Another Nocebo that's hard to fight

I am having trouble with another Nocebo I got from a physical therapist last summer.

I went to him complaining that my foot hurt even though I'd only done a 15-minute walk. He told me that "stress in your body adds up" over days. The stress does not get re-set every morning. So even though I'd only done a short walk, I was in pain because of all the walking I'd done in the past days/weeks/whatevers.

I really wish I'd never heard this, because I can't get it out of my mind! Even as I begin to increase my physical activity, I feel like I am always holding my breath, waiting for the pain (which, according to him, is just building and building) to burst out again. Even though I know it's not physical stress but mental stress that's doing this to me, I am finding it difficult to break out of this well-worn pattern.

Any and all support/advice welcome!

 

Long ago, far away in another world before TMS, I hiked 750 miles one summer and ran three half-marathons. Sure, it felt good to put my feet in a cold stream at the end of a day of hiking, but they didn't hurt so bad I had to abandon the trip. If the "stress" as your PT put it built up incrementally over that summer, I would have been a cripple by September. Obviously, physical "stress" is not at the root of your pain. It's something emotional and psychological you haven't confronted yet. Usually (barring major medical conditions), there is absolutely no connection between chronic pain and structural anomalies. Pain in the feet usually originates somewhere in the brain and central nervous system. Just think of the men in Alexander the Great's army who marched from Asia Minor to India in sandals. They didn't use arch supports either. I imagine they got pretty good sets of blisters when they started out before their feet toughened up, but there's no record of any of them having chronic foot pain. Your little walks every day are nothing to what they put their feet through and still made it back home to Macedonia.

 

Thank you, Bruce. That is exactly what I needed to hear!

 

If you want a real scientific explanation of why chronic pain cannot originate from structural anomalies, see The Hidden Psychology of Pain (2012) by Dr James Alexander, in particular Chapter 4 - Chronic Pain Misunderstood and Chapt 5 - The Physiology of Chronic Pain for details about how acute pain can transition into chronic pain due to anxiety, fear and repressed emotions in the psyche. Dr Alexander takes up Dr Sarno's explanations and gives a lot more current scientific details to substantiate them. You'll definitely see how walking "too much" can never adequately account for the pain in your feet. Just doesn't make scientific or anatomical sense. Of course, someone with diabetes can have inflamed feet, but I'm assuming you've already been check out for that. Barring such medical conditions, you should be ready to join Alexander's army and march to the Indus!

 

Interesting! I will put it on my to-read list. (And no, I don't have diabetes.)