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“the leap from a mental process to a somatic innervation … can never be fully comprehensible to us.” (Freud, 1909)
Back pain has increasingly been attracting public attention. It was found to be second only to upper respiratory infections in causing absence from work, with a reported yearly loss of 56 billion dollars (Forbes, Feb. 24, ; Aug. 25, ). There is now considerable evidence that emotions are substantially involved in the etiology of low back pain syndromes and in the recovery from them (Gentry et al., 1975; Sargent, 1946; Sarno, 1974, 1976, 1977, 1981, 1984a; Sternbach et al., 1973; Walters, 1961). It has not been difficult to demonstrate that structural pathology does not explain the symptom complex in most cases of low back pain (Fox et al., 1975; Magora and Schwartz, 1976, 1978, 1980; Nachemson, 1976; Rosomoff, 1985; Splithoff, 1953). For (one) example, physiologic studies now show that sustained nerve root compression or pinching rapidly leads to numbness (not pain). To explain the interrelations between feeling states and back pain has been much more difficult.
To a degree, low back pain has not been generally regarded as a “psychosomatic” disease. This may even be a reason for its current high prevalence (Sarno, 1984a). That is, as the general public accepts certain illnesses as (partially) psychologically derived, these may perhaps become less acceptable arenas for attempting to deal with, or to avoid, emotional conflicts. It is Sarno's opinion that the majority of neck, shoulder, and back pain patients, including those whose symptoms are attributed to most structural abnormalities (e.g., osteoarthritis and herniated disc), suffer from the Tension Myositis Syndrome (T.M.S.). This is a psychophysiological