Foot pain for 4 months — TMS or structural? Struggling to fully commit to TMS approach

[eline]

Hi everyone,

I have a long history of TMS and have resolved many issues using Sarno's work — including a dramatic recovery from bilateral plantar fasciitis where I was on crutches for months. I'm a skeptical, rational person so I wouldn't believe this if someone else told me, but it happened.

Four months ago I developed a nagging pain on top of my right foot (on the dorsum of the foot, near the front of the ankle, slightly medial.) during a ski vacation. It came on gradually during the skiing days, not from one specific moment. I ignored it and back home continued exercising (high intensity training), which made it worse. Eventually it hurt while walking too.

What's been done so far:

• 3 different physiotherapists — no clear diagnosis. One suspected a stress fracture, one said just go run and squat, one suspected tendon injury and said avoid all pain
• Echo: clean, tendons look fine
• X-ray: no visible stress fracture
• No swelling, no discoloration (also not in the beginning)
• One clear pressure point on top of foot
• Little pain when walking, more pain with rotating foot and push-off movements.
• Each time I forget and rotate and push off, the pain increases for a few days
• Today I went to my GP again who told me to simply rest. Which I already have tried a couple of times.

Why I suspect TMS:

• Classic TMS personality — highly stress sensitive, tendency to suppress emotions
• Pain started after ski vacation — I was anxious about an upcoming trip as a ski guide where I feared judgment from a more experienced colleague. I might have secretly hoped the injury would get me out of going. It did — I cancelled the trip with mixed feeling
• Rest hasn't helped much (although I did not rest fully)

Why I can't fully commit to TMS:

• One physio mentioned possible stress fracture (not confirmed)
• Pain has increased recently, now also present at rest and increases with certain painfull movements for a few days
• A friend (ex-physio) gave me a very painful massage on the painfull spot which made things significantly worse for weeks
• Multiple conflicting medical opinions keeping doubt alive

My question: Has anyone dealt with foot pain like this and successfully treated it as TMS? And how did you deal with the lingering doubt that keeps the cycle going?

Im at a point where I am getting really really sad about this since for me sporting (normally 5 times a week) is super important and without it I get really cranky.

Thanks in advance.

 

[Cactusflower]

"One physio mentioned possible stress fracture" (Not confirmed) - actually totally ruled out. Please see your x-ray comment. Work on the mindset that not everyone is a professional and that not everyone has the skill or ability to diagnose things like a break. It's important to remember that thoughts you have are not truths in the world. Yours just happen to be stuck and ruminating on one person you've seen when you aren't stuck on the other 25 people you saw about this. Notice this and simply keep noticing it. It's OK to have some doubt. It's OK to not be perfect about your approach to TMS.

Pain has increased: yes, you've been considering it might be TMS. The brain is sensing that you are on to it!
You have been paying attention and highly focused on the part of your body that is painful - that can create more and more pain because TMS is doing it's job!

Classic TMS personality — highly stress sensitive, tendency to suppress emotion OK that's a great point to add to your evidence list.

What stress did you have before the ski trip where you experienced some symptoms? What other stress do you have in your daily life? Sometimes it's not just one event but sort of a build up. The ski trip might have been icing on the cake. Your stress bucket completely filled up.

What are you currently doing for your stress: it sounds like all the chasing of medical treatments is creating MORE stress, and not less stress.

It's always good to remember that the "work" we do for TMS especially if you identify with the personality influences is ongoing through our life. If you found that journaling initially helped you overcome earlier TMS symptoms - then it's a great idea to keep some blank paper and a pen around and just journal either daily, weekly or every once and awhile. If you meditated, a regular and perhaps daily meditation practice might be a good option - make these things part of your normal life. I'm not sure what you are considering Sarno's ideas - many people think this is ONLY ignoring symptoms and carrying on with life the way we always did. That is not his prescription at all. He asks us first and formost to examine our emotions and most specifically our hard emotions eg. anger and rage which we are unaware of and not feeling.
How do you feel about your emotions? Do you avoid them like the plague? What other "proof" do you need from outside of yourself to feel more confident? What thoughts do you have about yourself in general: your confidence in yourself that you KNOW yourself?

Also consider that no matter if we are legitimately sick or have structure issues that Sarno's theories can really help us manage, and if things end up purely being TMS then you are already ahead of the game because you have been dealing with the stress, anxiety and OCD-like thinking that can come with TMS.

PS. Foot pain is = to back pain is = to digestive symptoms is = to chronic headache - if you arent' convinced you'll need to re-read Sarno and in specific The Divided Mind.

 

[JanAtheCPA]

Another great response from @Cactusflower

using Sarno's work

Did this include a structured workbook or program?

 

[eline]

"One physio mentioned possible stress fracture" (Not confirmed) - actually totally ruled out. Please see your x-ray comment. Work on the mindset that not everyone is a professional and that not everyone has the skill or ability to diagnose things like a break. It's important to remember that thoughts you have are not truths in the world. Yours just happen to be stuck and ruminating on one person you've seen when you aren't stuck on the other 25 people you saw about this. Notice this and simply keep noticing it. It's OK to have some doubt. It's OK to not be perfect about your approach to TMS.

Pain has increased: yes, you've been considering it might be TMS. The brain is sensing that you are on to it!
You have been paying attention and highly focused on the part of your body that is painful - that can create more and more pain because TMS is doing it's job!

Classic TMS personality — highly stress sensitive, tendency to suppress emotion OK that's a great point to add to your evidence list.

What stress did you have before the ski trip where you experienced some symptoms? What other stress do you have in your daily life? Sometimes it's not just one event but sort of a build up. The ski trip might have been icing on the cake. Your stress bucket completely filled up.

What are you currently doing for your stress: it sounds like all the chasing of medical treatments is creating MORE stress, and not less stress.

It's always good to remember that the "work" we do for TMS especially if you identify with the personality influences is ongoing through our life. If you found that journaling initially helped you overcome earlier TMS symptoms - then it's a great idea to keep some blank paper and a pen around and just journal either daily, weekly or every once and awhile. If you meditated, a regular and perhaps daily meditation practice might be a good option - make these things part of your normal life. I'm not sure what you are considering Sarno's ideas - many people think this is ONLY ignoring symptoms and carrying on with life the way we always did. That is not his prescription at all. He asks us first and formost to examine our emotions and most specifically our hard emotions eg. anger and rage which we are unaware of and not feeling.
How do you feel about your emotions? Do you avoid them like the plague? What other "proof" do you need from outside of yourself to feel more confident? What thoughts do you have about yourself in general: your confidence in yourself that you KNOW yourself?

Also consider that no matter if we are legitimately sick or have structure issues that Sarno's theories can really help us manage, and if things end up purely being TMS then you are already ahead of the game because you have been dealing with the stress, anxiety and OCD-like thinking that can come with TMS.

PS. Foot pain is = to back pain is = to digestive symptoms is = to chronic headache - if you arent' convinced you'll need to re-read Sarno and in specific The Divided Mind.

Thanks for your response!

For me so far for all my other TMS symponts, the trick to healing was simply "knowing it is TMS" with 99 percent certainty and resuming normal activity. That is all. So I am pretty sure this will work too this time, the problem is only that I am not 99 percent convinced yet. This because the other times, I kind of "caught" TMS on moments when I thought: Now I have you! For instance the pain started to move around, of the pain got worse from doing nothing. All stuff that would't make sense if it was a real injury. But right know I haven't been able to say: "haha TMS, you are busted!" yet. Thet pain does get worse after moving and only then, so it aligned with what would happen if it was a real injury. So that's why I still think it could be a real injury.

Good suggestion for reading The Divived Mind, I only read his other books. Is there much difference?

Yes I have had X-ray but also heard that X-ray doesn't show minor stress fractures, for that you need an MRI so that's why it is hard for me to rule out the possible stress fracture. Which is like expensive, hard to get and has long waiting lists.

And yes I had/have a lot of stress, I moved to another city one year ago ecause I couldn't really afford a house in my own city, where my work/friends/social network/great city/lots happening is, to a more boring city. I find it hard to settle and miss my old vibrant city a lot and that causes quite some stress alas.. Try to talk about it and doing some stress relief. But the thing is, the best stress relief for me personally is... exercising. Which is hard right now. I stopped played squash which is my absolute favourite sport but hurts a lot and with my HIT training I skip the running parts.

 

[eline]

Another great response from @Cactusflower

Did this include a structured workbook or program?

No just reading his books a few times and journalling about the pain, and saying: Haha TMS what you are doing right now is ridiculous and doesn't make sense at all (e.g. when the pain started to move around)

 

[JanAtheCPA]

No just reading his books a few times and journalling about the pain,

I would suggest starting our free Structured Educational Program, which will address the emotions that Dr. Sarno is actually talking about. Knowledge is great, but in our experience (mine is 15 years of observation on this forum) the "knowledge cure" alone works for a while, but under the stress of maturity (home ownership! etc) and with the rather extraordinary circumstances of the last decade, our emotional conflicts create a lot more stress than our brains think we should be allowed to experience - and they ramp up the TMS mechanism and make it MUCH harder to just "think" away with the knowledge alone. Journaling "about the pain" is definitely not deep enough for the kinds of existential stress we're talking about.

The SEP is free of cost, of ads, and even of any kind of registration. You just do it, with a commitment to brutal self-honesty about unconscious emotions that most of us would much rather not get into (because our brains literally think we will get eaten by predators if we're worrying about emotional stuff). It's on the menu at the main page of tmswiki.org. Be sure to review ALL of the recommended introductory materials, and do NOT try to rush it.

Also, the Divided Mind was "my" Sarno book. It's got chapters from six other medical/mental health practitioners.