Diagnose TMS

I am 36 years old. I am married with two boys (8,9). For the first 32 years of my life I had few physical problems and a fairly low-stress life. In the past four years significant health issues in my family have occured. My mother almost died after a mistake was made with her pacemaker, my oldest son had 2 near death experiences due to a severe tree nut allergy, my wife had 5 miscarriages, my wife had 3 surgeries for severe endometriosis (the last of which was thoracic surgery), my youngest son had a bone tumor grow on his leg which ended up being benign, etc.

As many of these events played out I became stressed over any health issue. I began to view everything as potentially serious. In spring of 2012 I began having significant right foot pain. I had an mri, which showed normal, went to an orthopedic dr, neurologist and podiatrist and other doctors, and did all kinds of bloodwork but no problem was found. I began to get more anxious and assume I had a rare disease. Pain started in my arms, hands and neck. The neurologist put me on Celexa and said he thought anxiety was playing a part and over the next few months all of my symptoms went away. Fast forward 8 months and I woke up with severe pain in my right foot, I had not injured the foot, there was no reason I could think of for causing the pain. It lasted 5 days and then went away. This pattern occured every 4-5 months until last summer. At that time my doctor did a uric acid test and it came back at 8.3. He said I may have gout and put me on Allopurinol, which brought my uric acid level way down. For 7 months I had no pain. But as soon as he gave me a diagnosis of gout it was a relief, because now there was some hope that I could recover. Almost as soon as I got that diagnosis I began having stomach issues. I thought I may have an ulcer, but I did not. This stomach issue caused anxiety for several weeks. I cut out coffee, doubled up on probiotics and a few weeks later my stomach was fine. About this time I noticed I had "muscle knots" in my neck, all of them on the right side. I had a CT scan, MRI, massage, chiropractor, muscle relaxers and physical therapy and saw but yet the knots did not go away and began causing more pain.
I began getting more anxious, and over Christmas 2014 had neck pain/migraines 14 days in a row. I also was in month 5 or 6 with trouble sleeping. I spoke to a psychiatrist who spent time with me and said my pain may be a manifestation of anxiety.
Over the past few months the foot pain has returned. It may go away for a few days but comes back. My doctor has ruled out gout. Sometimes pain will come the next day after activity, sometime the pain will come on even if I am limiting my activity. I have seen a rheumatologist, neurologist and orthopedic dr and all say they can't figure out why I am having the pain. The foot pain normally begins on the outside of the ankle but sometimes the top of the foot hurts as well.
I have dramatically reduced my activity level for fear of bringing on the pain in my right foot, or making it worse. I bought Sarno's book, Healing Back Pain, but I feel like I still have a lot of questions.
I had no trouble believing the neck pain/headaches and the GI trouble from last summer were TMS related but the right foot pain still has me doubting. I guess I don't quite grasp the concept of learned pain pathways and I am trying to figure out how I can have this pain continue off and on for 4 months, basically causing me to dramatically reduce my exercise regimen because when I have a "flare-up" I am left to limp around for a week in pain.
So my question to this great board is this, I live in Atlanta, I don't know of a TMS doctor in my area but I feel like I need further help to work through whether or not the foot pain is TMS. I am sleeping well now and the headaches/neck pain only occur a couple times a month so I have made great strides there, but for some reason this foot pain is causing a lot of issues.

I am 6-0, 165 lb's, healthy and don't drink.
Any thoughts are appreciated.

 

Georgia
David-Lipsig, MD (Physician)
Twelve Piedmont Center, Suite 410
3495 Piedmont Road
Atlanta, GA 30305
(404) 495-5900
(404) 495-5901 fax
lipsig@atlantapsychiatry.com
Website


Leonard J. Weiss, MD (Physician)
Board Certified in Psychiatry, Addiction Psychiatry, Forensic Psychiatry, Internal Medicine and Nutrition
3188 Atlanta Road
Smyrna, GA 30080
(770) 319-6000
Insurance Accepted: US Healthcare, Blue Cross Blue Shield, Humana HMO, Humana PPO, Blue Choice Senior, Cigna HMO, Cigna PPO, One Health Plan of Georgia, Inc HMO / POS / Choice/ PPO



WOW! Is your name Job? Reading your story makes me want to drink. Sarno says if things get to be too much, curl up with a bottle of good wine.

 

Hi ATL 03,
Your symptoms sure sound like TMS: no exact medical cause, one gets "fixed" and another pops up, and you see the relation to life stressors coming on before the symptoms started. Remember that anxiety and fear and obsessing about pain and diagnosese and cures is all part of the TMS. If it is TMS, you can always expect there to be "some big problem that worries me" medically. That is the way it operates. It can easily come and go and do all kinds of things to throw you off track.

Good luck with the TMS physician piece. You are right to slowly chip away at doubt about the TMS any way you can, and this is a powerful aspect, to eliminate physical stuff and get the word from a TMS expert.

Andy B.

 

I sure like being reminded that Dr. Sarno says if things get too bad, curl up with a bottle of wine.

I usually find that a cup of hot milk does about the same.

 

I understand it is common to have pain move from place to place and I have had several different symptoms. But most of the people who discuss foot pain were originally diagnosed with plantar fasciitis, which is not what I have.
This foot pain tends to start on the outside of my ankle and sometimes the pain is on the top of my foot as well. I have a muscle knot in my calf and at times have some pain from my ankle to my calf, but the main pain is in the foot itself. For several years the pain would come on suddenly, last 4-7 days, and then go away. For the past 4 months however the pain might leave for 4-5 days but then it comes back, sometimes fairly strong, sometimes not too bad.
I am must wondering if this sounds like TMS and what role a pain cycle, or nerve pathways may play in this.
I appreciate the responses.

 

I just want to clarify, the pain in my foot has been with me for the last 4 months with very few painfree days. The past two months I have not had any other symptoms. I know a common theme with TMS is that it moves around. If I have gone 4 months with the right foot pain does that make it less likely that it could be TMS?

 

Not in my opinion ATL 03.

I had severe long-term pain, it only moved very slowly a few times, and then stayed in the same place for years...

Hope this helps. But I think you may need to take other ways to re-assure yourself that this is TMS. In my experience I would say you have TMS, but you have to convince yourself, and it seems like you have doubts!

Andy B.

 

sounds like TMS to me.....email me if you want to discuss further..dovber26@gmail.com

 

Hey ATL03

I was wondering if you've looked into going to either of the TMS docs listed by Tennis Tom??I'm relatively near you (Pensacola, FL), and I am looking to have a consult with a trained TMS physician in order to alleviate some doubts I have regarding the diagnosis. I've contact Dr. Schubiner but have not heard back from him...I'm sure he's a busy man!!

Also, as far as the learned nerve pathways, Dr. Schubiner's book Unlearn Your Pain speaks to the topic a great deal. Though Sarno is the golden standard of TMS information, I'm finding a lot of help via Drs. Schubiner and Schechter's books. The Great Pain Deception by Steve Ozanich is also great to further your understanding of TMS....

Hope you are finding some relief.

Emily