Chronic Pain & the Mind-Body Connection

Treatment Options for Chronic Pain Stemming from Psychological Stress & Trauma

Editor’s note: ACR on Air, the official podcast of the ACR, dives into topics important to the rheumatology community, such as the latest research, solutions for practice management issues, legislative policies, patient care and more. Twice a month, host Jonathan Hausmann, MD, a pediatric and adult rheumatologist in Boston, interviews healthcare professionals and clinicians on the rheumatology front lines. In a series for The Rheumatologist, we provide highlights from these relevant conversations. Listen to the podcast online, or download and subscribe to ACR on Air wherever you get your podcasts. Here we highlight episode 39, “The Science Behind Reprocessing Pain,” which aired Oct. 11, 2022.

A woman with a history of abusive relationships develops migraines and irritable bowel syndrome early in life. She is later diagnosed with fibromyalgia. Is her traumatic background linked to the development of her chronic pain associated with fibromyalgia?

Dr. Schubiner

Howard Schubiner, MD, an internal medicine physician with Ascension Michigan, Southfield, and founder and director of the Mind Body Medicine Program at Providence Hospital in Southfield, shared with the ACR on Air podcast host Dr. Hausmann how pain can stem from psychological stress or trauma.

Dr. Schubiner, who is the author of Unlearn Your Pain and Unlearn Your Anxiety and Depression, also addressed how pain reprocessing can be used to treat patients living with this type of pain.

Managing chronic pain syndromes can be particularly vexing, noted Dr. Hausmann. “It’s challenging to diagnose [because] there are no specific lab or imaging studies that can confirm the diagnosis, and medications aren’t very effective. [This pain] also causes significant disability to both children and adults,” he said.

These chronic pain syndromes include fibromyalgia or central pain, as well as such associated conditions as irritable bowel syndrome, chronic headaches, chronic fatigue and even chronic pain associated with long COVID.

Although Dr. Schubiner acknowledged that not all chronic pain, injuries or ailments have a psychological source, he said that some do.

A Journey to Lessen Pain

Dr. Schubiner shared what brought him to mind-body medicine and pain reprocessing therapy. His medical work had no connection with pain treatment until about 20 years ago, after he read the work of the late John E Sarno, MD, a physiatrist who wrote Healing Back Pain. Dr. Sarno believed that repressed emotions and psychological stress often caused back pain.