The herniated disc nocebo effect is often to blame for setting the stage for an ongoing chronic back, neck or sciatica nerve pain condition. We have all heard horror stories about herniated discs and if we are diagnosed with a seemingly problematic disc condition, the psychological effects of this verdict can be worse than the actual disc pain itself.
This article will investigate the scientifically proven nocebo effect which can result from a positive disc prolapse diagnosis. We will explore how the psychoemotional consequences of the diagnosis can cause, worsen and perpetuate pain in many patients.
Nocebo is the Latin word which holds an implied meaning of “I will harm”. It is the exact opposite, in scope, as the placebo effect. In medicine, placebo describes a treatment which will enact a positive change or even a complete cure, even though it has no actual merit or healing abilities. It works completely through the power of suggestion and psychological influence. In essence, if the patient has a strong belief that the treatment will work, then they are likely to enjoy a good result from utilizing that particular therapy option.
Nocebo has exactly the opposite effect on a struggling victim. Instead of helping a patient, a nocebo will actually cause increased symptoms or even initiate symptoms when none were experienced before.
In terms of back or neck pain, we see the influence of the nocebo mostly in the diagnostic process. A patient is told they have a particular spinal condition and immediately suffers increased symptoms which are likely to last long term.
Many times, a disc irregularity is found by accident, such as when testing for an unrelated condition, and the patient has never suffered any pain from it in the past. It is common for these patients to begin to experience pain and other symptoms after the condition is discovered and diagnosed. In other cases, the patient has pain and undergoes investigative imaging. Once the disc herniation is positively identified, the pain worsens or becomes chronic.
The herniated disc nocebo effect can be increased, decreased or avoided completely, depending on the bedside manner of the diagnosing physician. If the patient is made to feel like they are in serious jeopardy by the diagnosis of a herniated disc, they are likely to suffer a serious nocebo reaction.
If they are not reassured and given at least a good chance of recovering from the disc condition, they are likely to suffer some nocebo reaction. If they are reassured and provided the facts about a mostly innocent and common disc abnormality, they are unlikely to suffer any nocebo reaction at all.
The choice of words used by the diagnosing doctor is crucial. If the diagnostic picture is one of doom, gloom and fear, the patient will naturally react negatively and might suffer an immediate downward spiral in their physical and psychological conditions. Meanwhile, if the doctor chooses to tell the patient that their spine is basically normal and their condition is common and rarely the source of chronic pain, they are likely to recover completely in a normal time frame.
The power of the nocebo effect is devastating and can even be used as a purposeful weapon by some greedy care providers.
Throughout my back pain journey, I suffered one nocebo after another, from even the best intentioned doctors and chiropractors.
When I was first diagnosed with degenerative disc disease and scoliosis by my first chiropractor, the words he used put me immediately into a sense of panic and dread for my future. Obviously, this guy had every intention of placing me in ongoing care to fatten his bank account. His treatments never cured anything and definitely contributed to the symptoms I suffered my entire adult life. Doing this to a 16 year old is nothing short of criminal and I wish I knew then what I know now. The situation certainly would have been handled differently on my end.
When I was diagnosed with herniated discs, it was as if I was condemned to death. My new chiropractor made more horrific predictions, but not as gloomy as the original guy. Regardless, I did get worse year by year and began to really fear for my future.
As my back pain suffering continued, I was given a host of dire predictions by a variety of care providers due to my spinal condition. Several doctors told me I would definitely need disc surgery and a few predicted serious disability in my future. How are these inaccurate and ridiculous prognoses supposed to ever allow a person to recover from anything?
I did have one good orthopedic surgeon who basically told me my spine was all messed up, but did not think it would get worse for me. This guy seemed to take all the degeneration in complete stride and told me to avoid surgery. Thanks for at least that much, doc. I do appreciate it.
Finally, I met Dr. John Sarno, the man who actually taught me about nocebo. He was completely unconcerned by my DDD and herniated discs, as well as the 18 years I spent suffering horrible pain. He was cool as could be actually. He simply said: "You have tension myositis syndrome and you will be fine".
Fine? Wow, that sounded good to me. I am thankful for this blessing and the knowledge which allowed me to overcome this common form of psychological trauma suffered by almost every patient with chronic pain. I cover my entire story and provide details of using knowledge therapy to defeat pain in my best selling self help book, Cure Back Pain Forever.
Learn more about the herniated disc nocebo effect by searching the word nocebo in the right hand column. It is a fascinating topic, to be sure.