Almost 2 years of trying to resolve intense sciatic pain using TMS

Agree with Diana here. I will say Dr. Hanscom's book left me a little discouraged because he does talk very much about a lot of issues still being structural. However, I think he's saying here that the narrowing could be causing your symptoms (I'll say I don't like that and that's why I wasn't a fan of his book, but I'm not a doctor) but you should attempt treating it as TMS first before resorting to surgery.

 

@warren23
I have a diagnosed “abnormality” in my spine.
Yes, it can sometimes cause pain and symptoms. They key is “sometimes” and doing the TMS work taught me not to freak out, to be able to stand back and assess the situation over time, to feel empowered in myself and not at the mercy of the medical profession while at the same time getting all the help I’ve needed without an anxious feeling of reliance and desperation.
Dr. Hanscom is careful with his words not because he thinks you may need surgery but because many of his patients already had it before they seek his advice and it was not the lone “cure” they hoped for.
I’m sorry you didn’t get the definitive answer you seek, but most of us around here are in a similar boat. No answer but for the one we choose.

 

... and that means you are likely to be one of them!

You could follow Dr H's pre-surgery mind/body programme and see what happens.

I wager that many of the people that Dr H talks about on the webpage he referred you to, who cancelled their surgery because their symptoms went away, did so right at the last moment of doing their pre-surgery course because sometimes the brain stops giving symptoms when it's frightened by thoughts of the danger of having a surgery. That happened to me, not with my spine, but with my dominant hand. I had horrendous pain for many months like a truck had run over it (and I'm not exaggerating). The suggestion was made of a referral for surgery for so called De Quervain's tenosynovitis (which can clear up on its own, but in a fraction of the time that I'd been suffering symptoms). I then read about all the risks involved with the surgery and over the next few weeks while I waited to see the hand specialist/surgeon, the disabling pain disappeared.

 

Diana - it’s definitely not I am determined to have a surgery, but I have worked very hard at the TMS approach for the last 2 years and am no better. I have used every TMS approach imaginable and four coaches, with no progress.

That, plus the fact my MRI correlates pretty directly with my sciatica, and even Dr. Hanscom suggesting this may have a structural cause, gives me a lot of pause.

 

Cactus - thank you for your note, I appreciate the context.

 

I will give Dr. Hanscom’s program a try, though I am already doing much of what he suggests in his “prehab” program, other than expressive writing. I will add that and see how it goes.

 

Warren,
I’ve been at it more than 2 years, tried all different methods—with relatively little physical progress, and mental and emotional progress by leaps and bounds. That’s the case for lots of folks—slow progress. Especially after the stress we all underwent from the pandemic. But whatever you decide, I truly wish you a speedy and complete recovery!

 

This is what Dr Hanscom says about expressive writing, about how important he believes it to be...
“I don’t know anybody who gets better without doing expressive writing. It’s the true beginning—until you start writing, meaningful healing doesn’t occur.”

 

OK, I saw Dr. Fanestil is a Boulder, CO-based TMS-informed physician who reviewed my lumbar MRI and X-rays. He said yes I have spinal stenosis, but he did not think that was causing my pain. He also thought I had some S-1 nerve compression, but didn’t care. He gave me some of his techniques to practice, which are similar to somatic tracking. He said I could consider an epidural injection for short term relief. Has anyone here had any luck with a steroid injection to reduce pain?

 

A friendly acquaintance of mine who has spinal stenosis and, I believe, nerve compression (not sure what nerve or nerves) and something else "going on" with her facet joints has been having steroid injections every 6 months. I remember she told me that for her the pain doesn't go down to zero but it helps really well for the first few months and then pain gradually comes back and she could do with having some more steroid after about 4 months, but they won't let her have a 'top up' as she refers to it as often as that because of the possible long-term side effects. There are risks with having the injections too, of course. I'll leave it up to you to decide whether or not you want to Google the risks. I know this muddies the waters, but I also know someone who has spinal stenosis who said a steroid injection "didn't help much, if at all". He said something about that his doctors thought that it didn't help because there "probably wasn't any inflammation present".

 

BloodMoon - thank you for your response here. I had one epidural injection in Dec, 2024 into the area that would address the stenosis at L4-L5, but it did not work at all. The doc that gave me the injection is highly skilled and experienced, and he also thought the stenosis was causing my problems. I am skeptical of another injection, but plan to visit with him again and get his updated thoughts.

 

After I read Watch Your Back, I decided against an epidural for my cervical issues. You might check it out with back issues, it was really illuminating on just how little we can really do for back pain.

 

Rusty - thank you - does the book address sciatica? That's by far my primary symptom.

 

I think that the use of the words of Dr Hanscom: 'Probably' -- responsible for the pain -- hasn't helped, assuming that he used that word.

From my experience it is difficult to recover from TMS symptoms until such time as you realize that structural issues are not causing it in the first place. I have had years of therapy delving into my issues but every time I beat a symptom/pain it is when I get to believe the that it is not structural.

Dr Hanscom heavily leans towards the science and his website has some fantastic information, for example, the backwards bicycle video which shows how we learn and pathways develop, but can definitely be interrupted.

 

I believe so but can't recall for sure. I know he has discussed it in some of his papers. Author's name is Dr. Richard Deyo.

 

Barkis - Hanscom did use the word "probably", which was definitely not helpful. I have now spoken to two prominent people in the mind body illness world, one of whom is a TMS doctor, who both were disappointed in his response and essentially said he can be "hit or miss". So that helped a lot.

Also, I agree with you and I have to have a "deep knowing" that my symptom is not structural to beat it! Any doubt raises my fear level tremendously and makes it near impossible to beat it.

 

I hear you. The main issue is that when doctors are guessing - and to me probably- is a non committed guess, then this makes me suspicious. I've always thought that Dr Hanscom was adamant that only a tiny amount of people require or will benefit from surgery. To be honest I feel you should treat this as TMS because as Schubiner has demonstrated bulging discs etc etc are not the cause of pain.