There’s been lots of debate about the role TMS can play in creating and sustaining localized & systemic inflammation. This chicken vs. egg sort of conundrum is at the center of my case, and though I’m still processing it, a recent experience has definitely altered my perspective. Does the stress cause the inflammation or does the inflammation cause the stress? I feel like this passage written by Dr. Howard Schubiner shows that he might consider TMS a minor/secondary source of my back pain. A recent epidural & returning to a daily, consistent & significant dose of corticosteroids has eliminated 85% of my back pain. I still have some of the neurological symptoms the doctors like to attribute to the ‘impinged nerve root’ caused by the ‘bulging disc’ (pins & needles in calf, numbness in toes, etc.), but that stuff is just a minor irritant. The pain had been relentless as of late – worse than ever. I was keeping up with physical therapy for the most part, but still firmly refusing to consider the recommendations of no fewer than 4 neurosurgeons who, despite mounting evidence pointing to inflammation as the primary source of the pain, remain 100% certain that a major spinal fusion surgery is the only solution. You can’t cut out inflammation with a scalpel. However, this also means that the primary source of my pain is not ‘mild oxygen deprivation’ in the muscles, doesn’t it? C-Reactive Protein (CRP) is one of the main blood tests for inflammation. My latest value was 12 (anything over 2 is considered high). Don’t get me wrong – there is no doubt whatsoever that I suffer from TMS. I have nearly every single personality trait Dr. Sarno connects to those most susceptible to MBS. The latest flare-up of my back pain no doubt coincided with quite a lot of stress. Yet all of that stress just melts away once the pain returns to a reasonable level. I believe the TMS developed as a result of the repressed stress that came with coping with the long-term impact of a chronic autoimmune disease. Many years ago Dr. Sarno tried to convince me that my Crohn’s Disease was another TMS equivalent, but I just couldn’t accept that I’d experienced a level of stress at the age of 6 (during an otherwise happy & normal childhood) that would make me susceptible to such a serious mind-body disorder. When I minimize the percentage of my chronic low back pain that is due solely to TMS, or even acknowledge a “physical” reason for my pain, I worry this handicaps my ability to heal that side of things. “Accepting the diagnosis” was pretty much all that was required to banish my back pain 20 years ago when I first met Dr. Sarno. I don’t know how it can all coexist, but I think (all input welcomed) the best way forward is to refocus my approach around modalities designed to reduce systemic inflammation. I’d really been spinning my wheels with the psychological-first approach anyway. I’m very interested in any shared experiences related to steroids, inflammation, and their relationship to TMS. Prednisone is a Devil’s bargain for sure – and it’s only a matter of time before the side effects overtake the benefits, so need to come up with something else real quick. Thanks for reading!