How do I make the leap?

[PotentialPenguin]

Hi everyone. I just joined the forum.

I developed RSI in both of my arms in late 2024. I was unable to type on a keyboard without pain. I did physical therapy for 6 months which moderately fixed my issue. I was able to type for 3-4 hours a day and go to the gym. There was still some lingering pain, but nothing crazy. I continued to do maintenance exercises every other day.

Then, in March of 2026 it came back after a slight increase in activity. I did physical therapy for 3 months and was able to type for 6 hours a day and exercise at the gym again. The pain still wasn't and isn't completely gone though.

In January of 2026, I bent over while shaving to splash water in my face and my low back spazzed out and gave me a ton of pain. I couldn't sit or walk much after that. I did physical therapy for 5 months and was able to walk and sit as much as I wanted, but the pain still wasn't completely gone. I couldn't do any exercise in the gym I wanted, just very slow/light rehab work. I continued to slowly build up on those rehab exercises.

At the end of July, I went on a 5 day vacation. I didn't do anything out of the ordinary - I sat the same amount of time as I normally would. Walked slightly more than usual. Had a 4 hour car ride there and back. I got out of the car and walked around every 1-2 hours. I felt great while I was there, I had nearly 0 pain. The day after I got home my low back pain was the worst it's ever been. I couldn't sit or walk at all. This time I also have pain around my pelvis, glutes, and quads. I started doing extremely light exercises again in hopes of healing. I haven't gone to the doctor for my back because they never help me.

Where I live is a bit of a breeding ground for negative emotions. I could see why it would have an impact on my pain. Since I had nearly 0 pain while I was on vacation I'm tempted to travel again and see if my pain disappears. I have some hotel points so it'd be almost free. I work remote so I could do it but I'd like to return to sitting for a few hours so I know I can at least make the car ride. Or maybe doing it asap would be a good TMS test? Do you think that's silly?

I've had a lot more injuries over the past two years such as vocal strain, tinnitus, knee pain, shin splints and shoulder pain. I've had a similar pain pattern in these areas. Physical therapy improves, but doesn't 100% fix.

I have a significant amount of evidence that my issue is TMS that I haven't mentioned here. I understand that doing rehab exercises can make you doubt the TMS diagnoses, but I'm not sure if I can make that leap of faith since PT has helped me before in nearly all of my injuries. Right now I'm at least able to do my job. If I end up back in pain again, especially with my arms, I'm not sure if I can avoid doing the exercises. If I'm wrong and my problem isn't TMS, I will lose months of progress. I'm tired and afraid.

Has anyone else had some success with PT but solved the problem fully with mind body work?

Any advice would be greatly appreciated.

 

[BloodMoon]

Hi @PotentialPenguin

Viewed through a mind-body/TMS lens, the reason PT would be helping you is because the exercises are showing your brain that it is safe to do those movements. Your PT believed these were safe movements for you to physically do from a physical point of view — otherwise they wouldn't have prescribed them. You've therefore been repeatedly moving in ways that your brain may have started associating with danger, and by doing the movements with that reassurance from your PT, coupled with nothing bad happening, you've been giving your brain evidence that the movements are safe.

So rather than seeing your response to PT as evidence against TMS, you could actually see it as something that fits with the TMS explanation. I can imagine you might be thinking, “But couldn't it simply be that the physical therapy is actually curing me?” — but you've not really found that to be the case, because although PT has helped you considerably, the symptoms have never completely gone away and have subsequently returned.

In the case of symptoms that are mind-body/TMS, the reason PT exercises aren't completely and permanently curative is that there is other work to do — particularly around the emotions (especially anger, but other emotions too), stress, and other factors that may be keeping your brain in a state of perceived danger.

You don't have to tell yourself, “PT helped me, therefore this can't be TMS”. You could instead choose to be open to the possibility: “PT helped me because it showed my brain that these movements are safe — and perhaps I can now build on that by addressing the reasons my brain is continuing to produce the symptoms.” In that sense, the fact that you can progressively do more without causing damage could actually be reassuring evidence.

My own experience with PT was very different. I didn't find PT helpful, largely because of the way it was approached in my case. I was given too many exercises and too many repetitions all at once, and that actually frightened my brain. Rather than teaching my brain that movement was safe, it seemed to reinforce the idea that there must be something seriously wrong with me if I needed to be doing such a huge amount of rehab. I believe the extent to which my nervous system was in a fight-or-flight/danger state was a major factor too. I've had to approach movement in incredibly tiny baby steps — essentially to “fly under the radar” with my brain — and that has been much more effective for me.

I also wonder about your vacation. I don't think it's silly to go away again, but I'd be careful about making it a deliberate “TMS test” where you're monitoring yourself to see whether the pain disappears. Your brain knows what you're up to, so if you go away specifically thinking, “This is going to prove whether I am suffering from TMS”, I'm not sure that would necessarily tell you that much...

There's also the fact that you work remotely, so you're combining being away with work. If work is potentially part of the problem, you may be taking some of the same stressors with you even though you've changed your physical surroundings. That doesn't mean your vacation experience wasn't meaningful — quite the opposite. The fact that your pain almost completely disappeared while you were away, and you weren't working, is a really significant observation and, to me, is another reason to consider that TMS is at play. I'm just saying that I wouldn't necessarily assume that changing location alone will act as a magic switch or definitive test, although obviously there's a chance it could if your home environment is a major factor.

The fact that you've had so many different problems over the last couple of years — vocal strain, tinnitus, knee pain, shin splints, shoulder pain, your arms, and now your back/pelvis/legs — with a similar pattern of PT helping but not completely resolving them, would certainly make me look very closely at the mind-body/TMS explanation. When you have a lot of seemingly unrelated symptoms occurring in different parts of your body like that, I think it's worth considering whether there is a common underlying mechanism rather than viewing each problem as a separate physical issue. (I had so many symptoms that I began to realise that there was no such medical condition as “all over the body-itis”!)

I really do understand why you're afraid to make that leap, particularly when you feel you've got so much to lose if you're wrong. But perhaps you can make the leap by looking at what has already happened rather than having to disregard it. PT has shown you that you can move and progressively do more without causing damage. That's not evidence that viewing your symptoms as mind-body/TMS is wrong — you could choose to view it as evidence that your brain is capable of learning that movement is safe. And the next step would be to build on that and work on the other things that may be keeping your brain in that danger state.

There are totally free mind-body/TMS programmes on the TMSWiki and forum. If you don't already know about them and may be interested in doing them, you can see the details in the posting I made on the forum here: https://www.tmswiki.org/forum/threads/fish-bone.33808/post-174206 (Fish bone)

Something else I would suggest considering is taking up some kind of meditative movement practice, such as qigong or tai chi. They involve gentle but nevertheless meaningful, whole-body movement, and can be beneficial for both mind and body. It might also give you another way of teaching your brain that movement is safe, while incorporating the mind-body side of things at the same time. Ultimately, you may find that something like this helps you gradually wean yourself off your reliance on PT.

I hope something I've said will be of some help to you.

 

[Khetu]

Hello Penguin!

I had the same symptoms as you back in 2020 and am now completely pain free. I tried everything the doctors suggested and while some PT worked, it was always temporary and would seem to whiplash out to other parts of my body when I felt I had a handle on it. If you've been to the doctors and they can't see anything structurally wrong with you, then your situation definitely sounds like TMS.
I spent almost two years unable to use my arms and hands due to 'suspected' RSI (the doctors had no idea why I was in pain) and I reached a point of desperation where I was willing to try anything to make the pain go away. I was so tired of my life being hobbled. I bought and read Dr Sarno's book and then did this online course (it's free.)

You need to give yourself time to identify what in your life is sending your body into danger-mode constantly. It could be something that has happened a long time ago and you haven't processed, or something that is happening right now: work, relationships, personal goals not being met, etc. You have to give yourself time to feel the frustration and anger (something the course tells you how to do successfully and safely,) and help your brain understand that you are not under attack. You must also come to terms with the fact the pain will not harm you, it is just pain.

It took me six months after following that course to rid myself of arm pain (and all the 'deflection' pain my body threw up to try and get me to fail and revert to living in fear.) At the start, I couldn't even brush my teeth without agony. Six months later, I was using a keyboard, writing, painting and doing whatever I pleased with zero issues.
I know it can seem like life has become claustrophobic and limiting when you're in the middle of it, but I promise you - if you do the work and give yourself time, you can beat TMS. It will go away.

In my post history you can see many kind and generous people offered me amazing advice, and it was with their encouragement that I didn't give up and kept struggling forwards. You too will one day be offering advice to someone with your symptoms on this forum, and you'll be on the other side of it and proud of yourself for not giving up. Best wishes!

 

[PotentialPenguin]

The fact that you've had so many different problems over the last couple of years — vocal strain, tinnitus, knee pain, shin splints, shoulder pain, your arms, and now your back/pelvis/legs — with a similar pattern of PT helping but not completely resolving them, would certainly make me look very closely at the mind-body/TMS explanation. When you have a lot of seemingly unrelated symptoms occurring in different parts of your body like that, I think it's worth considering whether there is a common underlying mechanism rather than viewing each problem as a separate physical issue. (I had so many symptoms that I began to realise that there was no such medical condition as “all over the body-itis”!)

I agree. It doesn't make sense that almost every part of my body has been injured individually with no root cause. I could make an excuse if it was just shin splints or just RSI, but there's no way my entire body is this weak.

There are totally free mind-body/TMS programmes on the TMSWiki and forum. If you don't already know about them and may be interested in doing them, you can see the details in the posting I made on the forum here: https://www.tmswiki.org/forum/threads/fish-bone.33808/post-174206 (Fish bone)

Something else I would suggest considering is taking up some kind of meditative movement practice, such as qigong or tai chi. They involve gentle but nevertheless meaningful, whole-body movement, and can be beneficial for both mind and body. It might also give you another way of teaching your brain that movement is safe, while incorporating the mind-body side of things at the same time.

I'll look into these, thanks

Ultimately, you may find that something like this helps you gradually wean yourself off your reliance on PT.

Wouldn't it be better to go cold turkey on PT, as any bit of doubt would cause symptoms? I suppose it could be different for everyone.

 

[PotentialPenguin]

If you've been to the doctors and they can't see anything structurally wrong with you, then your situation definitely sounds like TMS.

I've been to doctors for some of my injuries. For my RSI, I haven't had any imaging, they just told me it was either carpal tunnel or RSI. I haven't gone to any doctors for my low back. Do you think it really matters if I go? It seems like imaging is useless unless they see something severe, like your back is broken in half, which I'm pretty sure mine is not lol

You must also come to terms with the fact the pain will not harm you, it is just pain.

If the unconscious brain is reducing oxygen to certain tissues, wouldn't the tissues be injured more easily? For example if my arm had 50% of it's normal blood flow and I tried to swing a hammer for 12 hours a day non stop, wouldn't something actually bad happen?

It took me six months after following that course to rid myself of arm pain (and all the 'deflection' pain my body threw up to try and get me to fail and revert to living in fear.) At the start, I couldn't even brush my teeth without agony. Six months later, I was using a keyboard, writing, painting and doing whatever I pleased with zero issues.

I'm glad you got better, "rsi" is so rough. Did you work through the pain? or gradually ramp up on activity?

 

[BloodMoon]

Wouldn't it be better to go cold turkey on PT, as any bit of doubt would cause symptoms? I suppose it could be different for everyone.

I'm so used to people clinging on to doing PT and being mightily reluctant to the idea of giving it up (even though they may say that they are thinking of doing so) that I'm kind of 'conditioned', if you will, to approach talking about it with a view to them gradually getting used to the idea of weaning themselves off it. It can feel more palatable to many, and when you said...

I'm not sure if I can avoid doing the exercises... Right now I'm at least able to do my job.

...I may have erroneously surmised that you were erring on the side of wanting to continue with them. I believe, however, that for recovery from mind-body/TMS, it's best not to do things that keep you on the fence.

Unless a PT is truly mind-body/TMS aware and incorporates it in their work, the emphasis is almost always on what is physically wrong that you need to correct or improve... e.g. this is imbalanced, that is out of line, that muscle and/or your core strength is weak, etc., etc. That kind of thinking and language can reinforce the idea that your symptoms are physical and need 'fixing'... and we're already conditioned by society to 'think physical' first rather than 'think psychological' when it comes to pain and other symptoms.

So, you could choose to give up going to see a PT, but if you should want to continue the exercises that you've been doing that have been helping you, the important thing is to recognise the reason they've been helping you in mind-body/TMS terms... i.e. because your brain felt safe doing them (not because you're correcting a defect). I have a daily routine of movements that includes a few that were given to me by a chiropractor, which I feel are good for the range of motion of my arms and legs, but I don't do them because I think they're curative. That's the difference. I do them in conjunction with some tai chi moves and a little bit of dancing to make it fun.

 

[Khetu]

One piece of advice I would give before any other is always get your pain checked out by a doctor first. If you have periods where you can use your hands just fine when distracted and it only comes back (as you said) when you came back to work, then this sounds like TMS to me. However I am not a doctor, and its worth checking its not structural. If it isn't, then you know it's TMS and you can make it go away.

If the unconscious brain is reducing oxygen to certain tissues, wouldn't the tissues be injured more easily? For example if my arm had 50% of it's normal blood flow and I tried to swing a hammer for 12 hours a day non stop, wouldn't something actually bad happen?

First, anyone who swung a hammer at full capacity for 12 hours would injure themselves; but you're not doing that, are you? You're just trying to go about your life, type, write, use your hands normally.
Second, you are deflecting. I mean this in the kindest way, but trying to find any answer but the obvious is your brain now desperately searching for excuses to not do the work. "I can't do this, because I might injure myself", or "If I have no oxygen to my muscles, I might injure myself, I better not just in case." You have just successfully frightened yourself into not tackling the problem. Do the course, face your fears and innermost issues, and no doubt the pain will double down to keep you in a state of fear. You keep going, and then it will leave you. But you have to be brave to get to this point. You can't beat TMS unless you start trying to.

I'm glad you got better, "rsi" is so rough. Did you work through the pain? or gradually ramp up on activity?

I did the course (that Iinked above) and during that, I simply did activities that I normally would have despite the pain. I didn't do them in in smaller chunks of time, or use less energy, I just did them as a normal person would have. Every time the pain came, I accepted it and continued. Because I ceased being afraid of the pain, it then had no hold over me and began to wane.

Doing the course was the best thing I ever did. It's free, and all it requires is your time and the courage to face what is bothering you. It will be mentally uncomfortable, but I promise it does work. Please don't be afraid, you lose nothing by starting.

 

[Adam Coloretti (coach)]

Wouldn't it be better to go cold turkey on PT, as any bit of doubt would cause symptoms? I suppose it could be different for everyone.

Hi! I think my main question out of all of this is what is the purpose of you going to PT? Because it sounds a bit like you're going at the moment and just hoping for the best.

I would get a bit more deliberate about it and analyse it when it comes to TMS. You should use the PT to your advantage.

Using the example of RSI, I would go to the PT and say ok what do you actually think is wrong here? They might say I definitely think it's this or they might say it's either this or that. Then I'd say great, how do we recover from this using PT and what is the timeline? It might involve making some small changes in your life (like taking more breaks at the keyboard) and some strengthening exercises. There's no reason why this wouldn't be a permanent solution if the PT has the issue correct. It also shouldn't take forever (don't accept a rubbish answer that it needs to take 6 months, that's highly unlikely). If, for example, you do everything the PT says for 8 weeks and it's clear that you've strengthened where you need to strengthen, yet the pain persists, then that's brilliant evidence when it comes to TMS. You may have already done this, in which case great.

The problem (and this happened to me too) is if the PT has been wishy washy for a while and there's been too much trust (as in the patient just leaves it in their hands and doesn't understand what's going on), then people get caught in a PT cycle because they can't definitively say to themselves with enough confidence that PT didn't work, so as to really commit to TMS.

Do you think it really matters if I go? It seems like imaging is useless unless they see something severe, like your back is broken in half, which I'm pretty sure mine is not lol

The reason this can matter is related to something I said above. If the PT says it's going to take 6 months of physiotherapy to recover, then you're going to be able to call that out as rubbish more easily if you have the scans to prove it. It might take 6 months of recovery for something really serious (which I doubt you have - you wouldn't have had pain breaks at all, even on holiday, if you did), so scans can eliminate that doubt.

Just as a broader note, scans are far more likely to be misinterpreted when someone doesn't know about TMS and hasn't read any of the books. If you have, then your risk of this is a lot lower. Personally, and this is just my opinion, if I am well versed in TMS then I would want to know scan results regardless (for a multitude of reasons, I would never consider scan results to be useless). It seems like you are living in a lot of uncertainty at the moment, so if I was you I'd rather know where I stand (appreciating fully that things found on scan don't necessarily rule out TMS).

I've had a lot more injuries over the past two years such as vocal strain, tinnitus, knee pain, shin splints and shoulder pain. I've had a similar pain pattern in these areas. Physical therapy improves, but doesn't 100% fix.

I think this relates to what I said above, in that there's a lot of confusion as to what is going on and you're assuming injuries in all these cases. That might be true for the others, but with tinnitus for example what is the injury, and how are you figuring that a PT will be able to help this?

If they aren't all attributable to specific injuries, then that makes it a lot more likely that all of them are TMS (even just having all of them in the first place makes it highly likely). TMS symptoms tend to travel in groups.

 

[PotentialPenguin]

Hi! I think my main question out of all of this is what is the purpose of you going to PT? Because it sounds a bit like you're going at the moment and just hoping for the best.

I've misspoken a bit, I'm no longer in PT, just doing exercises myself and following programs they gave me. I'm doing PT because it's increased my ability in the past, even though not back to 100%. For my arms I was told I would be fixed within 8-12 weeks. Once I hit 12 weeks I could type 4-5 hours a day and since I had made progress we just kept going (and I continued to make progress). I've pretty much been told all of my injuries are tendonitis. I do see what you're saying though. It doesn't make sense that I've strengthened this much and still have symptoms if I go from 6 hours of typing to 7 in a day.

Just as a broader note, scans are far more likely to be misinterpreted when someone doesn't know about TMS and hasn't read any of the books. If you have, then your risk of this is a lot lower. Personally, and this is just my opinion, if I am well versed in TMS then I would want to know scan results regardless (for a multitude of reasons, I would never consider scan results to be useless). It seems like you are living in a lot of uncertainty at the moment, so if I was you I'd rather know where I stand (appreciating fully that things found on scan don't necessarily rule out TMS).

The reason I don't want to go to the doctor is because I pretty much know what's going to happen. I go in > get x ray > nothing found on x ray > get mri > dr sees something that could be physical or TMS > recommends surgery and drugs. It happens every time. This process costs me $500 every time I do it. I'd rather just save the time and money.

I think this relates to what I said above, in that there's a lot of confusion as to what is going on and you're assuming injuries in all these cases. That might be true for the others, but with tinnitus for example what is the injury, and how are you figuring that a PT will be able to help this?

I don't think the tinnitus was an injury. It's just something I experienced a lot. It's actually been gone for about a year now. I probably could have worded my post better


Over the past week I went from not sitting in my chair at all to now being at 1 hour and 15 mins of sitting. I don't know if that's because of reading the Sarno book or if my low back is just healing. This back "injury" only started at the end of last month so it's hard to tell.

 

[Adam Coloretti (coach)]

It doesn't make sense that I've strengthened this much and still have symptoms if I go from 6 hours of typing to 7 in a day.

Definitely! I would say it doesn't make sense for you to have symptoms in general - you were told it would be fixed within 8-12 weeks and you still have symptoms, so that is a strong TMS indicator. I'm not sure what more PT exercises will do to help if it was primarily a strength issue - I would potentially put that to the PT and say "I've done this program, gotten stronger etc. Why do you think I'm not better? Is continuing to do these exercises going to do anything or have they done all they can for me?".

The reason I don't want to go to the doctor is because I pretty much know what's going to happen. I go in > get x ray > nothing found on x ray > get mri > dr sees something that could be physical or TMS > recommends surgery and drugs. It happens every time.

So you have had scans? I was under the impression that you hadn't had any (especially on your wrist/arms + back). I am keen to know what the ones you have had say.

It's actually been gone for about a year now.

Awesome

Over the past week I went from not sitting in my chair at all to now being at 1 hour and 15 mins of sitting. I don't know if that's because of reading the Sarno book or if my low back is just healing. This back "injury" only started at the end of last month so it's hard to tell.

I agree that it's relatively early days - bending over a sink though likely wouldn't cause that great of an injury though if I can go back to the one in January for a second (if it did, I would say 5 months of PT would be more than enough to recover). Was there anything particularly stressful occurring at that time? A significant life event or change?

 

[BloodMoon]

bending over a sink though likely wouldn't cause that great of an injury though

Yes, exactly. I noticed you put 'injury' in quotes, @PotentialPenguin, which is such a helpful way to look at it. I’ve found that the words we use have a huge effect on what our brain believes. For me, simply trying to think of my own symptoms as 'sensations' was a game changer in helping me stop assuming there was physical damage and open up to the idea of the brain generating the pain.

 

[PotentialPenguin]

So you have had scans? I was under the impression that you hadn't had any (especially on your wrist/arms + back). I am keen to know what the ones you have had say.

I had xrays for my knees, shins, and arms. Nothing found. The only MRI I've had was for my cervical spine because one specialist thought something there was causing my arms to hurt. The specialist wouldn't tell me the results of the MRI without making another appointment. That pissed me off so I never went back. I still have the MRI on a disk.

Was there anything particularly stressful occurring at that time? A significant life event or change?

Yes, a lot of financial stress. That "injury" happened after I took a cold shower to try and save money. I wasn't even in immediate danger, I had enough money to survive for a while, but for some reason I was panicked about it for a few weeks.

 

[Adam Coloretti (coach)]

Yes, a lot of financial stress. That "injury" happened after I took a cold shower to try and save money. I wasn't even in immediate danger, I had enough money to survive for a while, but for some reason I was panicked about it for a few weeks.

That's very telling! A big piece of TMS evidence - I'll attach this also in case you haven't seen it - it's probably the best way to assess for TMS. the FIT criteria by Dr Schubiner - https://www.themindbodyapproach.com/_files/ugd/bd131c_e66345ae74d6423f8a1c86a8a7774f3a.pdf

 

[BloodMoon]

That "injury" happened after I took a cold shower to try and save money. I wasn't even in immediate danger, I had enough money to survive for a while, but for some reason I was panicked about it for a few weeks.

I know you weren't doing it for health reasons, but even if cold therapy is popular right now, a cold shower still delivers a sharp shock to the nervous system. When your brain is already sensitised and panicked about money, that physical shock can easily be interpreted as another layer of danger—a double whammy, if you will—kicking off a classic TMS symptom flare-up that could easily explain your lower back pain.

 

[Cactusflower]

"When your brain is already sensitised and panicked about money, that physical shock can easily be interpreted as another layer of danger—a double whammy, if you will—kicking off a classic TMS symptom flare-up that could easily explain your lower back pain."

I second this idea.
Right now my body is running through a lot of physical "stuff". I have some "real" things in my life that stress me plus we are just coming out of an incredibly hot and humid period where I live. I was MISERABLE and hurt, felt sluggish, hot and sticky, couldn't cook etc. it was 90 in the house and like 300% humidity for two weeks. The idea of being "uncomfortable" when you have physical symptoms is simply intolerable (which is probably why you ended up on this website). I have much fewer symptoms and sometimes none - but I think that being uncomfortable simply reminded my body of the time when I was far more uncomfortable in my own skin. I turned to it with compassion and admitted I hated the feeling, and that it would be a temporary thing I have to deal with.
I don't like being too hot or too cold, and that's simply my nervous system still not fully settled down. Focus on the fact that you tend to be reactive and search for solutions when "activated" or triggered emotionally and work towards softening the impulsivity. Your goal isn't to always be calm, it's to deal with the things that will be triggers in a softer manner so you can process the emotions around them in a kind and gentle manner. All it takes is gentle noticing when these things happpen: notice how your body feels: it might make you jumpy, thoughts swirl, hard to sit still or it might make your heart race and your breathing shallow and fast... or anything else your body does. Just sit with those sensations and notice them with some curiosity: soften the physical fear you might associate with those feelings. You slowly begin to teach yourself that the physical sensations of emotions aren't something to be afraid of, you can notice them flow right though you and dissipate. You might notice the comparative feeling of allowing these sensations and emotions vs "doing" something reactive to solve their sensations or in essence to stop from feeling them. An example is that you might really enjoy a luke warm shower and standing under it in silence for a minute, letting the water roll down your body and focusing on that sensation - which might allow you to open up to other sensations or emotions for a few minutes because it all feels good. However, if you tried the same thing with icy water, you might have the feeling of wanting it all to stop or go quickly because it just doesn't feel nice.