Day 25 Problems with resuming physical activity

[Pavel]

I am working every day to recover from TMS. I feel better every day. I have a single block that I know is limiting me and preventing faster progress. It is the fear of resuming physical activities. I believe the TMS is the cause of the pain, but I don't have the courage to start bending over, stretching and bending forward, which always causes me the most pain.

Yesterday I was working and decided to reach for the file on the ground. Knowing that I may be in pain, but that it is TMS pain. And the pain came, the old pain I always had when I bent like that. It was in the evening and all night and in the morning I had this pain and I still have it now but not as strong and my leg tingles like every time this happened.

I want to ask how you approached this, whether you were able to engage in physical activities immediately without pain, or is it the case that the pain will come, but you don't need to notice it (as if it were possible) and it will go away gradually when I repeat it several times.

Or am I not ready for this step yet if the pain still there?
I mean that I am not convinced enough about the origin of the pain if it manifests itself?

 

[Meu-retired]

Such a tough riddle I know. I am also stuck there… cannot muster the courage, not enough faith? Ohhh that last hurdle, feel for you, lets hear if anyone has advice

 

[Cactusflower]

I still get pain when I challenge my symptoms with activities, and that’s ok.
I just let it be.
The point is to learn not to freak out, worry and obsess over it.
Your mind has learned to associate that position with pain, that is all. I have found that over time, my symptoms pass more quickly. They may come on for any reason, but once I simply remind myself it’s TMS and temporary, they can pass in minutes or in a few days. I just don’t let it bother me so much

 

[Meu-retired]

Arghhhh yes I hear you, thanks. However, we TMS long time sufferers want to recuperate what we once had and not face this dilema anymore. In my case it raises its head a few times a year. I am almost 70 and like all my contemporaries, afraid of death, disease, injuries, not just for myself but for friends and family. Life gets serious at 70 and I cannot achieve getting older without fear. For myself and loved ones. This creates obsession with bodily symptoms, we are always on alert. Crazy difficult. Old age is for the brave I guess. I need a set of tools to help me navigate it. Sorry to ramble… god bless

 

[Pavel]

I understand you @Meu-retired , it's probably different at every age.

What I observe is that I feel pain like @Cactusflower when I do a movement that causes pain, but by caring less about the pain, the pain doesn't last as long.

Before I used to blame myself after a bad move, get mad at myself for not being careful and worry if the pain would go away or if I hurt myself. And the pain was long-term and persisted precisely because of that.

Now that I'm convinced it's TMS and I'm not worried I've sprung an injury or physical back problem, the pain is still there, but the duration is shorter. Still unpleasant, but qualitatively different.

What I'm wondering is why some people suddenly have no pain and others still have it. And whether with a higher degree of courage to move even through the pain, it will disappear over time. Do I thereby convince the mind of its insignificance in this way?

 

[Cactusflower]

What I'm wondering is why some people suddenly have no pain and others still have it. And whether with a higher degree of courage to move even through the pain, it will disappear over time. Do I thereby convince the mind of its insignificance in this way?

When Schubiner etc. describe the pain as "neural circuit pain" they talk about brain retraining. Essentially, you begin to allow your nervous system to turn off the "PANIC" sensors when you feel things - sometimes things that feel real and very sensitive, sometimes things that are far less sensitive but your brain registers them as being very painful (I think about times when I thought my pain was horrific, then I cut my finger...the finger was far more painful but I didn't think much about it after putting a bandaid on it, because I knew it would heal)...it doesn't matter. You eventually teach your brain that it's just more pleasurable and interesting to be thinking about other things, and that there is a sense of overall wellbeing because you KNOW that it's all just TMS, and you KNOW what triggers TMS and you also learn that those triggers are completely safe to feel, even if they are difficult and mentally/emotionally painful.

 

[JanAtheCPA]

When someone does physical therapy to relearn how to move and use their body parts after a surgery, injury, or stroke, it's really all about baby steps, right? It's a gradual process of relearning, and building confidence.

There is no difference with TMS induced pain, because the brain mechanism which creates pain at what appears to be the location of a broken bone or surgery cut is no different than the chronic neuroplastic pain that also appears to be at the location where the pain is experienced.

I will repeat that: all pain uses the same brain mechanism to create the sensation of pain. Acute pain is sent by the brain in order to keep the person from inappropriately using a body part until it can recover. Chronic neuroplastic pain is sent to by the brain in order to keep the person from experiencing dangerous negative emotions.

That is the only difference.

The way to recover from acute pain is to pay attention to the real danger signals being sent, and follow medical and PT advice in order to recover gradually and properly. The way to recover from chronic neuroplastic pain is to be mindful of the fear thought that occurs before you use your body part, and come up with a way in which you can slowly move into the required activity such as bending over, while carefully reassuring your primitive childish fearful brain that bending over is a natural activity and that any pain associated with it is completely unnecessary.

I say this as a (now) 73-year old who had to give up doing barbell deadlifts during the 2020 shutdown when the gyms closed, and I admittedly never got back to a gym when my beloved trainer left the country later that year, but I still bend over all the time, including freeweight deadlifts in strength training and forward folds in yoga.

Some people can get right back into an activity shortly after they start doing this work. Other people are living with a lot more fear that is a lot more entrenched for whatever reason . Of course, "doing the work", with commitment, means being willing to uncover the reasons why your fear is more entrenched than that of others.

In any case, you can't just throw yourself into feared activities based on some kind of expectation that this is what you "should" be doing. That's just setting yourself up to be disappointed.

Do it slowly, with care and mindfulness and a whole lot of self compassion. And I highly recommend doing this with a personal trainer if you truly want to be able to challenge yourself and practice overcoming fear. The job of a rehab trainer is to push people beyond their perceived limits. It was the best thing I ever did for myself for ten years.

 

[Pavel]

The way to recover from chronic neuroplastic pain is to be mindful of the fear thought that occurs before you use your body part, and come up with a way in which you can slowly move into the required activity such as bending over, while carefully reassuring your primitive childish fearful brain that bending over is a natural activity and that any pain associated with it is completely unnecessary.

Thank you @JanAtheCPA , this got me how you summed it up...