Are you familiar with the concept "illness as metaphor?" As illustration, if your neck hurts, you might ask yourself, "Is there someone in my life right now who's a real pain in the neck?"

Are you familiar with the concept "illness as metaphor?" As illustration, if your neck hurts, you might ask yourself, "Is there someone in my life right now who's a real pain in the neck?"

How about this: if you receive disturbing information and later find yourself with a sore throat — was the information "hard to swallow?"

Author Susan Sontag called my attention to the possibility that our disease conditions may be linked to our psyche in "Illness as Metaphor." In this book she discusses her personal experience with breast cancer using this perspective. Her work is impressive and deserves attention, but right now I'm totally focused on my own unrelenting back pain, and so far I cannot extract a metaphorical relationship, other than sympathetic friends who tell me it's a message to "slow down a little."

Here I sit before my computer, pillows propped on all sides and the smell of mentholatum in the air. My plan is to not move until I have tracked down the best pain management approaches on the planet. I am admittedly desperate. I've just used my last over-the-counter, stick-on pain patch.

Thankfully, Web-based ideas for managing pain abound — actually exceeding what I had anticipated. I should have Googled this earlier — although when you're experiencing explosive bursts of radiating pain across your lower back, all you want to do is lie in an inert position and moan a lot (But maybe that's just me.).

Good news: There are some innovative ways to manage pain ready for the taking. Non-invasive, non-drug approaches (always my personal preference) include water therapy, massage and relaxation techniques such as guided imagery and biofeedback. There is subcutaneous stimulation (hot and cold packs, applied alternatively). Acupuncture is an option. It's worth checking out www.spine-health.com or www.mayoclinic.com for additional information.

Before I go on — checking with your health-care provider is always advisable when pain is the issue. But if you are like me, you try to self-manage first (go to www.sohealthyoregon.org for more about self-management workshops).

Some approaches for managing pain are incredibly simple. Try this. Describe your pain aloud, as specifically as you can. For example, "The piercing pain in my lower back is like a serrated knife stabbing through my spine every 37 seconds." Once you have captured its essence, the next step is to give your pain a voice. If it could talk to you, what would it say? Here is where the real learning occurs. For example, my pain said, "If you would only remember to bend your knees when you lift those heavy boxes, we would not be going through this misery."

This particular self-talk approach could fall under the heading of a "distraction" technique. Anything that distracts you from thinking about your pain (like counting backward from 100 by 3s or continuously reciting old nursery rhymes) would fall in this category.

Here's a thought. Maybe by using distraction we become less self-involved in our own discomfort. And maybe, just maybe, "piercing" becomes "throbbing" and then maybe even "aching." Then, who knows, maybe the voice says, "Well, I'm certainly glad that's almost over; maybe we should go out for an ice cream?"

Sharon Johnson is an associate professor in health and human sciences at Oregon State University and on the faculty of the OSU Extension. E-mail her at s.johnson@oregonstate.edu or call 776-7371, Ext. 210.