Originally posted: December 12, 2014 Every day I see patients in the office who have pain. I also see patients with injuries to the shoulder, knee, wrist, broken ribs, etc. But pain is challenging and fascinating especially as one unearths the human stories behind the pain. When men come in with pelvic area pain-- odd penis sensations or burning, perineal pain (behind the scrotum), etc. it's often a brain-based problem related to emotions. Of course these patients have been thoroughly evaluated by urologist(s) before seeing me. They come to me because those exams have been unrevealing, those treatments ineffective and the pain or discomforting sensations persist. I ask them what is going on in their lives and what transpired around the time the symptoms started. Inevitably, when they share their stories, it has something to do with guilt-- about relationships, affairs, and the like OR fear.. fear of disease, dysfunction, something wrong that can't be fixed. It's amazing how our worries, fears, and guilt can cause sensations to get 'stuck' in the nervous system. These feelings solidify nerve pathways, in a bad way. My job is to help them understand this mind-body connection, accept a new, benign diagnosis (TMS) and move forward with their lives. I use journaling, educational materials, and sometimes psychotherapy to accomplish this. But it all starts with a discussion in my office, with sharing the narrative of pain and of life's ups and downs, and with a clear diagnosis.