Dr Sarno is very much influenced by Sigmund Freud, the discoverer of the subconscious mind. These days Freud's ideas are somewhat out of fashion, and indeed some of his theories seem bizarre. It is to Sarno's credit that contrary to fashionable thinking he has focused on what makes good sense in Freud's work, so helping to understand mindbody disorders. Reading the book, which also contains a fascinating chapter on the history of psychosomatic medicine, one can understand why the medical profession has made the fatal error of moving away from this very important part of medicine which in the 1940s was still an acceptable area of study and research. "So is the pain all in the mind? Definitely not, says Dr Sarno. TMS pain is real and physical - it is the result of either muscle spasms or a buildup of waste chemicals from the metabolism of lactic acid. The prime cause, however, is in the unconscious mind which is linked to the central nervous system. Though we do not yet know exactly how the TMS mechanism works, we do know how it manifests itself and how to treat it. "A fascinating feature of TMS is that it apparently latches on to well-known and socially acceptable disorders which it uses as camouflage. For instance, some decades ago peptic ulcers were endemic. These days ulcers are less frequently diagnosed, and spastic colons and irritable bowel syndrome seem to have taken their place together with lower back problems. According to Sarno and others, TMS is in many of these cases the underlying disorder, resulting from psychological stress which manifests itself physically. "Treatment, of course, depends on whether you actually believe that the diagnosis of TMS is correct. Regrettably most people have been so brainwashed by medical orthodoxy - which says that back pain must always be due to a mechanical problem - that they will find it difficult to accept a mindbody diagnosis. "And so the lower-back pain epidemic continues, with an ever-increasing industry of orthopedists, physiotherapists, osteopaths, chiropractors, Alexander technicians, acupuncturists, neuro-stimulator practitioners, aromatherapists, masseurs and reflexologists treating many so-called structural problems that may in fact have a psychological stress origin. If people do derive relief from this wide variety of healers - and the variety itself indicates a lack of real progress in this field - it could in many cases be due to the placebo effect. People, however, tend to have very fixed opinions about what ails them and also get used to their placebos. So only those who have an open mind will benefit from a mindbody approach." UPDATE - OCTOBER 2015: The above was a review I wrote in September 2013. Since then there have been a few minor relapses, followed by further progress. Today, TMS is no longer a problem for 99% of the time. For me, progress has been a zig-zag affair, with two steps forward followed by one step backward. My strategy was that on getting a relapse, I would simply return to reading one of the various TMS books, and if necessary to also write some more (daily) about my issues in a diary. That worked very well for me. It seems that my subconscious mind continually needs reinforcement of Sarno-inspired ideas, otherwise it may fall back into old patterns. I have been pain-free for months now, but should it rear its nasty head I know that I can simply go back to the books and do some reading, so that the worried inner child can sink back into its subconscious depths again, satisfied and assured that all is well. Also, apart from reading I have also focused on things such as improving self-image, self-respect and self-love. The subconscious child-body within us, and so also one's current physical body, needs constant respect, admiration, attention, security and especially love. You have to love yourself and the body you're in. These aspects, which I tended to ignore in the past, have become very important in my life, and they are probably a major part of my recovery. If you're still in the grip of TMS, do try working on these facets - I'm sure you will reap the benefits. All the best! Thanks for reading this, and all the best in dealing with TMS! Sarno was right; you have to become your own shrink and deal with your issues, and the pain will subside.