Dr. John Sarno has long held a revolutionary view of what causes back pain, and he’s frustrated that so many people remain skeptical of his theory

Dr. John Sarno, M.D., 83, has a dissident view of what causes back pain, and, like many renegades, he has grateful acolytes who say his ideas changed their lives and numerous detractors that have dismissed his theories as voodoo. Sarno, who is professor of clinical rehabilitation medicine at New York University School of Medicine, holds that back pain is caused by the relatively harmless tension myositis syndrome, or TMS.

His theory posits that emotional stress not dealt with in the mind is subconsciously transferred to other parts of the body in the form of imperceptibly tensed muscles — often in the back. Over days or weeks or months, the continually tensed muscles restrict blood flow, depriving muscles, tendons and ligaments of oxygen and eventually causing them to cry out in pain that is real and excruciating. Worrying that the pain is due to a structural problem in the back only adds to the tension, causing the pain to worsen.

Sarno has explained his views in several books: Mind Over Back Pain, Healing Back Pain: The Mind-Body Connection and The Divided Mind: The Epidemic of Mindbody Disorders, which was published this year. He argues that back pain — and hay fever, fibromyalgia and other maladies — spring from stress not dealt with in the mind. Sarno contends that in his successful patients the pain disappears once they understand how and why it’s being generated.

Q. At one point, you ran 20 miles a week. How active are you now?

A. Well, I’m a little bit older — a lot older. I’m still very active. I walk about 20 miles a week. I still jog some of that, but most of it is walking.

Q. How about weightlifting?

A. I do a lot of heavy gardening, so that counts as weightlifting in the amount that I do it.

Q. Can you offer a short definition of TMS (tension myositis syndrome)?

A. You should realize that question is almost impossible to answer. Let me say that eight out of 10 people reading your magazine will not accept this. They will think it’s a bunch of hokum. But I have an email I received (and I’ve received many like it). It’s from a 47-year-old attorney, and what he said is essentially that he had been a runner and in bad trouble (with his back) for quite awhile, and then he read one of my books. He started to run again and now he’s fine. What I say is that my work has demonstrated on a great many patients that the pain is due not to structural problems in the back; it is really due to stress that creates a condition in the body that is painful.

Q. Of the millions suffering from back pain, how many do you think are suffering from TMS and not from a structural spinal issue?

A. At least 80 percent of the people who are told that their pain is coming from a structural problem (such as a herniated disc or spinal stenosis) is actually coming from TMS.

Q. You’ve said athletes, as a group, tend to be more skeptical about TMS. Why do you think that’s true?

A. They have a hard time accepting that what’s really hurting them isn’t from damage to the body; it’s coming from (mental or emotional) stress.

Q. So would you say athletes who have been forced to retire because of spinal stenosis or other back pain diagnoses actually had TMS?

A. Spinal stenosis, that’s the kind of excuse that they use all the time. In my experience, spinal stenosis never causes back pain. That’s my experience, and I have the patients to prove it.

Q. Why do you think the medical community is resistant to accepting your view of back pain?

A. In my new book I have an explanation of why doctors and psychiatrists can’t buy it (TMS). The layman can’t buy it because something that comes from the mind scares them. They think it makes them crazy. The whole idea of something coming from the mind is hard for most people to accept.

Q. What’s your recommendation for a person suffering from back pain?

A. It sounds self-serving, but I would say read one of my books and see if it makes sense to you. I mentioned that 47-year-old lawyer. He was going to have surgery — before he read the book.