Does TMS Strike Again? Knee pain!

OK, so an introduction - I was briefly quite involved in the TMS wiki before going to live in Thailand - since then a combination of my new life, time difference and dodgy internet speeds have pretty much stopped my involvement in the TMS community. I have previously suffered from a number of pain related conditions - including RSI and tinnitus - but thanks to discovering Dr Sarno and this forum have been pain free for 4 years.

I'll recap my RSI success story first (I first wrote this about 4 years ago):

I had been suffering from RSI for 3 years, the last year and a half of which to a pretty debilitating level. In terms of medical contact I had seen and had tests with:

6 different GPs
1 hospital doctor
2 occupational health professionals
2 rheumatologists
1 neurologist
2 physiotherapists
A few nurses
3 different "Access to Work" disability professionals

2 MRI scans; brain and neck
2 courses of phsyio
steriod injections in both wrists
chest x ray
nerve conduction studies
blood tests
urine tests
NHS acupuncture

Pretty comprehensive!

Having exhausted every single medical outlet and after having talked to probably over 2 dozen various medical professionals it was pretty clear that there was no medical cure for my symptoms. And so, I thought I’d look around the internet for any non-mainstream approaches.

One name and one book kept appearing on my searches “Dr Sarno’s Mindbody Prescription” which sought to address a catch-all condition described as TMS. I was impressed by the numerous (and apparently genuine) testimonials from a wide variety of people who were adamant that following the recommendations in The Mindbody Prescription had led to a reduction and in many cases a complete cure of their symptoms, including RSI. Now, I have to say my expectations were pretty low, but a £5 second hand book from Amazon I figured was worth a shot in the dark.

And, to cut a long story short (the long story will be filled in below!) it has worked. How, why and by what mechanism I don’t entirely know, but I’m currently typing this by hand, when I hadn’t typed anything at all for over a year and a half without using voice recognition software. I wouldn’t have believed it if it hadn’t happened to me. But it has. And whatever the reason it seems worth further consideration.
The background:

There was quite a bit of stress going on in my life at the time of the initial onset of symptoms, I would be spending about 16 hours plus (pretty much every waking hour) either playing the guitar or on the computer. I'd also got somewhat addicted to Internet poker, so a typical day would be eight hours at work on the computer, come home, switch on the computer, play pretty much continuously until past midnight, then go to bed. My ergonomic set up was pretty much non-existent, a stretched arm with a bent wrist making tens of thousands of clicks every day. I had just decided to take a computer course qualification when I first got a tingling sensation in my right hand. It was suddenly uncomfortable to click on the mouse, indeed even uncomfortable to hear the sound of it clicking (a bit like hearing nails on a blackboard). I could type but anything more than about 30 minutes at one stretch would lead to short-term aching in both hands and wrists.

This continued for about 12 months before a completely sudden deterioration of the condition. I had some reports to type and as result was pushing my body through the aching from typing too much. Suddenly it felt as though something had just "gone". Both hands were completely inflamed, as though from really severe pins and needles. From that moment on I was unable to type at all or even write a couple of sentences without going flares up of pain often lasting an hour or more.

Since then there had been a gradual deterioration in symptoms. Persistent levels of pain in both elbows, occasional pain in both Achilles heels, a consistent level of low-level pins and needles in both hands and wrists. I found that going swimming brought on symptoms in a completely different way. Unlike typing or writing which would bring on symptoms instantaneously, I felt fine immediately after the swim, and yet over the next few hours both elbows became more and more inflamed. To the extent that by the evening I was unable to sleep due to the pain.

After reading "It's not carpal tunnel syndrome" I started to try some of the stretches recommended, though this seemed to make things even worse. I started waking up with the whole of my arm numb from the elbow down to my fingers, and with numbness and grip strength severely diminished continuing throughout the day. Thankfully this has only happened a few times

Then after three years since the onset of initial symptoms, and over a year and a half after they significantly deteriorated, I bought a copy of Dr Sarno's "The Mindbody prescription".The results:

Within even a day of reading the book was doing things that previously I hadn’t done for months/years, and noticing that there wasn’t as much pain associated with them.

Three weeks on I could;
Play the guitar with no pain
Write about 600 words with no pain
Type about 600 words with no more than mild tingling
Play badminton, go swimming, go running – all with no pain.
This for me was absolutely incredible – I had about 90% of my life back.

Three months on, the symptoms have continued to get better. I have stopped using any voice recognition software, I can play guitar and piano for as long as I want, I can write full essays, and can even do computer design. After years of hell I am basically cured.

Knee Pain

So, that brings me onto the knee pain! It has been persistent for the past couple of months and I have another doctors appointment today. I have previously seen 2 orthopedic doctors and a physiotherapist as well as having an MRI (nothing shown). Today I will see a rheumatologist. I have had in the back of my mind that this could be TMS - though I don't think that I can accept this until I have ruled out any likely physical conditions. I will use this thread to update my progress - let's see what happens!

Andrew

 

OK

So, back from the doctors. He gave me some steroid injections (still as painful as from when I had them for RSI....) and some anti-inflammatories. I'll go back and see him in another week. Having previously had TMS I find it very difficult now to trust my body - when I feel pain does that mean I need to stop, or actually is it just another manifestation of TMS? It's tough to know! I guess the only way to do it is to go through the medical roundabout first - and if nothing works to then start to really focus on the mind-body aspect.

Let's see how it goes next week.

 

Hi. TMSandrew. Your TMS healing success story is wonderful. Thank you for sharing it.

The knee pain sounds to me like more TMS. Your doctor with his steroid injections and anti-inflammatories hasn't stopped the pain, so it must be more TMS. You didn't write about HOW you recovered before, except that you believed it was TMS. Did you discover your repressed emotions and/or personality if you are a perfectionist or a "goodist" who wants everyone approve of and like you?

It appears to me that your unconscious mind still has not "gotten it," that you believe 100 percent that your knee pain is psychological and not structural.

You healed before with TMS. You can heal again. Maybe postpone more doctor visits and give TMS a 100 percent chance. Don't set a timetable.
Just relax and believe you will heal, and you will.

 

Thanks for your reply Walt. I think I am still in the cycle of not knowing what the cause of the pain is - but it is starting to play out very similar to last time, insofar as lots of doctors trying their ideas, then throwing their hands up and saying, "I don't know!"

The RSI started severely for the first time just when I was finishing my teacher training - and I was having to start applying for jobs. Looking back I really see it as a defense mechanism from my body - I was really stressed, a big part of me didn't really want to start a new job, and this RSI was almost like a subconscious break trying to give me a way out of the situation. I would say both repressed emotions and perfectionism and goodism all fit pretty well - the full set

I think I'm going to go head-long into the TMS diagnosis and see how this changes things with my knee.

 

Hi Andrew. I agree with Walt and I am glad you've decided to treat this as TMS. I mean you've already had an MRI, seen multiple doctors and you have a history of TMS. After working on my TMS for almost a year for right sided neck and head pain, the pain moved over to my left shoulder. I tried initially to just ignore it and after 2-3 weeks it started to get me. I started trying to figure out what I could have done, did some internet research and was considering making a doctors appointment. Then I realized that in all liklihood it was TMS. Duh. I have the "benefit" of looking back on all kinds of pain conditions that eventually went away without medical intervention and each and every one of them really felt like something was structurally wrong. I had a bad knee three years ago. I was limping around for months. Since I decided the left shoulder pain is TMS, it hasn't gone away completely but it doesn't bother me much anymore. Today I painted my bathroom all day and I was fine. That goes down on my evidence sheet!

 

Thanks Anne

I think is it starting to look like TMS striking again! Today was better than it has been for a few weeks - which is a good start. I was thinking back to how my RSI progressed, and this has a very similar pattern - an initial slight injury (perhaps real?) followed by a gradual worsening of symptoms as I start to get more and more concerned about it. There's also a similar situation career wise to last time - I am going to start a new job in August, and part of me doesn't want the stress of the new challenge - indeed with my knee pain I was already starting to think, "well, maybe I can't work there next year..." so I think this might be the underlying cause of the problem! This is a subconscious way of my body giving me a way out of all that stress.....

 

Hi, Andrew. Changing jobs is high on the list of causes of TMS, says Dr. Sarno.

Ten years ago I decided to sell my house and move away from a high-tax suburb that was very noisy. I felt anxious about the move,
but made a list of the things I would be leaving behind that stressed me, and a list of things I would be enjoying in the new house and suburb. I immediately lost the anxiety of the thought of moving and felt great thinking about the new life ahead.

Maybe think of your old job and the new job that way. Maybe make two lists. Leave your old one behind and look forward to the new one.

 

Nice idea - I'll give that a go

 

well, it's been a few days and so far mixed, if slightly promising results.

I'm throwing myself right back into the TMS mindset - which includes coming back on this forum and revisiting all the amazing resources on this site.

I made a list of all the reasons that this could be TMS:

1) Onset at a similar time to my RSI (new job coming up - possible way out of having to deal with this new stress)
2) Same experience in dealing with lots of doctors who don't know what is wrong
3) A progression of pain - from an initial twinge in the knee, which meant I started avoiding exercise, to constant pain even when I walk. My RSI progressed in exactly the same manner
4) Symptom imperatives - as I type this now I feel some RSI in my hands again for the first time in years. I'm not scared of it anymore because I know that it is TMS, but it feels like my body is turning to another outlet after it thinks I have rumbled my knee pain
5) The pain is definitely worse with stress

So all in all there is quite strong evidence!

However, the pain is still there (if slightly more manageable than last week), and this has got me down on a few occasions - I always project worse case scenarios, "what if it never gets better, what if it's going to hurt every time I walk? Can I do my new job? etc etc" I know I have this tendency to obsess over symptoms and also to catastrophise - but it happens nonetheless. Because the onset of these symptoms is still quite recent, part of me still thinks it might be a physical problem - so it's hard to get to that 100% acceptance that it is TMS.

Anyway, just writing this post is helpful - even it's something of a stream of consciousness

 

Andrew, your list of reasons for thinking the pain is TMS are all excellent,
so maybe you should spend an equal amount of time now on a list of reasons you may have
some repressed emotions and/or a perfectionist and "goodist" personality.

Projecting worse case scenarios doesn't help. Try to think of the pain as just temporary and it will go away soon
and you won't hurt yourself by resuming normal activities.

 

Today was an improvement again - I actually did some light exercise (swimming) for the first time in about 2 1/2 months - there was no real pain at the time of swimming, though there was pain after I had finished. However the pain was not too severe - and it also highlighted just how week that knee had become, no exercise for such a long time, and my muscles in that leg feel puny! I am sure that this is a contributing factor - not doing exercise because of a fear of pain, which then leads to a weakened joint, which leads to more pain and soreness. In the afternoon I was on my feet and walking for a couple of hours - again less pain than previously.

Feels like something of a breakthrough, so I am hopeful this will continue!

 

Before you do anything drastic, explore the topic of : "FAILED KNEE SURGERY!"

Knee Surgery to Repair the Meniscus Shows High Failure Rate

In a recently published study, where surgeons repaired a certain type of medial meniscus tear and then went back at a later time to look at the meniscus under arthroscopy, almost none of the repaired tears healed. This was despite many patients reporting relief. Why?A meniscus tear usually doesn’t heal well due to a poor blood supply. In addition,recent research shows that many meniscus tears may not even be the cause of pain.So in this study, the non-healing of the meniscus may have little to do with the patient’s resolution of pain, which may be due to the prolonged immobilization of the knee after surgery and the post-op rehab devoted to the knee. In addition, many medial knee pain syndromes may be due to other factors outside of the knee meniscus, such as:pes anserine bursitis, aloose MCL ligament, ortrigger points in the quadriceps and other thigh muscles. The upshot of this study seems to be that getting a meniscus to heal with surgery is difficult and the patient’s report of relief after surgery may have little to do with meniscus healing.For those that have read Orthopedics 2.0, this may not come as a surprise.

The article mentions "trigger points" which is often an alias for TMS. No mention of TMS, stress, or psychosomatic, non-allopathic causes--modern medicine evolves very slowly if at all.

 

Andrew, it's great to know you're swimming again and walking for a couple of hours.
That will boost your confidence and reassure you that you will heal because of belief in TMS.

I'm sorry for anyone who still has pain after having knee surgery. I sure hope they will study TMS.
This video from Steve Ozanich explains it very well:

http://tmswiki.org/forum/threads/tms-steve-ozanich-video-interview-with-jeanette-barber.4755/

 

Hiya everyone

Just a running update, things are definitely getting better - there is no longer any pain when walking or standing. This is a very big improvement because in my job (teaching) I need to walk and stand pretty much all the day! Things are not 100% yet - but certainly good enough for me to no longer be worrying about whether this will impact on my ability to start a new job next year.

It's always hard to pinpoint where genuine tears/injuries stop and TMS starts - but I think in my case one always leads to the other. That is, in the first case there is a real physical problem - but then the pain persists long after that initial injury should have healed due to a mindset which obsesses and focuses on that pain.....

Thanks for your support

 

Another update a couple of weeks later - things are around 85% better I would say. No pain when doing any day-to-day activities (i.e walking and standing) - this is obviously the most important hurdles, because it was this that was causing me to be so down. It's hard to be upbeat when even moving is painful! I've not done any more than mild exercise - walking and a little swimming. I'm still at the stage where I am not completely sure yet if:

1) there was an underlying problem with the knee that the TMS exploited to start making me obsess with the pain - thus making it a lot worse...
2) there is nothing wrong at all with the knee

it's difficult to know which of these is true at the moment - so I'm taking things slowly. As long as things continue to get better then I am happy either way

 

Hi. I can totally relate to what you're going through. I went through these same thoughts this past 18 months with my shoulder pain. I injured it during a vigorous swim session and the pain never went away until recently. I think it took that long before I was ready to accept 100% that it was TMS. But once i accepted with certainty it went away completely.
I want to figure out how not to let it take so long!!