> Then the idea that ulcers are just an infection took hold so the psychogenic manifestations of stress shifted.

It may be that treatments have been developed for those ulcer causing infections. That could be why you're not hearing so much about uclers.

I think the situation might be the opposite of what you're suggesting. It seems ailments that we don't understand are put down to stress. Then we find a physiological cause, and then a cure and then we stop hearing about the issue.

There was a massive decline in diagnosis of peptic ulcers. People just stopped getting them so often in the first place. It's not the case that medicine cured the problem.

> There was a massive decline in diagnosis of peptic ulcers. People just stopped getting them so often in the first place.

Once we understood the causes (H. pylori infection primarily, NSAID overuse secondarily) we were able to manage the second and intervene to control the first based on symptoms that develop before the peptic ulcers.

Additionally, the H. pylori infection rates are much higher in older Americans (H. pylori infections typically have a long lead time before developing any symptoms), probably because of lifestyle changes that have reduced environmental exposure. So with less and less people having H. pylori infection in succeeding cohorts, there's a decline in peptic ulcers.

We know the connection between the causes and the decline. And, yes, some of it is that medicine cured the problem (earlier intervention for H. pylori infections), and some of it is awareness of medicine side effects reduced actions causing the problem (NSAIDs), and some of it is that the age cohort that had been most exposed to H. pylori infection and was most at risk became a smaller share of the population as time progressed.

While Dr. Sarno's theories were helpful for my carpal tunnel, and apparently for many others, I would be hesitant to apply TMS to all back pain, carpal tunnel, and other "office chair diseases." I know you said "overwhelmingly psychogenic", which implies you meant not all cases. But I'm not sure overwhelmingly is accurate either, especially for back pain. With carpal tunnel, it's clear based on the plethora of cures with random success that calling psychogenic may often be right. But back pain has alternative, and seemingly better explainations (weak muscles, poor flexibility). So while TMS may be the diagnoses for some with back pain, and a contributor for others, I would not go around slapping it on everyone who says they experience back pain.

That said, Dr. Sarno's book is worth the cost of reading. It's very staunchly in the pseudo-science camp, and Dr. Sarno spends a lot of time bemoaning his ostracization from the medical community, but his theories are ultimately interesting, hold some weight, and have been helpful to many. For example, I haven't worn a wrist brace to bed since I read the book (about a year ago). And, even if it hadn't helped, it brought more awareness to just how stressed I was. I do a better job managing my workload and consequently stress these days. Just keep a healthy heaping of skepticism by your side while reading.

> Given only x-rays images, spine specialists completely fail to identify the individuals who report back pain.

I'm not surprised. X-rays are not the most reliable in identifying all spinal issues. X-rays are more for finding problems with the vertebra or curvature of the spine, not the discs. An x-ray showing mild degeneration could be produced from the same individual who on an MRI could show a severe disc herniation. I'm not a doctor, but I've worked on developing legal cases for disabled individuals, and an MRI is pretty much mandatory.

Anecdotally, I have a relative who suffered from severe back pain after a lifting accident, but the x-rays didn't show anything. I told him to ask his doctor for an MRI after a number of months, which indeed demonstrated the herniation.

I suspect a lot is actually from being out of shape; especially being overweight.

Plenty of people have MRI scans that can show herniated discs. Have a look at [1] for a very clear image of what you can see in some obvious cases. Obviously some aren't as clear as the image below, but mine for instance was.

[1]http://www.mayfieldclinic.com/Images/PE-HerniatedLumbar_Figu...

Most people have problems like these but experience no pain or functional impairment.

[citation needed]

Are you suggesting that back pain and carpal tunnel don't exist?

You have the common and popular misunderstanding of psycogenic illnesses.

>Does this mean that the sickness is “all in my head”? No, it doesn't. The people who are in these outbreaks have real signs of sickness that are not “imagined.” They really do have headaches, or they really do feel dizzy. But their illness is not caused by a poison or a germ.

http://www.aafp.org/afp/2000/1215/p2655.html

They exist and are psychogenic. The nervous system, directed by the brain, can induce localized inflammation.

I know it's just my own anecdotes but I find that really hard to believe given how painful my back pain has been. It was so painful once and lasted for about a week that I seriously considered that I would end my life if the doctor told me there was nothing they could do.

For me, at least recently, the trigger seems to be lifting something heavy and wrong way. It doesn't hurt that day but the next day I literally can't move in certain directions without searing pain. Just turning in bed, getting in or out of bed, getting in or out of a car, walking, using the toilet, sitting down or getting up, all of it hurt.

The doctor claimed it was muscle spasms. She gave me some muscle relaxants and it went away. I've since try to work out more. I haven't had an episode in a while but I can't sleep on my stomach like I used to as curving my back that way has been known to trigger it.

[0]http://rationalwiki.org/wiki/Anecdotal_evidence [1]http://en.wikipedia.org/wiki/Tension_myositis_syndrome#Medic...

The claim here is that a significant proportion of these illnesses are psychogenic; even if your anecdote was convincing it would do nothing to challenge the original argument, as you could easily be part of the 47%[1].

Furthermore, you base your conclusion on the severity of pain you experienced, in your opinion, being beyond what's possible for a psychogenic illness. You don't offer evidence to support this opinion, and, as there are many types of psychological distress that drive people to ending their own lives, I find it unconvincing.

In any case, I hope you keep an open mind and find an effective way to manage and improve your health. The lifts recommended in other parts of this conversation might be more in line with your values.

So basically yes, you are saying they do not exist, because if tissue damage or fategue don't show up in an X-ray (they won't) it must be being created by the person themselves.

Next time you get a pulled muscle, just drink some tea and calm down, it didn't really happen, you're just too stressed.

A pulled muscle will heal up in a couple weeks. We're talking about chronic pain lasting many months or years.