Spine Surgeon David Hanscom on his new book, chronic pain & DOCC

Leading Orthopedic Surgeon Dr. David Hanscom’s New Book Says Surgery Should Always Be A Last Resort

What kind of a surgeon tries to talk you out of surgery? An enlightened one? Seattle-based Dr. David Hanscom has been performing intricate spinal procedures for over 20 years. He has also suffered from severe burnout, debilitating back pain and anxiety disorders. After much investigation and personal soul-searching, he now shares his revelations in a must-read book, Back in Control: A Spine Surgeon’s Roadmap Out of Chronic Pain (Vertus Press, 2012), for all those contemplating, getting ready to embark on or frustrated with surgery of all kinds.

Chronic pain affects approximately 116 million Americans. An astounding one-third of the population live with chronic pain, dealing with everything from back pain to TMJ to arthritis and migraines. Within the past five years, the number of back surgeries performed has surged. And although spine surgery does have its place, the actual rate of success is very low. According to Dr. David Hanscom, the majority of all back surgeries can be prevented.

Really? How’s that? Well, apparently not all pain has an identifiable source. Picture the good doc Hanscom pouring over copious scans trying to find the source of the tirade he has just witnessed from an unhappy patient who is suffering from extreme discomfort. Scans look normal. No evidence of any kind of structural problem. But the patient’s pain is real. Certainly it is to them. How can that be? Where’s it coming from?

Hanscom writes in his book that “recent neurological research shows that the brain can create pain that is identical to the pain of a physical injury.” And that “stressful events and our emotional reactions to them can make that pain severe.” Ok, so does that mean the pain is in our head? Think of those phantom limb cases where amputees continue to feel sensations where their limb used to be. If our pain is indeed progammed neurally, then it stands to reason it can be reprogrammed neurally. To Hanscom and others, that’s the key to solving chronic pain. It’s through neuroplasticity–the reprogramming which actually turns out to be the creation of new pathways–that we address how we deal with our pain. The pain pathways will never go away. They are there forever. But we can calm our central nervous system (de-stress), detach from our negative thoughts which amplify the anger/anxiety cycle, and then pair new physical sensations with new thoughts to create new pathways. Eventually as the central nervous system switches over to the new pathways, the old ones will seem, well, simply antedeluvian, just a lot of history.

Dr. Hanscom’s five-step holistic, mind-body approach which he calls Defined Organized Comprehensive Care (DOCC) is meant to address the Mind/Body Syndrome (from Dr. Howard Schubiner’s mind/body program which Hanscom participated in and recommends) and help all those suffering cope with pain, and the anxiety, depression and anger, that accompany it. Customized for each patient, it involves stress management, anxiety reduction and improved sleep. Self-help books are great, he says, and he’s read many which he recommends to his readers. But unless you do the work, he further cautions, the information can just feed the complexity of the problem rather than activating a solution. Hanscom believes that it takes actions like Free Writing, a process whereby one writes down negative thoughts and then throws the paper away that enable a true separation from the negative thoughts, acting as a circuit-breaker to the anger/anxiety cycle that feeds the pain pathways. Dr. Hanscom advocates the need for a good night’s sleep (even if it means taking medication to establish it at first), becoming aware of your anger, anxiety and victimhood, releasing negative thoughts to calm the central nervous system and ready it for reprogramming to a more authentic, mindful existence.

Though Hanscom’s DOCC focuses on relieving back pain, it is applicable to all kinds of pain. His book stands as a synthesis of the many instructions, tools and understandings he has had throughout his career as a surgeon dealing with people in pain every day and his own journey towards living the life he was meant to live–happy, rewarding and pain-free.

Dr. David Hanscom, M.D., is an orthopedic spine surgeon at Seattle Neuroscience Specialists with Swedish Medical Center in Seattle, WA. He specializes in complex spine problems in all areas of the spine, and has expertise in adult and pediatric spinal deformities, such as scoliosis and kyphosis. Many of his patients have had multiple prior spine surgeries. He has successfully treated hundreds of patients for chronic pain. Read his book!

For more information on “Back in Control: A Spine Surgeon’s Roadmap Out of Chronic Pain” and Dr. David Hanscom, visit http://www.back-in-control.com.



  1. I have real spinal injury. It shows on the MRI’s My C5-7 vertebrae are “crumbled into many pieces. The neurologist says surgery is needed, the neurosugeon says it is an impossible situation that can’t be fixed with surgery. He says my only option is to continue with pain meds. It is becoming almost impossible to find a Dr. who will write pain meds because of the threats from our Government. I lost the most wonderful pain/spine specialist because they said he was writing to many scripts and took his licence away. He was so strict with his meds, that it was an excuse to slow down the pain meds being written in our area. Four other wonderful Dr’s also had the DEA sweep through their offices and take away their licences. What do I do! Will your method help someone with a spine that is literally falling apart? I’ve looked into stem cells-everything! Please help me!

    • Hi Victoria, Usually that comment refers to severe degeneration. If you are having just neck pain it is not from the degeneration and it is a solvable problem – usually without surgery. Take a close look at my book, Back in Control: A Spine Surgeon’s Roadmap Out of Chronic Pain and my website, http://www.back-in-control.com to begin to put together a plan. I don’t have the capacity to evaluate you here but the process is self-directed. David Hanscom

  2. My husband has had OCD since early teens. He has seen Dr. Jeffrey Schwartz at UCLA over many years. My husband is a case study in Dr. Schwartz book BRAIN LOCK. Have you ever helped someone with a severe case of OCD and been successful? Please respond. Thank you.

    • Hi Paula, I personally experienced severe OCD and it is one of the classic Mind Body Symptom disorders. It is treatable by the same principles that are outlined in my book and also on my website. The first step is the writing exercises. I have been OCD free for about seven years and I was in a severe state for over 10 years. I also have a couple of other patients who have come out from under OCD. The hardest step is persuading an OCD patient to engage. Obsessive thought patterns are also a symptom that blocks treatment. Let me know I can be of some further help. David Hanscom

  3. Spinal fusion is surgery to fuse spine bones (vertebrae) that cause you to have back problems.Fusing means two bones are permanently placed together so there is no longer movement between them. Spinal fusion is usually done along with other surgical procedures of the spine.The surgeon will use a graft (such as bone) to hold (or fuse) the bones together permanently.

  4. Hi Theresa, Thanks a lot for your interest and support. If you take a look at my website, http://www.back-in-control.com I think that the tools I have learned should be taught in elementary school. Here is a link that will lead you into my train of thought about this. It is not a major life philosophy. It is just the way the brain works. It is similar to brushing your teeth. I look forward to your feedback. David Hanscom


  5. THANKS SO MUCH FOR YOUR PROGRAM TODAY. I plan to utilize what I have learned as a school-based therapist in these ways: anxiety which leads to burn-out when we feel ourselves out of control of our lives; assisting children in the classroom to achieve their highest potential (with supports, where needed, based on their IEPs); informing the school IEP team as well as staff that we need a PRACTICAL program to move forward (from principal down to parent and child). My training as an occupational therapist is only the starting point to enlightening everyone around me. (I am a life-time seeking of truth…it all starts within each one of us)
    I TRULY APPRECIATE YOUR PRESENCE ON THE RADIO SHOW this AM. Both you and Dr. Rose Kumar’s books (who spoke before you) will be on my Reading List. -thv

Leave a Reply

Your email address will not be published.