Intermittent vs constant pain - same approach?

I've read a lot of the threads in this forum from people who are dealing with constant pain from TMS. My low back pain is intermittent but when it hits, it's severe. I'll go for years with no pain at all, so I can do all regular activities, exercise, etc. Then "out of the blue", I'll be hit with severe low back muscle spasms and knock-me-to-the-floor pain.

My most recent bout lasted for about a month until I got on this forum and started doing more focused things to turn it around. Specifically, right now I'm working through the Pain Recovery Program and also journaling with David Schechter's MindBody Workbook. Both are very helpful. And I've gotten some other great resource ideas from folks here.

But I'm wondering if there is anything different about the approach for someone who isn't currently in pain but is trying to get a handle on the "brain problem" to avoid future episodes? I can definitely relate to some of the content in the PRP about applying the approach to anxiety about the pain (which I have after this recent severe bout), so I can work on that even when I'm not experiencing the pain. But some of the other approaches seem like they are more tailored to those experiencing chronic, ongoing pain. Any thoughts on this?

 

What’s going on in your life leading up to these spasms? People are in various stages of nervous system dysfunction, some generate debilitating symptoms constantly for years on end, some are mild for years on end, some are mild for short durations, some are severe for short durations. TMS pain runs the gamut, the overarching theme is nervous system dysfunction which can be caused by a variety of things-trauma, repressed emotions, life stress, poor treatment of ourselves etc Still, TMS is TMS.

I think taking steps to get out of general dysfunction is wise, I’ve found meditation helpful, some like journalling, some just reengage with life. The problem is is that once we get better we can stop doing the things that helped us and as stress accumulates your thrust back into pain. When I was TMS unaware I went through these reoccurring bouts of various pains that would come and go, not really getting the message that my life needed some bigger inner overhauls than the ‘small’ adjustments I was making (stretching, changing sports, leaving a job, moving, ending a relationship etc).

 

Same approach yes! It's all about mindset - so whilst some things are better practiced whilst in pain, at the same time it's easier to be rational and update your beliefs whilst not experiencing pain

 

@BaxterBean
Yep, it’s as @Rabscuttle and @Adam Coloretti (coach) have said.

It’s about turning your relatively good stretches into “fortification” time—that’s the real game-changer with intermittent TMS symptoms. Use pain-free periods (as well as painful ones) to gradually train your brain to be less fearful, so eventually spasms will become a thing of the past.

Your mission is to calm your nervous system so it’s less fearful and overprotective overall. Make mind-body work a lifelong habit—experiment and stick with what clicks for you (meditation, journaling via Schechter/PRP), even when symptom-free. This isn’t temporary; it’s about changing and rewiring how you live.

Dr. Sarno’s “reservoir of rage” nails it, i.e. daily irritations fill it up until it overflows, but your brain blocks expression of your anger/rage (e.g. fearing job loss, retaliation, catastrophe) by disabling you with spasms. Alan Gordon’s neuroplasticity fits too—the brain’s fear (even of “minor” things it blows up) triggers protective symptoms. When you train it out, the brain and nervous system stops hobbling you.

I empathise with you as I’ve had numerous debilitating spasms (in my case, leaving me bedridden for long periods)—excruciating pain, yes, but for me the biggest terror was the disability, the “floored and helpless” dread. Chatting with @Adam Coloretti (coach) here on the forum helped me shift: if a massive spasm hits again, I can cope—I’ve done it before. Symptoms may or may not go on for a long time, but they are always actually temporary and non-life-threatening. Once you internalise that, you cannot unlearn it.

I've had symptom flares but not major muscle spasming in recent times. What mind-body tools have helped me the most? Self-soothing (as Sarno mentions in The Mind/Body Prescription) and grounding techniques—like just regularly lengthening the out-breath during spare moments in the day (perhaps see my posting for more about how I go about grounding/anchoring myself here: https://www.tmswiki.org/forum/threads/teaching-my-meerkat-sentry-brain-to-notice-safety.33489/) plus a general approach in life of taking it steady/easy, doing everything in baby steps wherever possible (so as to go ‘under the radar’ and not frighten my TMS-prone brain and nervous system). My TMSing brain feared movement, so I took a baby steps approach with that too... for me that has been so important in my recovery.

For self-soothing I use a lot of the techniques in this book (the simpleness of the techniques and the cutesy illustrations bely the profundity of how calming they are to the brain and nervous system): 101 Ways to Find Calm by Rebekah Ballagh.

I hope something I've said helps.

 

Yeah, this is pretty much the case for me @Rabscuttle - I would get to where I had no more pain and then "put the book away" and start living my stressful life again. Of course, I do have regular self-care practices - meditation, gratitude journaling (sporadic), etc. that I would continue. But I stopped the specific nervous system regulation focus, which I obviously can't do. Good lesson!

I must say that I'm a bit taken aback at your list of "small adjustments" that includes changing jobs, moving, ending a relationship - eek! To me, those are pretty major adjustments. Regardless, your point that a major life overhaul is required for ongoing management of TMS is a great one - thank you!

 

Good point lol. I changed small to ‘small’ to indicate incorrect but I guess I was being lazy with my words. They were incorrect because they weren’t addressing the root cause which was general nervous system dysfunction which in my case was caused by lifelong poor treatment of myself (which in itself started in childhood with a variety of things). Yeah, the leaving of jobs, moving cities, imploding relationships were big decisions but they were ultimately me running from my problems and not be able to look in the mirror and recognize the truth.

 

Thank you - this makes a lot of sense. Not what I had done previously so it's a good time to learn something new! (Love the image of a "meerkat sentry brain" LOL!)