23 years old, suffering from sciatica for 4 years

[WashedOut]

Hello there! I found some information about TMS accidentally (was just searching for some articles about the impact of emotions/psychical state/attitude on sciatica, due to someone's suggestion).

I think that I might be suffering from TMS, but to be honest it seems too illogical to me (and I am a very logical person with analytical mind). I've already read Healing Back Pain, but I think that my pain is too intense to be caused by emotional factors.

My story in short:
2010: I was carrying some heavy stuff. Next day I started feeling "strange" and some back pain appeared, after few weeks leg pain appeared. CT/MRI showed very small central protrusions of L4/L5 and L5/S1. Physical therapy didn't give any result. Actually, I only felt slightly better after muscle relaxants.
2011: I persuaded neurosurgeon to perform PLDD (Percutaneous Laser Disc Decompression). More invasive surgery was not an option, because the changes were too small. He also didn't do L4/L5 because he said something like "both protrusions are very small and the L4/L5 is even smaller...").
2012: EMG shows no abnormalities. MRI shows no recurrent herniation - all levels OK. I still feel the same.
You can imagine that those abnormalities in discs were really small, as the person decribing the MRI didn't notice the L4/L5 protrustion, which was spotted one year earlier (and not operated).
2013: One of physicians suggests to do MRI in the evening (my pain gets much worse throughout the day) and asks me to provoke as much pain as I can (not hard...), suspecting spinal stenosis. I do all the stuff that causes pain and can hardly stay in one place during MRI (due to pain), no spinal stenosis found and again:
L4/L5 - "features of a minor damage of the annulus fibrosus, minimal pressure on the dural sac; no pressure on nerve roots"
L5/S1 - "minimal, central protrusion reaching the dural sac; no pressure on S1 nerve roots"
No changes on other levels, all discs properly hydrated (including L4/L5 and L5/S1).

Now: Over last 4 years I have visited many well-rated physiotherapists, few neurologists, orthopedists, neurosurgeons. Had surgery. Heard "it cannot be the spine", "it must be the spine" dozen times. Still no relief.

My back pain (lumbar area) was fluctuating (bearable at some times), but sciatica (pain down to the small finger of the leg) is present all the time. I have a very fulfiling and prestigous job, I excel at it, but I am currently considering quitting it - it's a nightmare because sitting makes it much worse. So pretty much due to one stupid furniture lifting, I've ruined my whole life. I cannot go to the cinema, I cannot sit in a park and read a book. Train is a nightmare, plane is a nightmare.

TMS concept is very appealing. In the past I was suffering from cluster headaches (diagnosed by qualified neurologists) - c.a. 2 years, but at least they were not present all the time. Had also some problems with allergy affecting my eyes (also about 2 years) and earlier bronchial asthma. None of those come close to the sciatica.
I am definitely a perfectionist, high-achiving and very successful person in academic/career field. I just cannot see any reason of the mind acting against me. Repressed emotions? I feel anger and rage everyday, due to my spine, and I am well aware of them.

I suspect that my sciatica may be caused by one of those:
- L4/L5 protrusion, which was not operated;
- nerve damage, which could have been done during the surgery;
- you lay down during a MRI; I feel not bad when I am laying down and horrible when I sit - potentially my protrusion gets much bigger when I sit;
- last but not least - psychosomatic disease (least likely).

Unfortunately, basically nobody heard about TMS in my country so there is hardly any way to determine whether I am suffering from it or not. However, I've been going through psychotherapy aimed at some other areas - I got communication problems and show almost no emotions to other people (mild Asperger's features). I am thinking about telling my psychotherapist more about my sciatica (I only said once about "some back pain", not mentioning how much it affects my life) and change the main focus of the therapy to sciatica.

To sum up - I would like to ask you what should we (my psychotherapist and me) potentially look for. I.e. what information should I convey to facilitate the theraphy.

Thanks for any tips and sorry for the length of the post and poor English.

 

[Walt Oleksy (RIP 2021)]

Hi. WashedOut. You've been examined medically and nothing structural has been found, so it sure looks to me
like your pain is TMS from repressed emotions and/or your personality which you admit is focused on logic which
has made you doubtful about TMS.

I'm not a doctor but believe 100 percent in TMS causing my severe back pain two years ago after I also lifted
something heavy. I read Dr. Sarno's Healing Back Pain and began journaling to discover more repressed emotions
than I ever thought I had, most of them going back to my boyhood during the 1930s Great Depression.

I think you need to work on TMS healing techniques you will find in the TMSWiki forums and also
believe 100 percent that your pain is from TMS. That's the hardest thing for some people and because you
place such importance on logic, it may be hard for you to accept TMS as the cause of your pain.

Nothing else has worked for you, so maybe you ought to try TMS.

 

[Gigalos]

Hi washedout,
I think your whole story and personality description is screaming TMS. You must be very fed up with your sciatica as I can imagine.

I am a pretty 'logical' guy myself, but have slowly learned to not search for logic in every aspect of life. It is frustrating and can make you angry, which is not very useful to become more relaxed. Use your logic for your work but accept that you cannot always fully explain the things that your body is doing. Living organisms, even the simplest ones are still way too complicated to be cast into an all explaining model. What works for physics and math does not yet apply to ourselves... hopefully one day a guy like you stands up with 100% evidence that many physical symptoms are mind driven, but sadly it has not yet happened. Also I learned to be more in touch with my emotions, which really helps, mindfulness is a great tool for this. I also seldom look on Google for symptoms, only in a small percentage of cases does it help you. More often than not it only makes your head spin more and more and/or you get fearful or angry about what you find.

I think it will definitely help to focus on psychological stuff that might be at the core of your physical issues with your therapist. He/She does not have to believe the TMS theory, it should be known to him/her that mind issues can definitely trigger body issues. The big difference between mainstream medicine and TMS theory is really the amount of different issues that can be caused. If you think about it, it is pretty foolish to say that stressed people can get head aches or stomach issues but to reject other physical issues....
Sadly I cannot give advice about what to look for other than some large emotions that you keep feeding. There are other, better educated people here that probably can give better advice. What I can advice is to follow the program on this site.

Some things to help you become more convinced that it is your mind that is behind all this:
- You mention many symptoms that are high on the TMS list. So what is different about those compared to the sciatica? Many of us have or had one or two symptoms that really stood out, accompanied by many secondary symptoms that were less outstanding.
- In TMS certain positions, activities or locations can give a conditioned response in the form of symptoms. That is because your mind sees them as a threat as in that it might give rise to the chance of unconscious emotions coming to conscious. I think that is a pretty good concept. If I apply it to you, sitting down might infuriate your mind as this position is strongly connected to busting your balls about problems for what reason?? To excel even more?? Is it ever going to be enough?? What does not excelling do to your unconscious emotions?? Do you accept yourself if you were less excellent?? You can go many ways with this if you think about all the possibilities.
But if you have problems believing it, I might have an alternative theory for you. Sciatica is often accompanied by cramped up (oxygen deprived) muscles in your butt. Why are they oxygen deprived? Well, the only logical thing is that the nerves that control them are not doing there work properly. What makes them work incorrectly? Is it really an anomaly in your spine? If it was, wouldn't you have other, more serious symptoms in your leg? I think it is more logical to suspect that your nervous system is being screwed by the brain, either by shear intention or simply because you are in some sort of survival modus in which the nervous system is working overtime. Also, all the muscles that are affected have a function in movement. In certain activities those muscle need to work hard and that is when they give the most pain. The difference in contraction that come with different positions (sitting, lying down, standing) might affect the blood flow or put more pressure on the nerves lower down your leg, so for example sitting down might increase symptoms..... again, it is not so much about what explanation you believe in, it is about the fact that you acknowledge the possibility. Once you start believing, symptoms will get less intense or shift to other locations, further strengthening the belief in the theory that it is the brain that is at the core of your problems.
You might want to investigate, I bet if you search thoroughly you'll find some extremely painful spots in the "butt muscles", especially in the piriformis. You might even get sensations lower down your leg when you put pressure on it.
- If you read Sarno, you might remember that it is not the conscious emotions that are the cause of symptoms, it is the unconscious emotions... the emotions that are repressed. You being angry and fearful about your sciatica is not helping, but it is not the cause.
- I have seen numerous examples of people in real life and on the forum of people having sciatica that were strongly connected to emotional issues. My aunt got it just before a breast removal operation (and it disappeared soon after), my ex-colleague got it when his second son (his first died in a car accident) was the victim of an armed robbery (it never left, because he denies TMS as the cause....), etc. etc. etc.

good luck and take care, hope my post helps...
Giga

 

[WashedOut]

Hey,
Thanks a lot for your detailed replies (and sorry for my late reply - didn't have access to the Internet over the Easter). I will definitely look through all the material at the TMS Wiki and hopefully read the other books (apart from HBP) to get more insight.

@Gigalos:
When it comes to believing that sciatica might be caused by something else than my minor disc protrusions, the worst thing is something you've already mentioned - immediate pain caused by certain movements. When you feel constant pain in large area of your back, you can easily attribute it to muscle tension. However, when I bend over and feel rapid 'electric shock' down my leg, I quickly visualise my nerve being pressed. And it's only one of many movements, another is for example famous straight-leg test (of course I've read an explanation about it in Dr Sarno's book).

The 'funny' part is that when my first back symptoms appeared, I already knew what to expect later. Why? Few years earlier my brother also had huge problems with his back (which were also attributed to carrying heavy furniture when we were moving...). So I stopped bending immediately (didn't need a doctor to know "it's bad") and knew that sitting is something wrong... I even remember that I was in the hospital during the first month 'post-accident', they were asking me about leg pain - didn't have it yet (consequently they didn't give me any restrictions regarding physical activity - I gave them myself).

The more I think it, the more I consider my symptoms as illogical.
I will definitely discuss my emotions in details with my therapist. As I said before, I started the therapy not to 'fix' any problems visible to me, but to 'improve' my social skills (e.g. communication). However, the more we've talked, the more I realised there are actually some 'problems'. During each visit she was surprised by how much I had yet to reveal.
We've already made some progress, for example I always insisted that I didn't feel any emotions and any stress - we finally agreed that maybe I am not aware of any stress, but it's my body which gets punished for the great pressure I put on myself and accompanied stress.

Last week it was like 8th visit and we were discussing so-called 'automatic thoughts'. I mentioned something about my back/sciatica pain for only 2nd or 3rd time (never told her how big issue it was), so she was interested about my thoughts regarding that matter. When I finished, she looked really shocked by the amount and 'severity' (don't know the appropriate word) of my negative thoughts and immediately proposed to change the focus of the whole therapy to my problems with pain. She also said something like "Some things are clearing up now...".

"You might want to investigate, I bet if you search thoroughly you'll find some extremely painful spots in the "butt muscles", especially in the piriformis. You might even get sensations lower down your leg when you put pressure on it."
Yeah, I had (and after all those therapies still have) many painful spots. I even told some physicians that I feel that the root of my pain is in the butt muscles (because it often feels like that). I always thought it might be a reason why my pain gets worse while sitting. There are many points around my butt/hip which cause immediate pain radiation when pressed hard enough (actually piriformis syndrome was also a potential diagnosis at some point but in the end it was excluded). I had over 20-25 dry needling (trigger points) sessions and it was actually helping a little (one of few therapies which gave some result), even though it was very painful (needle insertion and movement was causing severe pain in line with my sciatica pain pattern). Unfortunately I had to change the place of living and stop the therapy - many painful spots remained. Actually the therapist was surprised how hard it was to 'treat' my muscles and how many trigger points I had. I remember in some 'areas of my butt' it was hard to find a place which was NOT a trigger point. She was also convinced that the lumbar spine was NOT causing my leg pain... Usually the patients were pain-free after 3-6 sessions. In my case we often had to spend one session just on a few trigger points - sometime the muscles were so 'tense and dense' that it was not possible to pull the needle out.

Woah, another lengthy post. Thanks again - now I will be getting myself familiar with all the stuff available on the Wiki!

 

[Walt Oleksy (RIP 2021)]

Hi, WashedOut.

I think it's great that you did not have access to a computer over the Easter holiday.
You spent the day much better, no matter what you did or who you were with.

Our neighborhood lost electric power in a thunderstorm a few summers ago
and we were without tv, computers, even light for four days and nights.
I loved it. I spent the outage time reading, listening to music on my battery-operated
headphones, meditating, and walking more with my darling dog.

I love being unplugged. Two nieces tried yesterday to talk me into getting Skype
so we could all talk and see each other electronically. They said it's free, but I
said I wouldn't even take it if they paid me! I think most people are over-plugged in
but are less personally in touch with each other.

I'm 84 and everyone wants me to drive out to see them. They're too busy to drive
to see me. They think visiting me on Skype is "visiting." I don't.

 

[Gigalos]

I feel you are definitely on the right road now. Hope you uncover some more with your therapist.
take care and good luck to you