Not sure if this could be Central Sensitisation

I know CS isn't exactly the same as TMS, but this is pretty much the only active forum for stuff like this I can find, and they are very similar so hopefully I can find info about it here.

18, male, had anxiety for ages but only been real bad over last 2 years. Mainly health anxiety.

From 5 to 2 months ago (i.e. a 3 month period ending 2 months ago), had psycosymatic wrist painbrought about by stressing asbout potential future issues.

From 2 months ago to 2 weeks ago, only once had a wee bit of wrist pain which was when I was trying to do some push ups.

2 Weeks ago noticed that if I type continually without a single break for 2 minutes, I get tightness and pain in right wrist. No pain when gaming. Continued to use PC for about 10 days, never had any pain when doing this. Over last 4 days have been trying to make sure I don't have pain. Sat in a weird position 2 days ago which made my shoulder hurt. Next day woke up and shoulder was sore, no idea if this is because of the weird sitting position, as the pain went away after I moved, so I don't know why it would appear again next day.

1 day later (yesterday) I read about central and peripheral sensitization. Now I have pain on right side that seems to move around constantly, but never in more than one place at once (plus if I pinch myself or induce pain any other way, it stops the other pain).

Now this worries me in 2 ways:

1) That I was already sensitive to this because of my anxiety, maybe HPA imbalance, idk if that would happen I read about that somewhere. I don't have panic disorder or anything, just bad GAD and health anxiety. And that this combined with the potential minor RSI in my hand (and not stoping working even after I noticed it (although never had pain when working)) caused some kindof quick onset central sensitisation.

and 2) That the pain I got when trying to do a push up about a month ago, was as a result of some kindof sensitisation from when I had 3 months of psychosomatic pain, and that this could get worse in the future (going into comp sci so gonna be using a computer a lot).

Do you think any of this could be a genuine issue, or is it just that I worry too much and at the momnent just have some psycosymatic pain, and there is no underlying issue?

 

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It IS TMS. Central Sensitization is a meaningless term for what is essentially just "learned pain" or neural circuit pain. That term implies some kind of inflammation or brain damage which is simply nonsense. Dr. Schubiner will not even use the term because it conjures up all sorts of fallacious ideas. TMS is also Anxiety. They are one and the same. TMS is just anxiety somatized (expressed through the body). I notice you use a lot of medical verbiage and I imagine it's from googling way too much and reading scientific articles that are reinforcing your fears and letting your imagination run wild. I was diagnosed with CRPS which is considered an incurable neurological disease, and it was still TMS. I'm totally fine now. If you use Dr. Sarno's approach and realize that your nervous system (and other systems like endocrine and the brain etc.) are NOT broken, you will get better. It's just a matter of working on the anxiety (the underlying emotions etc), losing the fear, and shifting focus to your life.

 

I'm not sure that's 100% true, there are a lot of papers and research on the idea of CS, what I can see happening though is that sometimes it would be misdiagnosed, that seems a lot more likely.

In regards to the treatment for TMS, I assume ti goes beyond just reading the book everyone talks about and "accepting that's what you have"? I've seen people say that it doesn't work unless you are 100% convinced that's what's causing your pain, but I assume there are other methods as well.

Personally, and I don't have any evidence for this, this is jut my view of how a lot fo pain works from my won experience, I feel like there are 3 things that are often conflated:

1) Sensitisation, as in the body getting sensitised because of a consistent pain sensation, which then makes the body more prone to feeling pain in the future.

2) TMS, which is the process of the body using pain as a sortof outlet for stress

and 3), Psychosomatic pain, which is when you get pain because you are worried about getting pain.

I think a lot of the time when people talk about getting diagnosed with one thing and then the technique for fixing one of the other worked, probably just means they were misdiagnosed, it is quite difficult as there isn't a simple test you can take most of this stuff sadly.

For 1) You would have to do specific treatment to de sensitise the body, for 2) you just have to treat general stress and anxiety, and for 3) you can either do that, or sometimes symptoms will go away/change if the worry changes to something else (at least in my experience)

 

I suggest you write to Dr. Schubiner who is an MD and he can explain why the term CS is misleading and false. It's a trendy term right now but much research has emerged about the brain recently that disputes these outdated ideas. There's no need to "desensitize the body". The issue is in the brain, sending signals from the danger center false alarms. I was diagnosed with the mother of "CS" conditions CRPS and went through hell and back. I even had visual color changes, swelling, temperature changes and bone marrow edema. It was still TMS. As far as treatment, acceptance of the TMS diagnosis is the first step and 100 percent belief is not necessary in the beginning. What is necessary is an open mind and a commitment to implementing the knowledge to your day to life (doing the emotional work, changing chronic negative thought patterns, maintaining a mindset of indifference to symptoms and making life changes if necessary.) Confidence and belief grows over time when fear is reduced. This has been my experience as well as millions of others. It has been proven and is not some fringe theory. Does that mean you can't better using some other method? No. It all hinges on harnessing the power of the mind. Dr. Sarno's approach is what made the most sense to me and has been backed up by neuroscience.

 

Is Dr. Schubiner on these forums?

You said "The issue is in the brain, sending signals from the danger center false alarms.", however from what I have seen, this doesn't seem to really contradict what the research says about CS. The current opinion in the pain science community is that pain is a function of the brain, that sometimes is in response to acute stimulus and sometimes is in response to changes in the brain.

"It has been proven and is not some fringe theory." Do you have links to studies showing it's effectiveness. I'm not doubting it can be effective, but it would just be good to see it in some studies as well.

I often read about how TMS is only effective in x% of people, is there any particular reason why the treatment doesn't work in everyone who is suspected to have it. Is it just that most of the other people do actually have a physical reason for the pain.

 

Hi @User4567 ,

Dr. Schubiner is involved with the wiki but you can email him directly. Check out his book "Unlearn Your Pain' and his website for more info. He has has conducted many studies himself . You can also YT his lectures (there was a recent talk this July at the Commonwealth club in CA that was wonderful. It's also posted there n the wiki.) as well as pain researcher Lorimer Mosely. I will go through my notes and try to link more info. later. There are a few reasons that the TMS approach doesn't work for everyone and it has nothing to do with a person's ability to "heal". I think D. Sarno himself said that only 1 out of 10 patients would even buy into the mind body approach. It goes against the prevailing biomedical model and the vast majority of people have been medicalized and conditioned to believe that chronic pain is not psychogenic. Then there are those who cling to the belief that their issue is somehow structural or somehow a pathology so they never get off the fence so to speak. Another barrier to progress is when the fear level is too high and the person struggles to get out of fight or flight mode. There are other reasons as well...including day to day stressors that are just too overwhelming for the person to gain inner calm and peace. This played a role in my own recovery. It took me a bit longer than it would have if it were not for the fact that I caretake a severely autistic son and I was going through a drawn out divorce. That's not to say one can't get better despite obstacles of course. I just had to make some practical changes and get through certain things. Once you have ruled out all structural causes of pain, it's time to rule in neural circuit (learned) pain. There are many ways to assess that and you only need one good one to qualify. For example: Does the pain come and go? wax and wane? That is dynamic pain as opposed to static pain...meaning it can be turned on and off.

 

Well, this is what happened to me, almost exactly.

Central sensitization is just another label for general pain symptoms that can surface anywhere in the body. There are people on this forum with various diagnoses, some of which are so long that it takes half a page to write them down. But they all boil down to TMS. Some people have oversensitive nervous system and it responds with GAD, depression and chronic pain anywhere in the body, literally, from head to toes. When I realized that my pain has a lot to do with my anxiety, I focused on anxiety - and, oh miracle! - my pain faded away. @miffybunny has given you excellent advice.

In addition, I highly recommend this film, about Dr. Schubiner and his patients. I wish I had this film available to me when I was beginning my TMS recovery.

https://www.thismighthurtfilm.com/ (This Might Hurt)

Another excellent source for those with GAD is Dr. Claire Weekes, her audio saved me.

Finally, how do you know that TMS would not work for you? Have you spent at least 5-6 months working on it, diligently and in earnest? It took me 2 years, but I am now better than I was before it hit me!

 

I've had it for almost a year now but I don't think time's a factor. And sometimes diligently becomes trying too hard and honestly it depends on how anxious I am and how in the flow state I am. I'm not sure I can voluntarily turn it on and off but I can dial it down and it sometimes moves around? It's so hard not to be anxious when millions of people are sick/dying and stress illness is on the rise with the news, economy, lots of other social/environmental factors, and I'm so stuck in my habitual thinking/nervous arousal. And I keep fixating on how thin and soft and slightly stretchier my skin has become and stuff like circulation and other sensations in a variety of systems. The doubt also reduces the effectiveness. My nails have become a little thinner too. I need to remind myself it's not an emergency even if I don't know the why behind every little symptom.

So I guess the question would be are you working on your anxiety diligently and living your life authentically and the TMS method just becomes a quick checklist of: is it my thoughts, is it my nerves (physiological fight flight), or have I not moved enough/ate/drink/slept/self care/non toxic habits etc.

I think this might help me stay on track better. There's people here with longer lasting symptom imperatives, some with recurring anxiety, and even a few people with autoimmune conditions and I'm so relieved that this forum has made a positive difference for all of them. That of all things we could do about the pain, this is the best place we could be (except if we're on here too much).

 

Thanks for replying.

Sorry, just to clarify do you mean you've had TMS or CS for a year?

Did your originally start because of pain that lingered after an injury or something, or was it purely from anxiety?

 

You are asking great questions. To find a balance between working diligently and not obsessing about it is hard. These are tough times and even people with healthy nervous systems tend to snap. The key to it is to normalize and stabilize your nervous system. Meditation literally lowers the threshold that your nervous system needs to find the proper response to the challenges of the outside world. The more you bring your mind in the relaxed state, the easier it is for your mind to stay in it, but the changes are subtle and occur slowly, much slower than we wish. So you need to train yourself to look for those small changes and take them as a sign of improvement rather than the cause for disappointment in your own progress.