What Western Medicine Misses

There is a theory of chronic pain that Western medicine has largely refused to take seriously. It goes like this: the brain, when faced with emotions it cannot safely process — rage, grief, shame, the slow accumulation of feeling too much for too long — will sometimes generate physical pain as a distraction. Real pain, measurable in the body, rooted in the nervous system, and in many cases entirely reversible — not through surgery or medication, but through the willingness to feel what has been unfelt.

Dr. John Sarno spent fifty years at NYU watching this happen. He called it Tension Myositis Syndrome. His medical colleagues largely ignored him. His patients — tens of thousands of them — often recovered after years of failed treatments, sometimes after reading a single book. What Sarno lacked was the neuroscience to prove what he was seeing. That science is now arriving and my bet is that it becomes more and more obvious as time goes on.

A 2012 study from Northwestern University found that researchers could predict with 85% accuracy who would develop chronic pain based not on the nature of their injury, but on the emotional circuitry of their brain. Separate neuroimaging research has shown that as pain shifts from acute to chronic, its neural address moves — migrating away from the sensory processing regions of the brain and into the limbic system, the seat of emotion and memory. Chronic pain, in other words, becomes a form of emotional learning.

Consider this: 85 to 90% of chronic back pain has no identifiable structural cause. And yet we have built an entire medical industry around finding and fixing the structure. MRI scans show disc degeneration in 96% of pain-free 80-year-olds and 37% of pain-free 20-year-olds — people with zero pain, walking around with the same spinal "abnormalities" that elsewhere earn someone a surgery. Meanwhile, when researchers treated chronic pain as an emotional and psychological phenomenon rather than a structural one, 63% of patients achieved significant pain reduction compared to just 17% receiving the current gold standard psychological treatment. The brains of people in chronic pain show measurable differences in their emotional and fear-processing circuits — not in the regions that track tissue damage. We have been fixing the wrong thing.

I have learned that the body keeps the score. Emotions live in the body. Traditional Chinese Medicine and other energetic traditions have been talking about it for thousands of years.

The reason I have an opinion on this and care about it is because I lived on the wrong side of it for two decades.

It started in my teenage years, playing sports. Hip pain first, then knees and ankles. I told myself the story every young athlete tells: this is just what it feels like to compete. You play through it. But looking back, what I was playing through was something more than the ordinary cost of sport. My body was holding an imbalance — one side bracing, one side compensating — that I didn't have the framework to understand. My junior year of high school, I broke my left ankle and both bones in my leg in a snap that I thought was a freak accident. I'm not so sure anymore.

By my twenties, the pain had migrated. Up the spine, into the neck and jaw. Headaches that radiated around the side of my head. A grinding, clenching tension that became the background noise of my life. I started the journey that anyone with chronic pain knows intimately: the specialists, the diagnoses, the treatments that helped a little but created new problems. One medication reduced my anxiety but worsened the teeth grinding, which worsened the jaw pain. The system felt less like healing and more like whack-a-mole, each solution introducing a new symptom to manage.

I spent tens of thousands of dollars across twelve to fifteen years. I spent more than money — I spent the stretched, depleted version of myself that found its way into how I parented, how I worked, how I showed up in relationships. I was willing to try anything, go anywhere, see anyone. Nobody asked me how I was doing emotionally. Nobody asked what I was carrying. The question was always: where does it hurt, and what structure do we fix?

The door cracked open slowly. Over the past few years, something I can only describe as a foundational realization settled into me: my nervous system had been in a chronic state of fight-or-flight, and the pain was not separate from that. It was an expression of it. My system was in hyper-vigilant mode. I didn't have good access to my emotions — I see that clearly now. Certain feelings, anger especially, felt so threatening to my system that the psyche had found other ways to handle them. The body is extraordinarily creative in this regard.

When I first read Sarno's The Divided Mind, something in me recognized all of it. It wasn't relief exactly — it was just recognition. Here was my own story, named. The central claim — that the brain generates real physical pain to protect us from emotions we aren't yet ready to consciously feel — landed as a description of something I had been living inside of without the language for it. From a young age, depending on how we're raised, certain emotions can feel like a matter of survival to avoid. Of course the brain would create a distraction. Of course it would rather give us something structural to fix.

What I've come to understand — and what changed more for me than any treatment — is that the body is an outward manifestation of our inner life. And crucially: the resistance to feeling the pain was worse than the pain itself. When I stopped fighting it, stopped trying to manage it away, and instead got curious — about the pain, about what it might be carrying, about what emotion might be underneath it — something began to shift. It's still shifting, but in a way that is consistently leading to relief. Relief that western medicine never gave me.

Here is the bold claim: Western medicine is genuinely good at emergencies. When something is broken, bleeding, infected — we are extraordinary. But for chronic pain, chronic conditions, the long slow erosion of a life lived in a dysregulated nervous system — we are largely getting it wrong. We are treating symptoms without asking what the symptoms are trying to say. We are prescribing interventions for a structural problem that, in millions of cases, isn't primarily structural.

What does this cost? In the United States alone, chronic pain affects 60 million people and carries an economic burden of $723 billion annually. That figure doesn't include the opioid crisis — 800,000 deaths since 1999 — which was itself a downstream consequence of reaching for pharmaceutical solutions to pain that a purely structural model couldn't otherwise explain. We already know the structural model is failing — the numbers make that plain. The cost is not just financial. It's the twelve to fifteen years I spent in significant pain before anyone thought to ask what I was feeling emotionally. It's the gap between what neuroscience now knows and what shows up in a clinical encounter. Research suggests it takes an average of seventeen years for scientific evidence to reach clinical practice. For the millions cycling through surgeries and opioid prescriptions right now, that gap is not academic.

Imagine a version of medicine where this changes. Where a doctor, when you arrive with chronic pain, has deep fluency in the psychological and emotional dimensions of what you're carrying — and asks about them not as a referral to somewhere else but as part of the encounter itself. Where children are taught, from early in their lives, that the body has its own wisdom, that emotions have addresses in the tissue, that feeling is not weakness but information.

I believe the implications of getting this right extend far beyond medicine. If we accepted — really accepted — that the body keeps a record of what we haven't let ourselves feel, we would become more connected to ourselves. Less numb. More awake. Our relationships would deepen. Our collective suffering would ease. We would find our way to something that looks less like managing pain and more like understanding it — which is the beginning of something that might actually be called healing.

This is what Sarno glimpsed. This is what the neuroscience is starting to confirm. The question is whether we're willing to let it change not just how we treat pain, but how we understand what it means to be human and embodied and alive.