Dr. Sarno on Larry King Live

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The following is a transcript of an interview with Dr. John Sarno on the CNN talk show Larry King Live, which originally aired on August 12, 1999 at 9:00pm Eastern Time.

Larry King Live: How Can Chronic Back Pain Be Cured?

LARRY KING, HOST: Tonight, your aching back and what to do about it. We'll hear from people who've felt the pain and found help. Joining us, popular broadcast personality, Howard Stern; famed defense attorney, Robert Shapiro; comedy producer for "The Rosie O'Donnell Show," Janette Barber; plus Dr. John Sarno, best-selling author of "Healing Back Pain: The Mind-Body Connection"; and spinal surgeon, Dr. Patrick O'Leary. They're all next on LARRY KING LIVE. Good evening. Our entire program tonight devoted to back pain. Howard Stern is with us by phone. He is fighting laryngitis, but bravely carrying on in the tradition of great broadcasters. The show must go on. Our guests -- we'll meet them each individually -- some tin type questions for each and then a roundtable discussion. Dr. John Sarno is professor of clinical rehabilitation medicine at New York University. He's author of "Healing Back Pain: The Mind-Body Connection," published in 1991 by Warner Books. It'll be number two on The New York Times bestseller list in the self-help category on August 15th. He's also author of "The Mind-Body Prescription: Healing the Body, Healing the Pain," published just last year by Warner Books. There you see both books. Some individual questions for each guest, Dr. Sarno, what got you interested in the back as a life's work?

DR. JOHN SARNO, AUTHOR, "HEALING BACK PAIN": Actually, it was a matter of having been exposed to a lot of patients with back pain, when I became the director of the outpatient department at the Howard Rusk Institute of Rehabilitation Medicine. Before that, I hadn't seen very many people with back pain, but then that position put me in the position of seeing a lot of patients. And that's how I got into this work.

KING: What is your specialty then?

SARNO: My specialty is rehabilitation medicine or physical medicine and rehabilitation. It's a relatively new specialty in medicine, actually came into its own after World War II.

KING: Dealing with people who get better after reconstructive surgery or whatever?

SARNO: Actually, dealing with people with a variety of very, very serious problems, spinal cord injuries, for example, with paraplegia or quadriplegia, patients with strokes, patients with amputations: all the heavy stuff.

KING: Dr. O'Leary, why did you choose spine surgery?

DR. PATRICK O'LEARY, SPINE SURGEON: Well, when I finished my residency training at the Hospital for Special Surgery, Dr. Wilson there told me that if I wanted to come back to the hospital I had to do either spine or tumors or feet. So, I picked spine. That was the more interesting topic. It also was less well known at the time and I thought it would be a good challenge to get involved in that area.

KING: Do you believe in the theory that the spine is connected with many body problems?

O'LEARY: Yes, I do.

KING: More than just back problems?

O'LEARY: Meaning what exactly.

KING: Well, you know, I guess the field of chiropractic thinks the spine is connected to almost everything.

O'LEARY: Well, everything is interconnected. All systems are interconnected. I think the spine is its own unique organ system, but it's interrelated with the brain and with the heart and with the muscles.

KING: Howard Stern is with us by phone. How are you feeling, by the way?

HOWARD STERN, RADIO PERSONALITY: I'm doing all right, Larry. I was anxious to come on the show, because I love Dr. Sarno so much and what he has done for me, that I was under any conditions that I would appear because his message and what he has to say is so brilliant that I feel that should get on even with laryngitis and support.

KING: Now, you dedicated -- when you wrote, "Private Parts," your best seller, to your parents and your wife and also to Dr. Sarno. So, what did he do? What was wrong with you?

STERN: Well, Dr. Sarno saved me from a life of pain. I had such tremendous back pain for years that even during my radio show I would lay down on the floor, and when commercials were playing I would lay down on the floor trying to somehow alleviate the pain in my back, and it was just near impossible. Life was becoming so painful, because of this constant back and shoulder pain. That's why I originally went to him. And I had been through the usual course. I had been through, you know, going to chiropractors. I tried every kind of alternative therapy. I went to doctors. I had one doctor tell me that I had a genetic defect in my shoulder and that I would need surgery. So, I was at any wit's end. And I had a friend who said me to that....

KING: Did it start young, by the way -- did it start early, Howard?

STERN: Yes. Well, it had been going on for years, and I found that I had friends who were going under similar problems. You know, I had a friend who used to walk around with a big rubber pillow, and his wife was annoyed by him, because he had constant back pain. And I ran into him a couple of months after I had seen him and he was pain free and he said he read Dr. Sarno's book. And I said, "Well, that worked for you, but it will never work for me. I have real pain. I have pain from lifting weights. I have pain because I'm 6'5." You know, I was convinced my pain was some sort of physical defect, when in fact it was the mind that was controlling my back.

KING: And was it the book or was -- you became a patient?

STERN: I went to see Dr. Sarno. I read the book and I became curious, and I went see him and he quite simply looked at me and said, "My friend, the pain is in your head." I said, "No, Dr. Sarno, you don't understand, my pain is real." He goes, "Yes, your pain is real." And he explained to me the biological occurrence, that my brain actually would cut off some of the blood to the area of my back, the vessels would constrict and cause this pain. After he explained it to me, I went to two seminars. They were an hour lecture a piece. I was in a room full of people who all squirming, all had back pain. When we got done, our back pain lifted, some of us immediately, some of us a week or two later.

KING: How long you been pain free?

STERN: Five or six years. It's a miracle, and anybody can do it.

KING: We'll get back to you. Robert Shapiro, what is your back problem?

ROBERT SHAPIRO, DEFENSE ATTORNEY: I have two, Larry. I have two disks that are degenerative in my back, and two also in my neck. My neck is from a sports injury. My back is probably just genetic.

KING: And how is it treated?

SHAPIRO: I have a terrific doctor here, Dr. Ted Goldstein, who took a very conservative approach, first, with anti-inflammatories to release some of the immediate pain, and then with a basic change in lifestyle. Simple things, the way I get in and out of bed, the way I get in and out of a car, not talking on a telephone unless I'm using a headset, simple things along with exercise in his rehabilitation program. I do a lot of crunches. I do a lot of stretches.

KING: Do you do anything connected with the psychological, as Dr. Sarno and Howard have discussed?

SHAPIRO: No, I haven't.

KING: What do you make of that?

SHAPIRO: I think it is for real. I think that so many things are connected from our brain -- from our emotion. I know for me, the biggest trigger point I have to my own health is stress.

KING: You do know that?

SHAPIRO: I know that without a question. Stress brings on pain.

KING: We'll take a break. We'll get Janette's story. We'll get the thoughts of Dr. O'Leary, more of the Sarno theory and more from Howard Stern, and your phone calls as well. Don't go away. (COMMERCIAL BREAK)

KING: Janette Barber is a comedy producer and writer for "The Rosie O'Donnell Show". What's wrong -- what was wrong with you?

JANETTE BARBER, PRODUCER, "THE ROSIE O'DONNELL SHOW": My ankles. I had, in both ankles -- it started in August of '95 and it was diagnosed as posterior tibialis tendinitis.

KING: Meaning?

BARBER: Meaning tendinitis in the ankles.

KING: Both of them?

BARBER: Both of them.

KING: So, you couldn't walk?

BARBER: Well, at first I couldn't -- it was just, you know, painful and I would like shuffle. For two solid years, I wrapped my ankles very tightly in Ace bandages everyday just to be able to walk. I used a wheelchair for the first time in '97 when the show went to Los Angeles, because there was too much walking. Then I would come back. I, finally, as of last summer, was in a wheelchair completely.

KING: Did your back get hurt, too?

BARBER: I hurt my back, actually, years ago in '85. And after I met Dr. Sarno I realized that coincidentally when my ankles began hurting my back stopped hurting, but I never would have made that connection. I just thought my back got better.

KING: What did Sarno do for you?

BARBER: It's very much the same thing. I was in a state of, literally...

KING: Like Howard?

BARBER: Like Howard. I could not walk at all. I literally -- I would cry every single day. Just before -- about two weeks before Rosie put me on show, which is how I found Dr. Sarno, to see, because a Dr. told me -- he didn't say you'll never walk again. What he said exactly is, "I am pessimistic about any recovery." And when I said, well, what should you do? He said, looks like you tried everything, and then he told me which hallway to go down to pay. So, yes, I was totally desperate about this. When I went to Dr. Sarno it was the same thing. He talked to me. He does like an examination to make sure that it's what he thinks it is, and he told me that this is what stress can do.

KING: did you read his book too.

BARBER: I read his book too.

KING: Did you do the seminar, like Howard?

BARBER: I did the seminar, and had exactly the same...

KING: You're pain free?

BARBER: I am pain free. I wouldn't say -- mine will occasionally come back. That's -- it's very interesting; under extreme stress.

KING: And you were in Kosovo last year, in a wheelchair?

BARBER: No, I was in Kosovo about three weeks ago, and which was -- I volunteered with an organization called AmeriCares. It's a relief organization.

KING: So two years ago, you wouldn't bet you would have gone...

BARBER: Exactly. I couldn't walk at all. This summer, as we're delivering food up the side of a mountain in Kosovo, and I'm able to run up, following the little AmeriCares van, and literally in my head, I couldn't get these two images away from myself, that a year ago, I couldn't walk, and this year, I can actually do something with my life that matters. Without him, I couldn't have done it.

KING: Dr. Sarno, what is TMS?

SARNO: It stands for tension myositis syndrome.

KING: Did you invent the term?

SARNO: Yes, I did. If I were putting a name on it now, it would be somewhat different, because at the time, back in the early '70s, I thought that we were dealing only with a problem involving the muscles. As time went on, we began to realize it could involve muscles and nerves, and as in Janette's case, tendons as well.

KING: So what did you call it now?

SARNO: Well, we're still -- we're stuck with the title, because it's been used in all my publications. But you know what Shakespeare said about roses, a rose by any -- so.

KING: Can you explain, briefly and again, without being too medical, for the lay audience, what it is you do?

SARNO: OK, I was going to say you want the simple explanation or the complicated one? You want the simple one.

KING: Simple.

SARNO: Actually, really what's involved here is that tension, stress, trying to do things well in our lives can produce internal reactions in the unconscious mind that we're totally unaware of, but the unconscious mind is quite frightened of them. We actually get very, very angry inside, to the point of rage. And the thing you must understand is that this is universal. We're all doing this to greater or lesser extent, and there are many, many different kinds of physical reactions that one can have. At the moment, these pain disorders are of, literally, epidemic proportions in the United States. And so what the brain does is to create symptomology in order to sort of draw your attention away from what's going on inside and make sure that that anger doesn't come out.

KING: So are you saying end the anger, end the pain?

SARNO: You don't end the anger. You simply make the people who got this aware of what's going on. This is an example of the power of knowledge, the power of information, the power of insight. And that's what I do with my patients, as they've indicated. I lecture to them. I talk to them. I get them to understand what's going on. And fortunately, for all of us, this has a therapeutic effect.

KING: Dr. O'Leary, what do you make of it?

O'LEARY: I think it's wonderful that he can help so many people. I think that there is a huge spectrum of people with all sorts of different disorders, and I think the vast majority with spine problems are and should remain nonsurgical. My area is the tip of the iceberg. He's got the whole iceberg basically to himself.

KING: So you're not here in conflict with him?

O'LEARY: No, no.

KING: You're just saying that in many -- or in some cases, it goes beyond just control by mind or dealing with anger? .

O'LEARY: For certain issues, strokes must arbitrate, like Shakespeare said, to quote the rose man here. But there are certain cases that absolutely need surgery. There are certain cases which surgery is a good alternative treatment. Certain cases where surgery is urgent and certain where it's elective. And -- but most patients who contact you for back pain problems are best off screened first by a neurologist or a podiatrist who understands the principles and directs them appropriately for care and management. Only those who fail to respond to conservative treatment or some acute process, those then come for surgery.

KING: We don't know why, do we, doctor, that John gets back pain and Jim doesn't?

O'LEARY: We do not. That's true.

KING: OK. Howard, can you describe what severe back pain is like?

STERN: Well, first all, I wanted to say to Bob Shapiro that, you know, listening to his story, how he's limiting himself by talking on the phone a certain amount of hours and only doing certain kinds of movements and he has to exercise, I really suggest he read Dr. Sarno's book, because those are the kinds of things that I was doing. You know, you start to believe that it's something that you're doing is causing this back pain. And as Dr. Sarno points out, 99 percent of these surgeries are absolutely unnecessary. People are doing things to their back and going through hell for absolutely no reason. The pain I was in is so discomforting and so horrible, that literally I would spend my weekends laying on my back in front of the television set. And in a way, what it really is, is our own version of the nervous breakdown. I know for myself, I would always be too proud to cry or scream about my problems, so what I did is I internalized them. Now I understand it. This way, when I was laying on my back, my wife couldn't bother me. My kids couldn't bother me. Everybody felt bad for me, oh, poor, Howard, he's in bad shape. And this was my way of tuning out the world.

KING: And did lying on the back relieve the pain?

STERN: Absolutely not. There was no relief. And it got so bad that, at some point, it started to disturb my sleep. So when I met Dr. Sarno, literally, not only did it heal my back and shoulder pain -- I had been diagnosed with something called frozen shoulder, and all of these diagnoses lead you to the physical therapist and hours of physical therapy. And when Dr. Sarno explained what was going on biologically and how my brain was causing this constriction of the blood vessels, it immediately connected for me. The pain lifted miraculously, Larry. I mean, in one fell swoop I was pain free for the rest of my life.

KING: Incredible.

STERN: It is incredible.

KING: We'll be back with more, and I'm going to get Bob Shapiro to comment on what Howard said. We'll be taking your calls as well. It's our subject for the full hour. Don't go away. (BEGIN VIDEO CLIP, "THE ROSIE O'DONNELL SHOW")

ROSIE O'DONNELL, TALK SHOW HOST: You can physically walk, but it's literally unbearable and most of the times you have ice packs on your ankles.


O'DONNELL: And sadly, we at the office find this a cause for ridicule sometimes.

BARBER: Well, not only that, I ride to work through Central Park in this.

O'DONNELL: In the buggy. All right, now the one doctor told you that there was no hope for recovery?

BARBER: Yes, a few weeks ago, the last doctor I went to said that -- quote -- "He was pessimistic about any recovery," and that, you know, get used to it, which I didn't like.

O'DONNELL: OK, now since it's Janette's birthday, I said what do you want for your birthday? She said, "I want my ankles to be better." So that's what we're trying to do. Anyone out there that knows how to fix tendinitis, so that Janette Barber can walk and get out of the wheelie-cart, please call our show. Fix Janette. Write us a little letter. (END VIDEO CLIP) (COMMERCIAL BREAK)

KING: OK, Bob Shapiro, Howard says you don't have to do all of these things you're doing. Go to see Sarno or read book.

SHAPIRO: Well, I'm certainly going to read the book, and I take Howard's suggestion to heart. But I do believe that what has worked for me is this type of routine of being very careful, just on simple things before...

KING: But you have to make allowances for your life because of it, right?

SHAPIRO: Well, not allowances, just avoid stupid things. Before when I'd go to the airport, I'd reach down and bend over and pull up a briefcase. That alone would trigger a reaction.

KING: Now, Howard, you're saying he doesn't have to worry about that, right?

STERN: Larry, let me tell you, I was convinced that my back pain was a cause of doing squats in the gym, so I stopped doing squatting. When the pain persisted, I was sure that the pain was from sitting in this chair that I had at the radio station, so I had the chair switched. I had a million and one reasons and a million and one things that I couldn't do, just like Bob says, and you start to restrict yourself. I have a friend that went to Dr. Sarno, who is a baseball player. He was told he could never play ball again. His back got worse when he got that diagnosis. He was told he needed an operation. He was about to go under the knife. Lo and behold, he heard about Dr. Sarno, went to see him. Within two weeks, no back pain, back playing baseball. In fact, Dr. Sarno will tell you that Bob Shapiro should stop doing all of the things that he has doing, and enjoy them and have absolutely no worries, and I guarantee you that Bob Shapiro will never again have to worry about picking up a piece of luggage.

KING: Dr. Sarno, is he -- address, Bob. Is he dealing with -- you talk about misconceptions, like don't bench, don't slouch, don't sit on soft chairs, don't arch your back, don't swim.

STERN: I am sitting upside down right now. (LAUGHTER)

KING: John, can you say to Robert, you could get him to -- that he could bend over for his briefcase at the airport?

SARNO: You know, I can only speaking in generalities. I know that many, many of the people that I see do come with the kinds of relatively minor abnormalities that he has. But I...

KING: "Minor" you call them. They're minor?

SARNO: Yes, you see, I think that degenerative changes in the spine are normal. Everyone knows this. Some of these changes begin when we're teenagers, believe it or not. So that, what has happened, I think, over the years is that because of an awareness of the existence of this stress-induced process, naturally doctors have attributed them to the abnormalities that they see in the spine, on X- rays and MRIs.

KING: All right, Dr. O'Leary, would you back that up? Would you say that everyone has, in a way, a degenerative back?

O'LEARY: Over time, yes. Our disks deteriorate over time for genetic reasons, age reasons and stress factors as well, and exact mechanisms, not well understood. Most people get through their lives quite well without seeing doctors and go through the same degenerative process.

KING: So when Bob Shapiro says he has a degenerative disk that's not unusual?

O'LEARY: No, it's very common.

STERN: Larry.

KING: Yes.

STERN: I am no doctor, obviously, and some people might think I'm a maniac. But think about it for a second. If you had a slipped disk, wouldn't it stand to reason that that disk would in fact cause you no back pain, because it would cut off your nerve endings in that area and actually deaden the area. So there's absolutely sort of this ridiculous notion that a slipped disk, which probably all of us have -- there's no reason why we should be experiencing back pain from it. I am sure if you took an X-ray of my spine right now, I've got a slipped disk.

KING: Bob, are you open to this?

SHAPIRO: Oh, I am very, very open to it. First, Larry it should be very clear. I think you know this, and maybe some of the listeners and viewers know this, but I exercise vigorously. I work out.

KING: You box?

SHAPIRO: I box four times a week in a professional gym. So my physical activity, as far as exercise, is not limited. What I'm saying is I have found in the past that if I was pulling a piece of luggage out of the trunk of a car, no matter what great shape I'm in, that would cause my back pain and I would be in a position where my back wouldn't straighten out for two or three weeks while it was healing. I know now just not to do that. That doesn't mean that I can't go in the gym and work out.

KING: Janette, have you made allowances too? Or have you...

BARBER: In the past I did. And that's a very interesting point, I think, because if the point of the pain is to distract you from your life, so that you don't have to face what's happening, the more you change your life to accommodate the pain, the worse the pain gets, because it's working as a distraction, and that's definitely what happened to me. Because all of this time, I couldn't work walk, I was -- I mean, but I was hobbling. I had the ace bandages. I was walking. It wasn't until last summer, one week into my seven-week vacation, my ankles hurt until I was able to not walk at all. They hurt. I thought, the best thing to do, tendinitis, I should stay off of them. Every day that I stayed off of them, everyday that I changed my life and my life got narrower and narrower, the pain got worse and worse, because it was working.

STERN: Larry.

KING: Hold on. We'll come right back to Howard, and we'll ask Dr. O'Leary who needs -- who does need surgery. We'll come right back after this. (COMMERCIAL BREAK) We'll reintroduce our panel at the bottom of the hour. We'll go to you phone calls. Before I -- Howard was going to say something before I ask Dr. O'Leary -- Howard.

STERN: Yes, well, I was just going to say to Bob again, you know, this drive mess crazy, because...

KING: Bob, someday you'll hold up signs: "Howard saved my life." (LAUGHTER)

STERN: Yes, well, I guess I'm trying to save Bob here. I don't know why, but -- you know, it's a funny thing that a man says he can box four days a week but he can't lift a piece of luggage. And all I'm saying is...

SHAPIRO: No, I can't lift it improperly.

STERN: Right, but all I'm saying is, there's no improper way of lifting a piece of luggage. I know that sounds crazy. But I've got to tell you, once I understood Dr. Sarno and what he was saying, that I apply this to every little ache and pain I get. The other day I had knee pain. I am a runner and I run a couple of miles a day. My knee started to hurt and I just looked at that knee pain and I laughed at it, and went out and ran five miles, and it was quickly gone. And literally, I know that to people who listen to this conversation, they're saying, oh, gee this must be a placebo, this sounds like a cold or something. This is just -- when you read this book, there's such medical evidence supporting Dr. John Sarno that I guess I kind of feel like, wow, this guy can really save the world, and I really feel that he's somebody who has come up with knowledge that should be hailed by the medical community, and it almost sickens me that the medical community doesn't embrace Dr. Sarno.

KING: But Dr. O'Leary is, right? You are not declining the views of Dr. Sarno, right, Dr. O'Leary. Let's reiterate that.

O'LEARY: Absolutely not. We're talking about the 10 percent five percent of back problems who cannot respond to Dr. Sarno's treatment, who he himself knows quite well that not...

KING: Who, Dr. O'Leary would need surgery? What's the kind of case where a back has to be operated on?

O'LEARY: Well, an absolute has-to would be impending paralysis from pressure of the disk on the nerves that might affect movement of the legs, function of bowel and bladder, things of that nature, where there's severe sudden pressure from a massive disk herniation. That's one example. Another example would be somebody who has got increasing spinal stenosis and increasing pressure on the nerves from arthritis to a point where they can't stand or walk.

KING: That would be easily seen under X-ray?

O'LEARY: Yes, with MRI scan or CAT scan, it would be readily visible. Initially, it can be handled by Dr. Sarno quite well, but then it reaches a point where the surgical factors take over and it becomes a surgical reality, over time.

KING: What, Dr. O'Leary is a slipped disk?

O'LEARY: Well, a slipped disk is a common language that's used for herniated disk, slipped disk, protruded disk. It's when the disk that cushions the vertebrae gets displaced beyond its parameters, and it comes in varying degrees and sizes. Most of them are self-limiting and respond over time, and a few slip too far, and they harm the nerve and cause severe sciatica pain.

KING: We'll take a break. I'll be right back. And we'll be back with more. We'll reintroduce our panel. We'll take your phone calls. This is LARRY KING LIVE in Washington. Don't go away. (COMMERCIAL BREAK)

KING: Welcome back. Our show tonight is all about back pain and what to do about it. Our guests are, in New York, Dr. John Sarno, professor of clinical rehabilitation medicine at New York University School of Medicine, and author of the runaway bestseller "Healing Back Pain" and "The Mind-Body Prescription." Also in New York, Dr. Patrick O'Leary, spine surgeon with Cornell Medical Center and Lennox Hill Hospital. Here in Washington, Janette Barber, comedy producer of "The Rosie O'Donnell Show." In Los Angeles, famed defense attorney Robert Shapiro. And with us by phone is the famous broadcaster Howard Stern, who was a victim of this. Janette, before we go to calls, Janette wanted to say something about moving.

BARBER: Yes. It was what Howard had said about his knee. It was very interesting to me. I was pain-free from November until March, and then I was actually jogging here in Washington, fell down on my head. My hip started to hurt the next day. I'm thinking, oh, I must have hurt myself. Two weeks later it's still hurting. I'm limping. I went -- I called Dr. Sarno, and he said, oh, no, it just moved. I went back to him because I couldn't get rid of it. I went back to his lecture, sat through it. I limped, walked out.

KING: A lecture changed the movement?

BARBER: Well, it just -- it reminded me of what it can be, because that's all that lecture is. As long as you believe that there's something, when you believe, oh, I've hurt myself, then you're going to act like you've hurt yourself and you're going to stop thinking whatever it is you're tense about and you're going to think about the pain.

KING: Dr. John Sarno, could you tell me what it is, when Howard's knee hurt, what did he do, what did you teach him to do with regard to that knee that stopped it from hurting?

SARNO: Well, you see the idea is that he learned very, very well that these physical things were a reaction to some very strong emotions and feelings that were going on in his mind, in his unconscious mind. You see that's the thing that makes this a little tricky. And so what he's learned to do, whenever he gets a new pain, is to recognize that this is probably the brain trying to bring back the old regime again. And he simply thinks about that, thinks about the emotional things.

SHAPIRO: Larry, can I ask the doctors a question?

KING: Sure.

SHAPIRO: From a lay person's point of view, is there such a thing as throwing your back out, that you just move wrong or lift something the wrong way and you immediately get a pain in the back that is debilitating or sometimes incapacitating?

KING: Good question. We hear the term all the time. "I threw my back out." Dr. Sarno.

SARNO: OK. Well, this is, of course, an extremely common phrase that people -- many, many people use. What I have concluded is that they have not thrown anything out. Actually it's virtually impossible to dislocate your spine. What I have concluded is that these people are having an acute onset of the disorder that I work with, and in which there is severe muscle spasm and so on. They can have a great deal of pain. So no, I don't believe you can throw your back out, and I think Dr. O'Leary would agree with that.

O'LEARY: In general, yes. Most of these problems can best be handled by (UNINTELLIGIBLE) and rehabilitation, and generally do not come to the surgeon.

SHAPIRO: But you do get an injury as a result of it, don't you?

STERN: No, you don't. It's Howard.

KING: All right, Howard, what if you have a real pain of something that's really wrong?

STERN: Well, you know what? I -- I -- I've had an issue with that. But remember one thing, most of these aches and pains are exactly what Dr. Sarno points out. And you can tell. You actually can begin to tell. And you have to remember that the back industry is a billion -- billions of dollars industry.

KING: You mean in pills?

STERN: Pills, doctors, chiropractors -- all of that can be thrown out the window. That's how revolutionary this all is and how important it is. I just believe that Dr. Sarno -- he's going to blush when I say this -- is a saint. And what I mean by that is he has come up with something so revolutionary, his thought process is so unique that really what he's talking about is doing away with all of these psychosomatic problems. And in this book, you can actually read the book and get rid of your problems. It's amazing. That billion-dollar industry becomes nothing.

SHAPIRO: Is there something more beyond psychosomatic where you actually have some type of injury, not in the lay terms that you've actually thrown your spine out of -- out of...

KING: Yes.

SHAPIRO: ... dislocation.

KING: Dr. Sarno, you can hurt your back, can't you? You can fall down. You can be tackled in a football game and hurt your back.

SARNO: Well, of course you can. And injuries are very, very common, particularly in sports. But when a patient of mine has been through the program, develops something new, I say give me a call and tell me about it. If I think you need to see an orthopedist, I'll send you to an orthopedist. If I think it's probably another manifestation of the same thing, then I'll tell you that.

KING: Ah. New York City, as we go to some calls. Hello.

CALLER: Hi. I have been diagnosed with stenosis of the spine along with several herniated disks. How can Dr. Sarno's method of therapy actually help this condition?

KING: Might this be a case, Dr. Sarno, that Dr. O'Leary would have to help?

SARNO: Certainly. What one has to determine is whether the stenosis in the disks are causing a problem that needs to be addressed surgically, or whether, if the disks abnormalities are minor, the patient could be having the tension myocitis syndrome, but the pain is being attributed to the -- but these things have to be studied. They can't be answered arbitrarily.

KING: Did anyone ever recommend surgery to you, Janette?


KING: Howard, were you ever recommended surgery?

STERN: Yes, I was.

KING: State College, Pennsylvania, hello.

CALLER: Hello. How are you tonight?


CALLER: I have scar tissue and nerve damage from disk surgery. I understand that Dr. Sarno screens out his patients for his 90 to 95 percent success rate. Would I fall in that category? I know I'm in daily pain, and it's not in my head.

KING: Doctor?

SARNO: Yes. She's absolutely -- absolutely right. I do carefully select my patients. I talk to them beforehand. I try to get some idea of what their history has been and particularly whether they're open to the possibility that stress is causing the symptoms. Again, these are very, very individual things. You can't answer a question like that arbitrarily.

STERN: Let me tell you something, Larry. When I first heard about this, people told me about it, I was thinking they're insane: because I thought my pain was real. What do they mean, the pain is in your head? Yes, the pain is real. Your brain is causing your back to hurt. And even with these severe diagnosis, the fact of the matter is that sends people into more pain. They get scared, and they start to believe.

BARBER: But the pain is real, and the trigger is emotional. That's the difference.

STERN: Right.

KING: Dr. O'Leary, is spine surgery often successful?

O'LEARY: I think if the cases are carefully selected, properly evaluated, well-screened, for the patients who need surgery, surgery would be very successful in most cases: 85 to 95 percent of the cases.

KING: Dr. O'Leary, are a lot of people having surgery who don't need it?

O'LEARY: I hope not. I think there are certain areas where surgery is an option for care. For example, a slipped disk may be operated upon. It can also be treated without surgery over a longer period of time. Sometimes patients, because of schedules and business demands, will ask for a quick fix. The surgery can often relieve the pain very promptly within one or two days, and then the healing process for a month or two afterwards, whereas the conservative treatment may work over six months to a year but can work just as well over time.

KING: Does any back pill work?


KING: Depending on the degree of pain and what the condition...

O'LEARY: Exactly.

KING: We'll take a break and be back with more phone calls and more of our guests. Don't go away. (COMMERCIAL BREAK)

KING: We're back. Fort Lauderdale, hello.

CALLER: Hello. Thank you for taking my call.

KING: Sure.

CALLER: I have rheumatoid arthritis and it's extremely painful. And I'd like to know if Dr. Sarno's distraction therapy would work for my disease.

KING: Doctor is shaking his head, no.

SARNO: No, rheumatoid arthritis is a totally different kind. There are structural changes in the joints. And this is not the kind of thing that we deal with at all.

KING: North Hamptonshire, England, hello.

CALLER: Hello. I've had chronic pain in my back for about eight months. I've had an MRI scan and it revealed a disk sitting on my sciatic nerve. I am on a strong pain killing drug. I'm now awaiting surgery. I just wondered if the doctors know the alternative therapy...

KING: It's hard to prescribe on the phone, but Doctor O'Leary, do you know what she has?

O'LEARY: Yes, I do. I think she has a herniated disk. It's compressing her sciatic nerve and if it's been eight months, it probably would not respond to treatment and her surgeons in London or England are perhaps wisely recommending surgery for her under the circumstance.

KING: Janette, do you get to the point where you get mad at doctors?

BARBER: I was livid before I finally got to Dr. Sarno, because I had been -- I can't -- I went to so many doctors. I spent tens of thousands of dollars on orthopedists, acupuncture, accupressure. I -- Chinese herbalist. I went to a faith healer. I did everything imaginable. And I did get -- a surgeon recommended surgery. He said, "I don't know if I can fix the pain." I said, "Well, what can I do other than that?" He said, "Absolutely nothing." And I literally -- I went around telling my friends the guy needs a boat.

KING: Howard, did you see a lot of people?

STERN: Yes, I went through the mill. I was into every kind of therapy possible. And even listening to that last caller, I want to almost just reach out and say to her, please read Dr. Sarno's book. There is no reason for her to go under the knife. That was suggested to me. I tried every therapy. And let me tell you, pills and chiropractors, they work for a while. Even back surgery seems to be a placebo and works for a while, but the pain returns, which obviously indicates that this is a problem to do -- that deals with the mind and nothing more.

KING: Do you ever go to bed at night fearing you're going to have it the next day, Howard?

STERN: Never. I never fear it anymore. In fact, I now have such a full life. I am so athletic now. I do everything that I never used to do. I sit in any kind of chair. I schlump over. It doesn't make a difference. You know, Larry, I always thought my problem was that I was so tall and that perhaps it was a spinal defect. And you can find a doctor to tell you that there is a spinal defect. This is such a miracle that I can literally do anything now.

KING: What do you think Dr. Goldstein, Bob Shapiro, would say about Dr. Sarno?

SHAPIRO: Well, I think he probably would endorse him greatly. He's a very open-minded doctor who takes a very conservative approach toward surgery, but when essential, he is certainly one of the best surgeons in America.

KING: He wouldn't say to you, don't read the book?

SHAPIRO: I don't think so, at all. I think a lot of these things are precisely what he would believe in. I have another question that I'm curious about, for the panel, Larry, and that is whether there are certain things of manipulating the spine, an adjustment that a chiropractor would do, do parts of the spine go out of whack or out of alignment, and can they be placed back by manipulation into alignment?

KING: All chiropractors say that. Can they, Dr. Sarno?

SARNO: Well, in my experience, dislocations in the spine have got to be very, very difficult. The spine is very well put together, very well engineered. And I personally do not believe that...

KING: It works?

SARNO: ... that -- well, that dislocations occur. I think, however that chiropractors do help people through their manipulations. Whatever the reason is, I'm not sure.

SHAPIRO: But what does the manipulation do, doctor, when they crack your back and you hear that pop?

SARNO: I think what you're hearing are the joint noises when one spinal bone moves on another. I think that's essentially what you're hearing.

SHAPIRO: Is something going back in place when that happens?

SARNO: No, I don't think anything is out of place to begin with.

KING: Dr. O'Leary, what do you think of the chiropractic approach to the spine?

O'LEARY: Well, I think a lot of people are helped by chiropractors who are in the nonsurgical category. And it's a question of not fully understanding the mechanism, but being aware that it works, and if it works, we allow it to work. I think the chiropractors recognize, also, there are fractures, there are tumors, there are other conditions which they would not manipulate. But back going out is often managed by a chiropractor successfully.

KING: Howard, doesn't it feel good when you went to a chiropractor, and you heard that little crack?

STERN: Yes, it sounds great. And you know what, it's a great little band-aid. It works. I think anybody who goes to chiropractors knows this to be true. You go, and for about an hour or two after you go, sometimes a day, you feel OK. And I even joined something called the Alexander Technique, which was supposed to teach me how to straighten out my spine as if my spine wasn't straight, and I would go for hours and practice this technique, and lo and behold I would leave and I would feel better for a couple of hours, but what Dr. Sarno is talking about is a permanent solution.

KING: You've made that clear. We'll be right back with more. Don't go away. (COMMERCIAL BREAK)

KING: We have verified this. So, we have a patient of Dr. O'Leary's from New York. Yes, ma'am.


KING: Go ahead.

CALLER: Hi. I'm a patient of Dr. O'Leary's. I was -- I've been in excruciating pain for four years. I had two diskectomies that did absolutely nothing for me. And the pain continued to be absolutely debilitating. I finally made my way to Dr. O'Leary after years of doctors telling me that all the pain was in my head and that there was nothing wrong with my back. And as Dr. O'Leary will tell you what they found in my back was something so extraordinary.

KING: Ah. OK. Dr. O'Leary, can the reverse happen? Can you be told it's the mind and it's not?

O'LEARY: Correct.

KING: And Dr. Sarno, would you agree with that?

SARNO: I certainly would.

KING: So in other words, there are cases where someone is told it's the mind and it's not the mind?

SARNO: Yes, sir.

KING: What is, Dr. O'Leary, spinal fusion and pedacle (ph) screws? You do that?

O'LEARY: Yes. I think that's a hot topic. We have had major problems with FDA regulations. One of our famous spine surgeons of all America, Dr. Art Steffi (ph), was hurt badly by strict regulations. He made tremendous research into pedacle screws and spinal fusions. He was a mentor of mine, still is. And he was undermined by a political process one time, with the FDA process.

KING: You're a proponent of it?

O'LEARY: Yes, it's a very, very important part of surgical care. It has to be done really well, and you have to be well-trained to do it, and it should not be done by an inexperienced person. But it's a critical instrument in the management of spinal fusion problems.

KING: Beaumont, Texas, hello.

CALLER: Yes. I would like to find out if the doctor has a suggestion for me. I've had four crushed vertebrae, which I have had no injury from, numbness, (UNINTELLIGIBLE) and pain in my legs, chronic. I have got fibralga (ph).

KING: Dr. Sarno, it's very hard to diagnose on the phone. From what you hear, can that woman be helped by your book?

SARNO: Well, I think that certainly someone, if they think there's a possibility that they might have this, that they should read the book. They certainly will get a clear idea as to what this is, and then they can determine whether this might apply to them or not.

KING: I want to take break, and when we come back, we'll get a closing thought from each of our guests -- right after this. (COMMERCIAL BREAK)

KING: We're in our remaining moments. And obviously, we'll do more on this. Dr. O'Leary, are there malpractice suits in this profession?

O'LEARY: Yes, sir.

KING: A lot?


KING: People then complain that it didn't come out right?

O'LEARY: Correct.

KING: Are there -- is there a lot of controversy over the way methods are taught in this subject?

O'LEARY: I think that the spine education is still in its infancy. I think it's a product of -- a stepchild of orthopedics, a stepchild of neurosurgery, and acquired its own dimension, its only special specialty: with five year of basic training in spine. And all the different practitioners should have some common educational process as well so we can talk to each other in a civil matter, understand who does what the best.

KING: Howard Stern, in all the years I've known you, finally I've never heard you rave about someone like this.

STERN: Yes. Well, actually I'm pretty cynical.

KING: No kidding.

STERN: And the only thought I would have is that when I hear each caller call in and describe their condition, they're thinking, well, Dr. Sarno's theories don't apply to me, I'm the one person that's different, my pain is not in my head. I suggest that this book is for everyone and that more people need to read this. And I wish the government would support some sort of research with Dr. Sarno's materials and really just change -- change the way people look at back pain.

KING: Janette, you are mostly pain-free?

BARBER: I agree. I am mostly pain-free. And I think there's actually a little gift involved if you happen to have TMS. And I do believe that there are tens of thousands of people in unnecessary pain that can be taken care of with this. But the gift of it is that once in a while I'll get it back. I'll get it in the hip. I'll get it -- in the elbow the other day, because I had to go back to work after vacation. I don't know if it was because, but it coincides. But the gift is that it's a little warning sign. It goes bing- bing-bing, you're not handling your stress. And we know -- and scientists, they'll tell you that stress can kill. This -- for those of us who have it, we get the hello.

KING: Now, Robert, you accept the fact that it is stress- oriented for you?

SHAPIRO: Oh, I don't think there's any question that stress not only plays havoc with your back, but certainly with your stomach, with your throat and many other things. But I can tell you, from my own experience, Larry, I'm feeling much better because I got to sit in your chair tonight. (LAUGHTER)

KING: The chair is comfortable?

SHAPIRO: Absolutely. It's perfect.

KING: See, Howard never has an uncomfortable chair anymore. You still -- you had to have a special chair in the courtroom?

SHAPIRO: Special chair in the courtroom. And I think it was a savior for me.

KING: Dr. Sarno, you -- I don't know how you handled all of these accolades that you're getting here tonight. It must feel pretty good to know that you have helped so many people. Are you continuing to write on this subject? Anymore books coming? You have got a book 8 years old that's on The New York Times list.

SARNO: Yes, I am. I'm working on a book now which really I intend for professionals. It's going to have to do with all the details of the psychology of these things. I don't always agree with everything Howard says, but he said something very important a moment ago. These problems should be studied by academic medicine at the highest levels in order to determine exactly what is going on and why. As long as there are just practitioners like myself who are having experiences, this is fine. But I think these problems have to be studied so that the information can be spread abroad to all doctors who treat these problems.

KING: Dr. O'Leary, federal government, National Institutes of Health, we spend a lot on back pain? Do we?

O'LEARY: We spend enormously on back pain. And I do think that we can do a lot more a lot better. I think we need to examine carefully how we're dealing with this and categorize the patients to surgical and nonsurgical, and in the surgical realm, have highly qualified surgeons, well-trained doing an excellent operation.

KING: How many people would you guess in the United States have back pain?

O'LEARY: Millions, of course.

KING: In the millions?


KING: I thank you all very much. Thanks, Howard, for staying the hour. I know you weren't feeling well. I really appreciate it.

STERN: Thank you.

KING: And Dr. O'Leary and Janette and Robert Shapiro, and of course, Dr. John Sarno, thank you all as well. Tomorrow night, Sable will be here and also Goldberg, and if you're into wrestling, you know what I'm talking about. Thanks for joining us and good-night.

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