The Book that Healed 70% of My Back Pain

"While it sounds like preposterous woo," the book "Healing Back Pain" by John Sarno changed my life

For four years, starting in 2018, I struggled with terrible chronic back pain. Years of physical therapy and surgery on both my right hip (to fix a torn labrum and impingement) and low back (an L4/L5 microdiscectomy) helped with symptoms like sciatica but did little to reduce the overall pain.

I couldn’t perform even moderate-intensity exercise without flare-ups in pain and muscle tension. My social life tanked as I spent most evenings and weekends lying around in pain.

Then in August 2022, I saw this tweet from Patrick Collison, the CEO of Stripe:

I read the book, Healing Back Pain, put the ideas to work, and within a few weeks, my back pain reduced by around 70%. I transformed from “a guy whose life is severely limited by back pain” to “a guy who sometimes has back pain but can do most normal activities.” Here’s what I learned:

1. Pain is not an objective, externally measurable entity. Rather, it is a signal fabricated by your own brain. A common occurrence is referred pain, where pain is felt in one part of the body (like the low back) but the source is somewhere else (like the psoas). The idea that pain is less “real” than I thought it was brought some immediate, albeit modest, relief.

2. Acute pain is often a useful signal you should take it easy; you shouldn’t walk on a broken ankle. Chronic pain is often no longer a useful signal indicating that you are risking further injury with movement. I took the book’s advice to stop treating pain as a signal that I needed to lay around all the time and I increased my movement.

3. Resisting pain or freaking out about pain leads to fascia and muscle tension that can generate more pain than the underlying structural injury. Accepting and relaxing into whatever pain is there can help stop this pain cascade. This is similar to the Buddhist idea that suffering = pain * resistance.

4. The other source of pain-inducing muscle tension, according to Sarno, is repressed emotion, especially anger. I made up a mental exercise in which I visualized becoming a Game of Thrones dragon that destroyed objects of my anger, and a bunch of low-back tension melted away.

Per the book's recommendation, I stopped doing my prescribed physical therapy and eased back into normal exercise (couch-to-5k running and then Orange Theory) for the first time in years (but note that this recommendation only makes sense if you’ve been doing physical therapy for a very long time with negligible results). In three months, I lost the 40 pounds I had put on while couch-bound.

Nearly two years later, most of the gains have stuck around. I haven’t been pain free, which is why I say it healed 70% of the pain, not all of it. I have had a couple of flare ups of back spasms, and I do have some limitations in life: I minimize long plane flights, I don’t ski or play basketball, and I don’t lift heavy weights like I used to before the injuries. Over the past couple of months, I’ve invested in acupuncture, body work, chiropractics, and physical therapy to upgrade my strength and mobility.

But ever since reading the book, my life has no longer been dominated by physical pain. This rapid transformation opened my eyes to the power of the mind/body connection, which started a two-year deep dive into meditation, somatic therapy, and opening to emotion.

Note: Dr. Sarno’s book The Mindbody Prescription has very similar content to Healing Back Pain and has a much better audiobook.

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