Schubiner Medical Evidence Video

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Slide 3: Medicine's Blind Spot

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Arizona 3

Slide 4: A model for understanding psycho-physiological illness

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Arizona 4

Notes:A majority of TMS related chronic pain is not caused by one specific physical factor. Mind body pain is caused by a variety of factors and it can be manifested in a variety of ways. While a micro-level treatment of chronic pain may relieve pain in a specific area, it fails to treat the patient as a whole and the pain can re-manifest itself in another area. For certain diagnosis, like cancer, the Disease model can be effective in treating it. However it is paramount in the treatment of mind body syndrome (or TMS) to focus the treatment on the patients mind and think psychological.

Slide 5: Epidemiology of chronic diseases

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Arizona 5

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Arizona 6

NOTES:

There is a tendency for people to blame their chronic pain on their age, and say their back hurts because they are older. However a study completed by the The Center for Disease Control shows that chronic pain is not a degenerative disease. The National Health Interview Survey shows the percentage of people suffering from chronic pain in three age groups. It shows that the level of chronic pain drastically can increase in people between ages 45-64, however chronic pain actually decreases in people over 65 years old. This study suggests that chronic pain is not a degenerative condition. For the most part, people do not experience more pain because they are older.

Slide 7: MRI in those without low back pain

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NOTES:

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 of 98 asymptomatic people carried out by Maureen C Jensen et al. 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. Disc abnormalities do not necessarily equate back pain in a person, and are likely not the cause of a person's back pain."

REFERENCE:

Jensen, MC; Brant-Zawadski, MN; Obuchowski, N; Modic, MT; Malkasian, D; Ross, JS. "Magnetic Resonance Imaging of the Lumbar Spine in People without Back Pain." New England Journal of Medicine, July 14, 1994. 331(2): 69-73.

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Slide 8: Lower Back Pain Review -- Deyo

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NOTES:

It is extremely difficult for physicians to successfully diagnose low back pain using MRI results. While physical examines can successfully rule out serious conditions such as tumors and infections, it is not likely that a physical diagnosis can cure back pain.

REFERENCE:

Deyo RA, Rainville J, Kent DL. " What can the history and physical examination tell us about low back pain?" Journal of the American Medical Association. 1992, 268: 760-5

Slide 9: Costs and benefits -- U.S. Lower Back Pain Statistics

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Arizona 9

NOTES:

Medical costs in the United States have been dramatically increasing, and this has made the treating chronic pain extremely expensive. More and more doctors are prescribing expensive procedures to cure people of chronic pain to no avail. Currently the primary benefactors of the treatment of chronic back pain are drug companies who profit from prescriptions. [1]

REFERENCE:

Deyo RA, Mirza SK, Turner JA, Martin BI. "Overtreating chronic back pain: time to back off?" Journal of the American Board of Family Medicine. 2009, 22: 62-8. [2]

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Slide 10: Lower Back Pain Review -- Carragee

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Arizona 10

NOTES:

There is a tendency for the medical community to interpret disk degeneration and spine abnormalities that are revealed by a MRI scan as the source of back pain. However, this study shows disk degeneration and end-plate changes have been found in people without back pain. Therefore, these conditions do not necessarily cause back pain, and suggest that their are other causation to chronic back pain. A person's chronic pain is not necessarily caused by a physical condition that can be cured using physical treatments. This study supports the theory that chronic pain can be caused by the mind body syndrome and needs to be treated with a mind body approach.

REFERENCE:

Carragee EJ. "Clinical practice. Persistent low back pain." New England Journal of Medicine. 2005, 352: 1891-8.

• About Eugene Carragee

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