We detached this subthread from https://news.ycombinator.com/item?id=14922985 and marked it off-topic.

There is a drug so powerful that every drug other drug is tested against it: the placebo.

If this book saves just one HN reader from opioid addiction then I am glad it made the list.

What if people try it instead of a scientifically supported treatment and then it doesn't work and they give up and get addicted to opioids when a real method would've worked for them?

Don't get me wrong I think the placebo effect is a very useful tool but best to combine it with other methods that work for many back conditions, such as yoga routines that strengthen the back muscles. Of course what works depends on your particular condition which is why anyone with severe back pain should see a medical professional to get advice for their specific problem.

Actually there is pretty limited support that placebo actually works on anything but subjective measured outcomes.

Like pain?

Back pain is mostly subjectively measured outcome, and many types of back pain respond very well to placebo.

I would not call it "anti-scientific pseudoscience," but the author does openly admit that the science behind why his techniques work is still fuzzy. It's a field that needs more research and understanding.

Regardless, the book is very effective for many individuals, myself included. I highly recommend it to anyone dealing with back pain.

I haven't checked out Healing Back Pain: The Mind-Body Connection but if you want another book that I think speaks from a similar angle, and that I know has a scientific grounding, check out A Guide to Better Movement by Todd Hargrove[1].

The crux of some recent research into pain can be summarized in a few points:

* Sometimes you'll hear patients talk about pain and look at their area of pain and find nothing in their bones/muscles/etc that would indicate they should experience pain, and sometimes you'll look at other patients and their bones/muscles/etc and find they should experience pain but they don't.

* If you have three cups of water–two of them warm, the middle one cold–and stick a finger in each cup, your finger that is in the middle, cold cup will actually feel a hot, burning sensation. Try it yourself. Pain can be misleading and not indicative of actual danger.

* Similarly, ever play a sport and not feel an injury until the next day? (I'm not talking about soreness.) This indicates that pain can be silenced, and that underlying physical damage doesn't immediately and directly cause a sensation of pain.

The mind-body connection in essence is this: your body is the territory, and your mind is the map. Your map of the territory can become out of sync with the way the territory actually is. The body is incredibly adaptable, if you teach your body to feel pain, it will, if you teach your body to move freely, it will. This doesn't mean, if you're feeling pain, go and do crazy things and hump the dragon so to speak. It does mean: approach the dragon. Lean into the pain. Allow yourself to feel pain. Recognize the pain and listen to it and learn more about where the flare-up line exists in your body. Constantly strive to elevate where the flare-up line is, mindfully and with good vibes. :)

Increasingly we're moving away from a past where physical pain is stigmatized.

[1] https://www.amazon.com/Guide-Better-Movement-Science-Practic...

For another example, VS Ramachandran has shown that some people who have lost a limb experience significant pain in a phantom limb. And the pain can over time be significantly reduced and even eliminated with mental exercises.

With that in mind, I don't think it's anti-scientific to think there may be legitimacy to other mind-centered approaches to pain relief.

Yep great example, didn't remember to mention that too.

To expand on your point for others about mental exercises: if you experience pain, say, in your leg during a squat, if you mentally visualize doing a squat, and imagine doing it while not feeling pain, and practice doing that visualization, that will help you feel less pain when you actually get around to doing a squat.

Another way I've heard people treat phantom limb is by getting a tall standing mirror, so that their other limb in the mirror looks like their missing limb. And then they will move their limb and that will help treat the pain they feel in their phantom limb.

Thanks! I actually did pick up Sarnos book after many recommendations. I didn't throw it out because I think it was completely invalid, but rather because it had a completely invalid basis. I'm glad to hear similar ideas are addressed elsewhere and if my pain comes back, I'll pick that up.

I'm not familiar with the book, but behavioural therapy has acutally been shown to be useful for managing back pain.

Since the cover of the book shows a nicely muscled back I searched the book for squat, deadlift or barbell and found nothing. I'm not sure how you're going to get from back pain to that back without solid exercise. However, I can tell you from personal experience that a solid diet of squats, deadlifts and barbell rows has pretty much solved any back pain problems I ever had with the exception of soreness after lifting. My posture is significantly better. And I don't have that back. Yet.

Is it really anti-scientific?

Plus, as they say, "if it works, it ain't stupid"

Reading Sarno's book cured my RSI and my friend's RSI as well. If it works, it's not stupid.

Well, if it's placebo and it works anyway then what's wrong with that?