An effective new treatment for chronic back pain targets the nervous system.
A new treatment offers hope for people challenged with chronic back pain. It focuses on retraining how the back and the brain communicate, and was demonstrated in a randomized controlled trial. The research was performed by scientists at the University of New South Wales (UNSW) Sydney and Neuroscience Research Australia (NeuRA) and several other Australian and European universities.
The study, was described today (August 2) in a paper published in the Journal of the American Medical Association. Funded by the Australian National Health and Medical Research Council (NHMRC), the study was carried out at NeuRA. It divided 276 participants into two groups: one undertook a 12-week course of sensorimotor retraining and the other received a 12-week course of sham treatments designed to control for placebo effects, which are common in low back pain trials.
“This is the first new treatment of its kind for back pain – which has been the number one cause of the Global Disability Burden for the last 30 years – that has been tested against placebo.” — Professor James McAuley
Sensorimotor retraining alters how people think about their body in pain, how they process sensory information from their back, and how they move their back during activities, according to Professor James McAuley from UNSW’s School of Health Sciences, and NeuRA.
“What we observed in our trial was a clinically meaningful effect on pain intensity and a clinically meaningful effect on disability. People were happier, they reported their backs felt better and their quality of life was better. It also looks like these effects were sustained over the long term; twice as many people were completely recovered. Very few treatments for low back pain show long-term benefits, but participants in the trial reported improved quality of life one year later.”
The new treatment challenges traditional treatments for chronic back pain. This includes drugs and treatments that focus on the back such as spinal manipulation, injections, surgery and spinal cord stimulators. It accomplishes this by viewing long-standing back pain as a modifiable problem of the nervous system rather than a disc, bone, or muscle problem.
“If you compare the results to studies looking at opioid treatment versus placebo, the difference for that is less than one point out of 10 in pain intensity, it’s only short term and there is little improvement in disability. We see similar results for studies comparing manual therapy to sham or exercise to sham,” Prof. McAuley said.
“This is the first new treatment of its kind for back pain – which has been the number one cause of the Global Disability Burden for the last 30 years – that has been tested against placebo.”
How it works
Prof. McAuley said the treatment is based on research that showed the nervous system of people suffering from chronic back pain behaves in a different way from people who have a recent injury to the lower back.
“People with back pain are often told their back is vulnerable and needs protecting. This changes how we filter and interpret information from our back and how we move our back. Over time, the back becomes less fit, and the way the back and brain communicate is disrupted in ways that seem to reinforce the notion that the back is vulnerable and needs protecting. The treatment we devised aims to break this self-sustaining cycle,” he said.
Professor Lorimer Moseley AO, Bradley Distinguished Professor at the University of South Australia said, “This treatment, which includes specially designed education modules and methods and sensorimotor retraining, aims to correct the dysfunction we now know is involved in most chronic back pain and that’s a disruption within the nervous system. The disruption results in two problems: a hypersensitive pain system and imprecise communication between the back and the brain.”
The treatment aims to achieve three goals. The first is to align patient understanding with the latest scientific understanding about what causes chronic back pain. The second is to normalize the way the back and the brain communicate with each other, and thirdly, to gradually retrain the body and the brain back to a normal protection setting and a resumption of usual activities.
Professor Ben Wand of Notre Dame University, the clinical director on the trial, emphasized that by using a program of sensorimotor training, patients can see that their brain and back are not communicating well, but can also experience an improvement in this communication. He said, “We think this gives them confidence to pursue an approach to recovery that trains both the body and the brain.”
Training the body and the brain
Traditional therapies concentrate on fixing something in your back, injecting a disc, loosening up the joints or strengthening the muscles. What makes sensorimotor retraining different, according to Prof. McAuley is that it looks at the whole system – what people think about their back, how the back and brain communicate, how the back is moved, as well as the fitness of the back.
The authors of the study say that more research is needed to replicate these results and to test the treatment in different settings and populations. They also want to test their approach in other chronic pain states that show similar disruption within the nervous system. They are optimistic about rolling out a training package to bring this new treatment to clinics and have enlisted partner organizations to start that process.
Once the new treatment is available via trained physiotherapists, exercise physiologists and other clinicians – Prof. McAuley hopes this to occur in the next six to nine months – people with chronic back pain should be able to access it at a similar cost to other therapies offered by those practitioners.
Reference: “Effect of Graded Sensorimotor Retraining on Pain Intensity in Patients With Chronic LowBack Pain” 2 August 2022, Journal of the American Medical Association.
Very interested in the possibility of a successful outcome of pain relief of lower back for myself and a family member.
Read Mind Over Back Pain by Dr. John Sarno. It’s the reason I’m pain free today.
It does work along with natural supplements for me.
If only the science and medical industry treated pain as seriously as they do all these new imaginary genders and identities. I get accused of being crazy or an addict for saying I’ve been in pain all my life but if I said I was an addict or believed I was a male fairy dragon princess queen well they’d be more than willing to give me meds and surgery. 🤔 The industry is a joke it’s gone back to the dark ages.
Yes , I totally agree ….
Meds and surgery will not help you. The pain is real but it is caused by your brain, thoughts and nervous system. Until you accept this you Will never heal. I used to be lile you, in chronic pain, getting surgery after surgery, diagnosed with all sorts of things until i finally read DR Sarno, accepted my pain was psychosomatic and i was pain free almost immediately. It worked for me and it works for everyone. Give it a shot, you have nothing to Lose and everything to gain.
Nurve damage in the neck and lower back has put me on disability. Life changed drastically. Interesting treatment that i will inform my doctor about.. Thank you for the excellent article..
Also try natural supplements, such as Turmeric & Ginger Root. I also have neck and back nerve damage. Please read my long post on here. May help you.
I also have neck and back nerve damaged. Try natural supplements, Turmeric & Ginger Root. I told my story on here in a long post. I hope it posted and helps others.
No actual source to the study?
I’ve tried the prescription cbd oil for chronic back pain and arthritis, it doesnt work or help with pain nothing
This was originated by Dr. John Sarno, author of Mind Over Back Pain over 30 years ago. Give credo where credit is due.
This kind of therapy has been around for quite some time such as TuiNa(traditional Chinese medicine), Somatics by Thomas Hanna and others. Western 20th century AMA Medicine has painted it previously as quackery under the guise of “not enough research or its not proven or I’m not trained in it so I can’t charge you mentality encouraged by the insurance and pharmaceutical industrial complex”. Hopefully those that are already trained and practicing will be able to receive credit and appropriate reimbursement.
I have chronic neck and back pain and it’s the worst I have yet find out what works I’ve tried everything
So basically if one has constant back pain, one should simply think they don’t have back pain and magically make the pain go away. Sounds mind blowing. I have my own research that proves this to be wrong as it does not do anything but make one realize pain cannot magically go away when there is REAL pain involved. How did this article even get published anywhere??? What a joke.
The pain is real but it is caused by your brain, thoughts and nervous system. Until you accept this you Will never heal. I used to be like you, in chronic pain, getting surgery after surgery, diagnosed with all sorts of things until i finally read DR Sarno, accepted my pain was psychosomatic and i was pain free almost immediately. It worked for me and it works for everyone. Chronic pain is always caused by the brain. Give it a shot, you have nothing to Lose and everything to gain.
“They also want to test their approach in other chronic pain states SHOW SIMILAR DISRUPTION within the nervous system.”
It looks like they’re testing this on people with a specific issue connected with the nervous system…
Which is too bad, I was hopeful. But I’ve got many injuries, I doubt it would work for me anyway. But if it’s effective, many people will be very relieved!
Tried the mental thing! It didn’t work I have gotten radio frequency and I have been able to go back to work after 17 yrs and now just use a can to walk with not a walker.
What is radio frequency
To other commenters…
This is not about mind over matter. This is about reprogramming the brain.
If it can be done with pain it should work on addiction
This has been known for 25+ years. It does really work.
Sad that this guy doesn’t pay tribute to Dr. John Sarno, who is the real pioneer.
Find the right spine surgeon!! 11 year pains gone!!
You have no idea how you going to come out of back surgery. Nor does the Dr.
Finding the right Dr. theory doesn’t make any sense.
Will this work for people with injuries and compromised spine structure? I’ve had 2 failed spinal fusion surgeries attempting to remove 22 inches of broken titanium hardware. Ive been on Morphine and oxycodone for 20 years and I’m only in my early 40’s.
If you search sensorimotor and jama you will find the article and the results are meh at best. The “clinically significant” decrease is 1 point on a 0-10 scale, which are terribly unreliable to study for several reasons. This is vs sham, the overall reduction was closer to 2 to 3.
I agree that it could be a useful adjunct to pain management plans, however, it does not have the numbers to support whole sale adoption and abandonment of other interventions.
I also have Chronic Neck & Low Back Pain,now have Arthritis,I was sent to a Psych Dr. I did the radio Frequency to the ear lobe, it didn’t work, how do u sit still in the chair if u have pain? MIND OVER MATTER. At the end of one of my sessions the Dr asked me ” What can I do for you” I said if you can stop this pain it would be wonderful, he says well I’m not an M.D. he didn’t help me at all. I also tried it all, with these idiots overdosing Dr’s dont prescribe Meds anymore.Has anyone been to a Rheumatologist?
I have severe back problems. I was 6ft 2 & 3/4 in tall. Now I am barely 5ft 10in tall. I have scoliosis severe enough that surgery is not an option. I did injections with some positive relief. I did RFAs 4 times. The first 2 times with no results. The last 2 times messed me up even worse. I would love to be pain free without drugs and/or surgeries. I do not sit around the house with a “poor me” attitude. I still get up, go out, and do things. Because 1: if I don’t do things, they won’t get done. 2: I want to do these things. I may not be able to do things as long as I want, but I can do 5 or 10 minutes in the floor with my grandson. 5 or 10 minutes at a time tending my flower garden. There is a mental way of looking at pain. There is a physical way if looking at pain. My mental way is “I will do this”. My physical way is “But only for a few minutes.” Because the physical feeling of pain will kick my ass is I push myself too far.
Please don’t think this is just “mind over matter” pop commodified mindfulness drek. Please read the article more carefully people. They are talking about a set of treatments that are physical as well it’s not just you sitting there thinking about not being in pain. They’re talking about physical therapy treatments to help get the nerves muscles and tendons to act and respond differently.
Well, does this therapy address folks whose lower back’s (L4-S1) disc is gone, just ruptured 25 years ago and has consistently deteriorated over the course of the past 25 years? Would love to hear of your help in this regard, but personally,I’m not buying that this will help me. Please prove me wrong. Thank you!
I strongly suspect sample size and placebo effect are impacting results and conclusion. I hope I’m wrong but I’d almost be willing to bet this is a red herring.
Most of the medical community and media are against the use of medication – opioids and whatnot – assuming that everyone is vunerable addiction and misuse. They are desperate for alternatives and ‘ here’s your sign’.
We’ll see what comes of it. In the meantime I’ll stick to my opioid….. that I have never become addicted too (there are times I go months between use) after 15 years and controls my pain incredibly well.
Waiting for the day (that may never come) where science can rebuild my spinal column as easily and safely as removing tonsils.
Tom, I would love to know your “right” spine surgeon. I had a fusion L4/L5 in 2016 & a heart attack the same week. Now I need another fusion above. I’ve been in pain for yrs & do injections & do not want this surgery. I would do it if I had your surgeon tho.
EOh, agree with you 100%. As a long time pain suffer I have tried everything under the sun. Opiate therapy actually offered the best result. However because of government interference doctors are no longer prescribing the meds needed. I would also like to point out that there is a difference between addiction and habituation. People get addicted to opiates because they’re either being overprescribed or their pain is minimum. Those people will get a pleasurable feeling from taking opiates. I habituation is different in the fact that the opiates do not give any type of pleasurable feeling but rather only a pain reduction. That is also why chronic pain patients do not go through the type of withdrawals that an addict would have with the cessation of the treatment. I wonder why every year deaths from opiates drastically increase as a years go by regardless of the fact that doctors are no longer prescribing them. Could it be that chronic pain patients are going to the streets to get their pain relief or are they just committing suicide?
This is really interesting my wife suffers from Degenerative disk disease or from what I understand is that her middle to lower back is stiff even in the spine
seriously…this is just junk science. People in pain will try anything…you can’t blame them…only the snake oil salesmen!
I have a thorasic injury. I never see anyone study this area of the spine. I have tried all sorts of therapeutic interventions. I also noticed that most are designed for lower back and neck pain. It would be wonderful if someone came up a solution. It’s very hard to have your life limited by constant severe back pain.
This is old it’s basically another fancy word for therapy which only works on those who don’t actually have serious chronic pain and are able to exercise stretching like yoga which only agitates actual chronic pain. I’m so tired of all these long proven bunk medical and science scams keeping patients from recieving care that works it’s inhumane to tell someone who’s in pain to think differently learn to cope and try to exercise which only makes things worse not better. It’s sad that if you’re in pain they in deny you medicine out of need to protect addicts so they let you suffer and hand you things like marijuana that does nothing for you meanwhile actual addicts who are the entire reason you are denied care are given pills for their pain and recovery. I’ve never had an issue with medicine I have episodes that last months non stop severe paralyzing pain nothing works but opiods as soon as I get them within days it’s all over with no need to keep to taking them I only take them as needed not as prescribed. I’m disabled because of addicts I survived child trafficking I’m often denied care because of them to they try to push me into the mental health system refusing to aknowledge the the long term effects of being tortured and malnutrition my abusers get way better care from the system and society than I do. All this so called new aged pain treatment is inhumane gross medical neglect everything they’re coming out with has already been proven false and quite harmful to patients many years ago. I tried this method it made the pain way worse with every session and staff just tells you that if it’s not working it’s just your mindset pain is real and uncontrollable without proper treatment meaning medicine.
When I was 14. I fell 42’to 45’and struck a 14″×14″ wood beam lined for a loading dock that was originally built as a train stop. I’m 30 now I wake up randomly throughout the nights because the pain is so far beyond unbearable that most nights I’m having an anxiety attack because I cannot breath cause whichever way I happen to be laying at that moment in my sleep mind you that it hurts to breath
. Been to several doctors (for surgery
and physical therapy/chiropractor) that all said no to my question of “It truly beneficial in the long run”. One chiropractor had me sign some papers that we agreed upon. At this time I was 22 and for the first and only time I’ve been to the chiropractor.
With that being said. My suggestion isn’t only “teaching” the body and brain to transmit communication to one another similar to morse code. Short and time the point moments while moving slow and ease. the process and connection they have like “hey body let’s move this way to put less strain on that part there. Slow, easy, stretch, good.” Personally by doing this and taking a LSD (cause it’s been proven to help receptors and help not necessarily rebuild but find a different path of receptors to the same destination it needs to go but after taking this psychoactive hallucinogenic didnt only partially help me understand myself and system but it helped me learn how to move without crippling pain constantly being present. I can actually move a lot now. I did it for approximately 2 years. About 11 to 13 months of realizing the effects my own brain could help me overcome (like everyone knew) that I could (with help previously stated and don’t forget psilocybin and Dimethyltryptamine) helped me retrain or help rebuild or guide my movements ever so cautiously into not needed to use the substance since. It’s been 3 years since I’ve taken or done any treatment on/for myself. Now I am starting to feel slight pain again edging it’s way back (pun intended) but seriously. I dont find it difficult to find.. umm.. peace and a better obtainable more achievable way of living than that right there. I can say. The risk does NOT outweigh the rewards. Cause I’d much rather be able to breathe regularly and walk. Than to live… like that..
Ditto for the Dr. John Sarno book. I read and followed “The Mindbody Prescription” which was personally recommended by Dr Sarno to a friend of mine. Bottom line … it works if you believe it and do what he recommends. 90+% success rate. I hevent had a problem in many, many years. Before that, Pilates helped a ton.
Sadly spinal surgery at eleven years old was my only option with idiopathic scoliosis. I’m always interested in new research vs taking medications or going for injections that don’t work.
I went through hell with spine surgery due to an accident years ago. Ended with bodycast because part of spine was fused with bony tissue then wheelchair and strong pain medications like morphine, demerol, flexeril…I was a professional ballet dancer then a health spa manager and personal trainer…As you can see, I exercised my entire life tgerefore my accident brought me to a physical condition and lifestyle of intense suffering also complete abandonment by everyone…People, family member realized that it wasn’t like a cold that last few day but years so they were busy and took off. Even Spalding rehab gave up on me…. I started from learning how to hold a glass of water because even this brought pain…Phisically speaking I couldn’t do much nevertheless stand up. I decided to quit medications that kept me weak and decided to take just tylenol as need ( I still take Flexeril when is a most otherwise I avoid it too) only medication I haven’t been allergic to and helps me to get back on my feet if need to rest one or two days or few days. I knew muscles have memory so I threw myself off the wheelchair and started to crawl and my arms took the lead for all physical needs. God knows how many years I suffered until one day I stood up back again when people less expected. The doctor talked with me: You won’t be able to physically be do the things you used to be & do. I advice you to look for something in life that will suit you accordingly and learn to modify…At times you may need to stop and rest in bed for few day or a day….Be kind and do so. I learned and I would have to write a book for you to get the entire story. Today I go to b.v the spa and many times in look like a champ then disappear for weeks then I go back again and go home to rest for weeks as needed but I refuse to stop. Right now, I have been sedentary for 3 months….but I keep on trying beyond my chronic pains…Why?….I have lived exercising all my life with great discipline and it is on me never to give up….I gained weight…up and down…I will never fit my body in a tutu again or dance on my toes but I wear very well high heels and sneakers and I refuse to be less…Why high heels?..Because my body and spine have been all my life standing on my toes not flat on the floor and this is tge way inexperience less pain and difficulties. Remember than my muscles flexibility and body structure was built as a ballet dancer and not as a secretary sitting behind a desk. One day my orthopaedic asked…I explained…He saw my spine vertebrae separated a little when my body was on high heels therefore spine pressure was released also chronic pain. When it comes to injuries, people can’t be treated as one size fits all also there isn’t a thermometer that tells degree of each iij individual pain. In my case, I am a strong person and tolerate pain because more than others due to my background. I was raised with lot of discipline also a stepfather a chief in hinecoligy and surgery, a mother same feel but a nurse who practice psychoprofilaxix and I wasn’t even allow to cry during menstrual pain because according to them, pain is in our mind therefore it doesn’t exist. I luve with chronic pain but have come a long way. I manage every day like the champ and professional I believe I am. Thanks for this opportunity…..Like your article and test indeed…You are tight! 🌺
Would love to be pain back free I’m always hurting daily. As I work and stand on my feet for 8hrs a day on concrete.
NITA ,Basically nerve burns ,radio frequency ablation I believe it’s called sometimes they burn the facet nerves at each joint down the spine as well.
I am a type 2 Diabetic with Graves Disease and am 72 years old. At the age of 50 I was roller bladding when another skater clicked the back of my skate and I landed on my spine. I have contusions from L1 to T 4 and have had epidurals and radio frequency injections also Physical therapy. I also have arthritis in both knees and have had the gel injections and cortisone – the gel lasts about 2 1/2 weeks and the cortisione a bit more than 2 months. I live in Forest Hills, Queens N.Y. if you are looking for a subject I am very interested – I have Medicare and AARP insurance.
Hi, I would do about anything to rid my Spinal Pain! Unfortunately I have had so many high tech Spinal Surgeries that I am the only one in the world that has complete Spinal Failure. I am 1-57 in the world that has the original Antior Zielke Instrumentation/Dr.Authur Weber, L.I.J.M.C., My spine also has 34 screws, 4 other rods, 2 anchor screws, cages, disc, botched surgeries, loridosis, Stenosis, Scoliosis, Rotating Scoliosis, Spondylosis, degenerative disc,Arnold Chart, etc…… Plus, I have had 2 knee replacements&am desperate to find a Knee Orthopedic Surgeon to put the 3 rd knee in. I also have a tri layered bilateral antior illiac stents system with an extension to vena cava. They enter through both thighs, and go to vena cava. The Opioids provided very good relief at a certain level, but I have to still need to feel some pain in case my spine breaks again! Also, The Nuropathy in my feet and legs, on and on. I do not qualify for the Nuro stimulator or a pain pump. So would this even work on people like .e, or am I STILL LEFT IN THE DARK LIVING ALIVE NIGHTMARE! Especially, since the U.S. didn’t make a class to put people like me in, then yanked the Opioids that were working? P.S. the 3 layered bilateral Antior illiac stents system has been throwing multiple monster clots for the last 6 months!
P-Stim works for pain. It’s stops fantom pain from Amputation. It stopped my spinal stenosis a hour after wearing the device . Look on YouTube. I swear on God. It works.
Leslie Flores. I learned to ignore my aches and pains. Especially back and neck pain. I had to learn this because I was constantly being accused of being a drug addict when the VA was giving me Vicodin and tramadol and constantly threatening to cut me off. Getting the pain meds became too much of a hassle. But now thank God I can cope. Me daily walks in the park and light weight training and the treadmill 5x week are a tremendous help. God bless.
Wow..25yrs+ of proven let’s play trix on the brain from 24/7 pain studies???..haha
If anyone said that this works has never had true back pain. That like me getting a baseball bat and hitting you repeatedly in the back as hard as someone can and say that’s not pain it’s all in your mind
I’ve had a Medtronic back stimulator for 15 months and it was not worth the $$$$. Recently had 3 laminectomys for L3-4-5 and removed some of the fusion hardware and doing this without pain medication and it tough on me mentally everyday. Physical Therapy 2x week and the Dr says need more time to heal. What they are saying is bologna and once you have serious back problems only schedule 1/4 narcotics are the only thing that helps but they just see you as a pill candy freak at these pain clinics.
It is bad enough to tell a patient that their pain is ” all in their head” I am chronic pain patient with 4 surgeries in 1 year that resulted in rods and screws. It has been classified as a Failed Fusion.
I now have a morphine pump because an SCS did not work.
It is time that we Pain Patients tell the FDA and Doctors enough bs..we just want to be out of pain and help us get our life back.
No more studies saying it is ” ALL IN OUR HEADS” WE ARE NOT GUINEA PIGS FOR YOU TO TEST YOUR THEORIES ON!!!
The pain is real but it is caused by your brain, thoughts and nervous system. Until you accept this you Will never heal. I used to be lile you, in chronic pain, getting surgery after surgery, diagnosed with all sorts of things until i finally read DR Sarno, accepted my pain was psychosomatic and i was pain free almost immediately. It worked for me and it works for everyone. Give it a shot, you have nothing to lose and everything to gain.
I read all the comments on here and did not see one say anything about Homeopathic supplements. I have a very severe messed up neck and back. From life’s experiences, athletics, arthritis, osteoporosis, spinal stenosis, spondelysthesis, bulging discs,herniated discs, scoliosis, car accident, etc. I have tried ALL pain management methods. I have had several Neurosurgeons, orthopaedic, chiropractors tell me this “DO NOT LET ANYONE DO ANY SURGERY ON YOUR NECK OR BACK.” Period. When they tell you, surgery could make your pain worse and you could end up paralyzed, I tend to pay attention. When you CANNOT find ONE doctor that WILL tell you Surgery WILL help, you tend to look elsewhere for other methods of treatment. I have done and still do research on everything. I am allergic to most medications. I have taken Flexeril when absolutely necessary. I also have something attacking my muscles and tissues to the point of tightness and stiffness of my neck and back affecting my breathing. Gasp for air to speak. At some point eases up. The inflammation is what I have found causes the severe pain. I have a Rheumatologist that ran numerous tests. Result, I have a number of different autoimmune diseases that cannot be pinpointed to correctly treat. She wanted me on Hydroxychloroquine to help inflammation. Some mild side effects nausea, diarrhea, etc. Major side effect can affect your vision to the point of permanent damage and loss of eyesight. NO thank you. Over the last six years I have been managing my “problems” and pain with the following: Turmeric Curcumin (Root extract with Bioperine) 2,000mgs in capsule form(anti-inflammatory) Ginger Root (organic whole root) in capsule form 2,160mgs (dosage it comes in)for pain. I use to take Ginger Root for severe migraines. Worked very well. I don’t get them anymore. Also take Centrum Women’s, Citracal, EsterC, Potassium GLUCONATE(spasms)& Magnesium Glycinate(anti-inflammatory), I also take one Tylenol 500mg (pain) & one Advil 200mg(anti-inflammatory),together at bedtime to keep inflammation and pain down during sleep. I also know I HAVE TO KEEP MOVING. I walk several miles everyday, then do strength training exercises and stretching for one hour. I like another woman on here have always exercised. This is what works for ME. Yes, I still have the problems and pain but it has decreased a great deal. It is minor. I had a Bone Density test done and the doctor said my osteoporosis had proven to be better. I also go to my Chiropractor every two-three months when back actually goes out. I truly am sorry for what everyone on here has endured. I hope giving you an alternative (supplements) helps just one of you. Keep researching and don’t give up.
Great to see that Dr sarnos ideas are finally becoming more and more popular. They saved me from my pain and they will save you too.