Sarno, Back Pain, and Coffee?

It has been a while since I did a post on Back Pain. Honestly, I thought I said everything I needed to say on the topic. For those new to the site, let me quickly recap my background with back pain. For many years I suffered with episodes of lower back pain. Then in 2009, I decided to make ending my back pain my number one health priority. Unlike prior attempts that all failed, I took the assumption that I knew nothing about back pain and did some serious research to discover the cause of my back pain.

My investigation took me to Dr. Sarno, whom I rediscovered over on Conditioning Research. Dr. Sarno believes the root cause of most back pain is psychological. This is a difficult concept to understand at first. The pain is real, but the root causes are based in stress. The back pain is a diversion tactic used by our brain to redirect our attention away from what it perceives as the greater psychological pain. For those interested in that topic, I did a more in detail post titled The Psychology of Back Pain.

With that long background out of the way, I want to bring up a topic I was unaware until a few weeks ago. There appears to be a link between excessive coffee drinking and lower back pain. At my local Farmers Market I was introduced to an acupuncturist. He was interested in my coffee detox experience. Then he volunteered that he tells all his patients with lower back pain to stop drinking coffee. I was puzzled. He explained that the adrenal glands are located in the lower back region. Stress the adrenals and you could trigger lower back pain. He had been an acupuncturist for many years and had a long track record of success with this advice. He himself only drinks a single coffee a day and believes tea is much easier on the adrenals and doesn’t trigger back pain.

When I got home I read Is Caffeine Causing Your Back Pain? on The Healthy Home Economist. From that post:

Here’s what happens as explained to me by a chiropractor friend.  Stressing out the adrenals all the time with an unchecked caffeine habit weakens not only the adrenal glands but the entire area around them which includes the lower back.   Weak adrenals also suck vital nutrients away from the ligaments and tendons as keeping an important organ like the adrenals happy is more important that strong connective tissue.

The body is very good at sending nutrients to the area that needs them most.   Trouble is, the less vital areas that get shortchanged in favor of the adrenals – such as the ligaments and tendons – suffer and over time, the first ligaments to go are typically the ones that support the sacroiliac joint which supports the weight of the entire body.

Fascinating. I instantly thought back to the times in my life when I had the most back pain. Sure enough it was the periods I was drinking the most coffee. So does the caffeine theory invalidate the Sarno theory? I actually think they are complementary. Sarno explains that people with control issues have the most back pain. The need to feel in control is very common with back pain suffers. This morning the idea popped in my head that one of the reasons I drink coffee and tea all day is to control my mood. Being below baseline is an uncomfortable feeling, because it represents a loss of control. But one coffee later and I’m back in control. The problem is this goes on all day long without breaks for years or decades.

In my post Medicating Mood With Caffeine, I refer to my caffeine breaks as pockets of joy. There is no doubt that caffeine can elevate mood, but it comes at a cost. Not only are you potentially causing lower back pain, but you might be masking the fact you feel out of control without stimulants. At least that is the thought that came to me this morning.


Add yours

  1. Seattle. Coffee. It all makes sense.

  2. If you haven’t already, check the foremost researcher on lower back pain, professor of spine biomechanics Stewart McGill from the University of Waterloo.

    His decade-long experience and interaction with both patients and athletes is astounding. I am planning to make a post about the “3 exercises” that he has found to be the most effective in reducing pain.

    That’s his website:

    Hope that can help!

  3. I am still pretty convinced by the Sarno approach….but I do believe there can be other things at play too.

  4. @Stephan – I look forward to your post.

    @Chris – Maybe adrenal exhaustion might just be another physical manifestation of what Sarno believes? It does seem to fit together. The more coffee I consume, the more I am trying to control my mood. Why must I control my mood so closely? To avoiding dealing with stress? Maybe.

  5. Glenn Whitney

    Nov 14, 2012 — 7:18 pm

    I think the vast majority of people have a need to feel in control… Looked at from an Evolutionary perspective, I suspect those who exercised more control over their environment successful reproduced more than those who didn’t.

  6. @Glenn – Excellent point, but what was considered a strength could now be seen a weakness, because we live in complex environments that are outside our control.

  7. When I was told recently by a natural therapist in her shop that stress responded best to extra supplementation of Vitamin B5, I started researching and found B5 gave support to Adrenals. I think this supplement has been one of my breakthroughs. Then I read in my caffeine research that caffeine knocks out your adrenals, that’s why I had such a marked response when I had B5 (calcium pantothenic acid). The affect is immediate or soon after ingesting B5. I have many cups of coffee daily for years. My sister who is a huge coffee drinker has also had marked response on B5 on my advice. This is all very interesting. The lower back pain I have had on and off over the years, but I put this down to some inflammation response to gluten/flour in my diet and other sensitivites. So many interesting connections with caffeine research. Thanks for this.

  8. @Pauline – I just started B5. What time of the day do you take it or do you think it matters? Also do you take it with food?

  9. I tend to take it with breakfast (give my partner some too) that’s also when I have my first cup of coffee. If I forget, then I will take it at lunch time and then one more with with evening meal. I also dose according to what kind of day I am having – 2 x 250 mg is ok but might increase if the day has had more stresses than usual. Other times I may not take at all until evening. I also use this time (evening) to take my magnesium as I sleep better for it. I find walking in the day seems to equate to better sleep throughout the night. I am following Seth Roberts idea that the more we stand/walk in the day the better our sleep quality. So far it works for me. I basically dose with B5 to assist my coffee intake which is 2 cups a day at moment. I try not to be too rigid as the body adapts and I don’t want too much dependence on it. But initially I took 2 x 250 mg for a week or so, that was when I had just gone through a month of caffeine detox and was re-introducing coffee and it sure helped a lot.

  10. but dosage would also be according to your body size/weight, as the nutritionist told me she sometimes gives her husband. who has a very stressful job I think he teaches wrestling/boxing full time – dosage 4 x 250 mg in one dose, as it calms him very quickly.

  11. Actually that is incorrect, initially i took 2 x 250mg x twice a day until I felt my adrenals had calmed down (took about a week) and then cut back two 2 x 250mg. Hope that helps.

  12. @Pauline – Thanks!

  13. Hi,

    I will throw in my 2 cents as I used to have severe back pains in the past and for many,many years every Americano Grande seemed to have my name on it.

    I also read Sarno back then and I dealt with different modalities from homeopathy to chiro to whatever.

    Everything I will talk about here does not refer to those back pain caused by a sport accident or lifting a heavy object. I am only talking about those ‘mind’ back pain.

    There is no question that squeezing out adrenals several times a day, on top of our daily stresses will kick the crap out of them, especially when combined with inadequate rest, family and work pressures + too great an intake of negative news, etc.

    With all that good stuff, our resilience level go down after a while. This means that the ‘seal’ we have between our conscious mind and our unconscious starts getting porous or very porous, therefore allowing feelings, images, scenarios, emotions (most of them negative) to invade our daily conscious thoughts and steal some fresh energy. The amygdala is clearly involved in this whole deal but I won’t go there.

    The mind starts to feel it looses control and starts contracting many body parts, usually unconsciously but we can figure it out to some extent when it happens. For example, if your boss says: hey, I need you to take that call. It’s one of your customers you left you 4 messages already, he is pretty pissed off. Let me know how it goes.

    Chances are we will tighten up pretty bad, especially if we are already burdened with overwork. Guilt might be in the mix, resentment, etc. The subconscious will do its best to manage that threat and it will often pull on the dura mater inside the spine (old reflex). The dura mater is extremely strong when pulled up or down and it will easily pull up the lower back and pelvic area. Even if those contractions are a few mm, that’s often enough to start a chain reaction where one side of the back ‘protects’ the other, etc.

    Back to coffee : despite the nice smell, often nice flavor and great atmosphere around a coffee and a few good friends, coffee remains a VERY powerfully addictive substance and it’s over consumption will lead to some issues for a lot of folks.

    I have been 100% off coffee for about 3 years. Like an alcoholic, once I get my fingers on an Americano, it’s one a day…. then a second one down the road. I still have a few cups of tea every day which is still caffeine but it is way less loaded. However, if I had back problems or something like that, I would re-asses this habit.

    My post is a bit all over the place as I tried to link a few things together here. Another point I want to address is don’t be surprised if chiros, nathuropaths, chinese medecine, Sarno, etc. hoover around the same conclusions. They are simply holding a different part of the elephant.

    To Michael, if you still have a back prob shoot me an e-mail directly as I went through some unusual back treatment about 6 months ago for the kick of it and it was interesting. I don’t want to be too long but back probs are very problematic and we really need to open our minds as to their causes… Cheers.

  14. @Eric – Great comment. I like the “holding a different part of the elephant” explanation. These days I do not get back pain. But 10 years ago I did all the time and that is when my coffee consumption was the highest. Lack of control – just a different path.

  15. Glenn Whitney

    Nov 16, 2012 — 9:46 am

    Hi MAS. We humans have always lived in complex environments that are outside our control. Glenn

  16. When ever i have headache or backache i try have some fresh made coffee. I have only medicine gives proper relief but its great temporary solution.

    Regards, Arnold

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