This seems like TMS, right?

Hey guys,

I’ve followed the forum and have been aware of the work of Sarno, Schubiner etc for a while now. I’m very much of the belief that pain and other weird, yet not so wonderful, symptoms can be the result of psychological processes. I just wondered if some of you who know a bit more about TMS presentations could give me your opinion on my situation.

I was doing my PhD, just finishing my first year, when I decided to pursue a complete change of career. I am now working as an apprentice carpenter, which obviously involves using my hands throughout the day. Not long before starting my apprenticeship, I began experiencing pain in both wrists and hands. I had also been dealing with pain/stiffness in my right thumb or about a month, which the doctor confirmed was not dequervains, RA or OA. The doctor just said “tendonitis” and offered me a cortisone injection, which I refused. I just got on with the thumb weirdness and, truthfully, could put up with it for a lifetime and it wouldn’t phase me. But then, just before starting the new job, my wrist started hurting. Then, the other joined in.

What makes me think TMS is the pains often shift, like one day my left wrist will be worse, the next it’s my right wrist, then it’s more the right hand or left hand. I’m still able to work just fine at my job, the only thing that really gives me any bother is the nail gun but that’s just because the impact is felt in my sore thumb. A lot of hammering can be sore on my wrist, although thanks to nail guns we don’t do much of that.

My biggest fear with this has been that if I can’t put a lot of strain on my arms, I would need to pursue a different career, which I really don’t want to have to do. I believe it is this fear that keeps me focussed on the pain, thus feeding it. The only thing that keeps me from fully believing that the pain is not structural is the fact that I can’t get an ultrasound scan or mri from the NHS to see if there is any soft tissue damage/irritation.

It certainly seems to me that, due to the bilateral presentation, lack of any “out of the ordinary” strain being placed on my wrists prior to the pain, and shifting of pain etc., that somatic pain is probably what I am experiencing. What do you guys think?

Forgot to add, when I asked my doctor about the wrist pain, his only suggestion was that due to the thumb injury, I am probably using my hands in different ways (partially true) in order to protect it, thus placing increased load on different joints and soft tissue around the wrists/hands. I can’t say I really believe his theory that holding my phone in my other hand and typing with my index finger, rather than my thumb, is enough to cause some sort of soft tissue damage in a matter of a couple weeks.

 

Yes, definitely sounds like it!
Can relate to the fear of losing a new career goal.

My issues are definitely related to the fear of not being capable in my new career field, or not being able to do my new job. Therefore my body is creating issues so I can't, or don't have to do my new job.

 

My guess is the following:

OF COURSE your hands are going to feel funny when you are using them in a new way for carpentry. It would be bizarre if they didn't.
But your mind may have latched onto the pain with an "Uh oh!" and then your brain may have turned it from a temporary of all your little hand and wrist muscles being used in new ways to a manifestation of your worry about it. Along with whatever worry you have about the career change and other things exacerbating it.

The reason I think that is because you quickly went to a doctor to check to make sure it was OK ...when those hand pains would be completely normal and expected. So either you were over focusing or your unconscious wants to be told you can't do carpentry work or something along those lines. Like your unconscious was trying to find a reason not to continue so it turned up the pain dial on something that would have gone away on its own once your muscles acclimated to new use.

Making a complete career change can cause a lot of emotions. There is probably a lot tangled up in the why you wanted to change. And then your deeper feelings about the change. Maybe even a little guilt moving from white collar pursuit to blue collar? Could you feel like you are letting someone down who has or had other expectations from you? Or is there any hidden anger about either the PhD pursuit or the change?

Disclosure: I'm not a doctor or a therapist nor have any professional expertise in this area.

But maybe that's some food for thought?

 

I have had RSI, tendonitis and nerve pain in both hands for years. It was TMS. Gradually started in my right wrist from "unergonomic computer use" and as soon as I switched hands, went to my left one as well. BTW it can affect anyone (began when I was a healthy but depressed 17) Went the usual route of physical therapy and eccentrics and the most they did was strengthen my wrists to a point where my physio said pain shouldn't be there because my wrists are strong and functional. Carpentry is heavily focused around the symbol of "working with your hands". You said it yourself, so I would assume thats one of the reasons you have decided to pursue that career instead of the academic PHD side of life. TMS loves symbols because they secretly control us, and so the pain associated with them can also control us. Im a drummer and pianist which both are symbolised by hands as well ("slender, pianists fingers", "the strong arms of a drummer"). You may not have heard those sayings before but they are quite common. As @Booble smartly asked, Are you concerned with failure in this new career? Have family members or close ones criticized your change from academics to a trade? Have you been conditioned to see trades as less profitable and successful than academic jobs and uni qualifications? Humans are susceptible to blunt force trauma yes, but the idea of micro trauma and sustained usage outpacing our amazing capacity to heal is illogical. Also those with fully ruptured tendons (very difficult to get this injury, think bus hitting you) never heal back to normal and leave scars (not a bad thing), but are mostly asymptomatic and strong after 2 months due to the nature of injuries in the animal kingdom, they HEAL. There are studies that show a large number of wild animals have tendon degradation and joint capsule damage (even juveniles) without any pain signals (measured through fMRI) or decreased movement, because of nature intended injuries to hold us back like ours do, all those animals would get eaten!

I havent proofread so things may make no sense and also im not a doctor (though I could be with the amount of research ive done, compelled by pain)

 

Yes, that's right.

 

Hey guys, sorry I'm a bit late in getting back. Thanks for the responses, they are very insightful. A wee update - fear of further physical damage had kept it's grip on me, despite my belief that my pain was likely psychosomatic, until I had a turning point over the weekend. I was camping with my partner and her family, spectating and tending to the dog while they endured a 24 hour relay race. On Saturday, the pain in my hands/wrists/arms was possibly the worse it had been in weeks, despite not having placed much strain on them for a few days prior. Up until late afternoon, I was on the edge of an anxiety attack due to my focus on the pain, until I finally decided that this made absolutely zero sense and could not have anything to do with real structural damage. From one moment to the next, it was as if the pain just vanished. Not entirely, but enough that it did not distract or upset me anymore. This sense of relief lasted all evening, and most of the following day. This morning, my hands have been a bit sensitive, but I am not worrying about it. Today was also the first time in weeks that I have not woken through the night and instantly thought about the position of my hands/wrists in my sleep. I am regaining trust in my bodies innate ability to heal any physical injury I may (or may not) have endured, while gaining more confidence that the majority of the discomfort I experience in my hands and arms is simply a manifestation of my fear of "RSI".

What has definitely helped is comparing this to my experience with BFS (chronic muscle twitching, paresthesia etc). I have had constant twitching in my legs for more than a year, but after about 6 months I decided to just start ignoring it, and now I go through the entire day without noticing a single twitch. At my worst, it also felt as though there were thousands of insects crawling up and down my legs, every single second, of every day. How did I develop these symptoms? Literally from reading about them. I had a twitch in my arm one day that wouldn't let up, so I googled it and found out about BFS. Literally just reading about the tingling, vibrations, cramping in the muscles etc caused me to manifest these symptoms in a matter of days. A year later, I get a pain in my thumb, google RSI, come across horror stories of forearm pain, wrist pain, finger pain etc etc, and now I experience it all. It's the exact same cycle, just a different manifestation.

 

Well done!!

Our brains are funny things, aren't they?

I like when you said this part:
Today was also the first time in weeks that I have not woken through the night and instantly thought about the position of my hands/wrists in my sleep.

It really kind of tells it all doesn't it? The over thinking that we do. And how nice it is when we don't!

 

I had similar pain in the wrist and hands, was diagnosed with carpal tunnel syndrome, offered steroid injection which I refused. I followed TMS path and I am now absolutely pain free. Note that you started experiencing symptoms at a stressful time in your life BEFORE you started working with your hands. Clearly the culprit is stress to your nervous system, not to your hands. You can start with the free programs on this site and go from there.