Your Scan Is Not Your Sentence

What two studies told me about pain, and what I wish someone had told me at 50

I posted a line in the Bern's Bench group last week that got more comments than anything I've written this year. "I'm not a badass. I can be a badass." Most of the replies were the same sentence in different words. Bad back. Bad thyroid. Bad hormones. This is just how I'm built now.

I asked what sentence you say about your body, and you told me. So this is the follow-up I promised, and it comes with homework at the end.

Here is the first thing I want you to sit with. In 2015 a group of radiologists pulled together every study they could find of spine scans done on people who had no back pain. None. Not a twinge. What they found was that 37 percent of pain-free 20-year-olds already had disc degeneration on their MRI. By 80, it was 96 percent. Disc bulges went from 30 percent to 84 percent. These were people who walked into the scanner feeling fine and walked out with a picture that looked like a diagnosis.

Read that again if you have ever had a doctor point at your scan and say, well, there's your problem.

The second study is the one that changed how I talk to clients. In 2022, researchers took 151 adults with chronic back pain, most of them years into it, and split them into three groups. One got usual care. One got a placebo injection. One got four weeks of a treatment with no needle, no surgery, and no drug. It worked on the brain's threat signal, teaching the nervous system that the pain was real but the danger wasn't. Two-thirds of that third group were pain-free or nearly pain-free after four weeks. Placebo got 20 percent. Usual care got 10. A year later, most of the two-thirds were still there.

I know what a woman over 50 hears when someone tells her that. It's in your head. You're stressed. Your labs are fine, move more, eat less.

That is not what the science says, and it is not what I am saying. Your pain is real. Your fatigue is real. What the research says is that the scan does not get to decide what your body does, and a nervous system that has spent twenty years running a company on adrenaline will keep the alarm on long after the tissue has healed. The alarm is the thing. Not the disc.

I learned this the expensive way. I took every treatment I was offered. Some of it helped. What I refused to do was take the diagnosis home and make it who I was. The question that changed everything for me was the second one, the one nobody in the exam room asked. What was in me that my body was expressing?

That question is the whole job. It is why I look at cortisol rhythm and sleep and gut and the way a woman talks about herself before I look at anything else. The scan is a photograph of the past. The nervous system is what's happening now, and it's the part you can retrain.

So here's the homework. Write down the sentence you say about your body. The one you'd say to a friend over coffee when she asks how you're doing. Then write down whether it's a description or a verdict. Most of the sentences you sent me were verdicts.

The full video is on the channel this week, with both studies walked through and the comments from the group that got me writing this. Watch it, then come tell me in the group whether your sentence changed.

Sources Brinjikji W, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. American Journal of Neuroradiology, 2015. Ashar YK, et al. Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain. JAMA Psychiatry, 2022.

Until we connect on the Bench

Bernadette