Medical Evidence

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There are two main pages in this section. Below the table is a brief summary of the current medical evidence on the subject. We would encourage people to read through the annotated bibliography section - all abstracts have been summarised for easy understanding - and there are links to the original research for people interested in the more detailed scientific discussion. This page should really help to convince you that there is good evidence both for the Mindbody effects on chronic pain and for the TMS techniques recommended by Dr. Sarno.

	Annotated Bibliography	The Annotated Bibliography, created for researchers and laypeople alike, contains summaries, links to abstracts and full text of articles, information about authors, information about related research, and other helpful information about the most important research relevant to TMS. To make it easy to read, the articles are grouped by subject. (This page is fairly mature but is still under active development.)
	Master Bibliography	The Master Bibliography, intended primarily for researchers, is intended to be a comprehensive list of all articles cited in books, articles, or presentations about TMS. When possible, it will contain links to abstracts and the full text of articles. To facilitate its use as a reference, sources in it are organized alphabetically. (This page is still fairly immature and is under very active development. It should change significantly from week to week.)

In addition to the Annotated and Complete Bibliographies, there is also a page listing the various conferences on TMS.

Medical Evidence: A summary 1) There is peer reviewed evidence that adopting TMS techniques can very significantly reduce chronic pain suffering. D Schechter et al. measured the effects of TMS techniques on patients with chronic back pain. They recorded significant reductions in pain and medication usage and significant increases in activity. Dr Sarno has documented two separate follow-up surveys of his patients with long histories of severe debilitating chronic pain. In both cases there was a significant reduction in levels of pain reported – in both the short and long term. 2) There is strong peer reviewed evidence that psychosomatic factors affect perception of pain, development of symptoms and success of surgery. Population studies have shown that predictive factors for the development of back pain are job dissatisfaction and distress. A history of childhood trauma strongly correlates with unsuccessful back surgery. A meta-analysis of meditative or cognitive behavioural techniques has shown that these can significantly reduce chronic pain. Comparative studies between RSI and fibromyalgia have noted that workload and emotional stress are important factors in development of these conditions. 3) There is peer reviewed evidence that journaling and meditation can reduce pain in chronic pain sufferers and improve general health Studies demonstrate the benefit of talking or writing about stressful events. These actions actually lead to biologically measurable changes in the body including improved immune function. A meta-analysis (where a number of studies are compared) of the evidence for the health benefits of mindfulness concluded that mindfulness-based stress reduction may help patients cope with their both clinical and non clinical problems - reducing pain levels 4) There is strong peer reviewed evidence that many structural diagnoses of back abnormalities based solely on MRI scans are flawed. There have been a number of studies which have demonstrated that a large proportion of patients with no symptoms of back pain will nevertheless have an disc “abnormality” show up on MRI scans. The conclusion for one such study was that “given the high prevalence of these findings, the discovery by MRI of bulges or protrusions in people with lower back pain may frequently be coincidental.” 5) There is strong peer reviewed evidence of the physical symptoms that stress both causes and exacerbates in the body. There has been shown to be a strong correlation between work related stress and the existence of chronic pain conditions. One study demonstrated how abnormalities in the hypothalamic-pituitary-adrenal (HPA) stress-response system were predictive of who would develop chronic widespread pain amongst a group of psychosocially at risk subjects. 6) There is peer reviewed evidence of the spread of conditions like whiplash in an epidemic like manner - where it is the preconception of injury which predicts development of the condition. These studies include cultural comparison studies between East and West Germany which demonstrated that back pain spread like a communicable disease based on cultural perceptions. In Lithuania - a country were there is no preconceived notion of chronic pain arising from rear end collisions whiplash symptoms have been found to be absent. Other studies agree that the participants neck and back pain resulted from symptom expectation or emotional stress caused by the collision rather than physical injury. (Please look at the annotated bibliography above for the study details)

DISCLAIMER: The TMS Wiki is for informational and support purposes only and does not provide medical advice, diagnosis, or treatment recommendations. See Full Disclaimer.