Hi everyone - I'm new to the forum and am early on in my TMS journey. I'm looking for some support and guidance from experienced members here as I deal with a ongoing pain. My big question is: What if some of my pain is from TMS and some of it is actually structural? Is that an unhelpful way of thinking, or is it a realistic approach? Here's my story: I'm currently 34 years old. For two years I have been struggling with pain in my feet, which more recently spread to my knees (especially right) and sometimes the left ankle. I've also had issues with pain in my hips and lower back/SI joint/glutes. I also started getting bad pain in the base of my thumbs last year, which was deeply concerning as I am a pianist and cellist. I read Sarno's Healing Back Pain and Mind-Body prescription this past June and it eliminated most of the pain I was having in my lower back and thumbs within a couple of weeks. My foot pain seemed to be better for a short period, but then it came back again. Meanwhile, the knee pain has stuck around. Sarno's books made a lot of sense to me, and I very much fit the perfectionistic, do-good personality type he describes in his writing. I was easily able to accept that my thumb pain was TMS. I had convinced myself I had arthritis based on Dr. Google, but after my x-ray showed up normal and the pain went away so rapidly after reading Sarno, I knew for sure it was not a structural problem causing the pain. I am also able to accept that my lower back/SI joint pain is TMS based on my symptom reduction after reading Sarno. My two stumbling blocks are my feet and knees. I was initially diagnosed with plantar fasciitis and metatarsalgia in both feet, and the pain is mostly in my arches. I have flexible flat feet that obviously collapse when weight bearing. I've definitely noticed a correlation with pain reduction and wearing certain orthotics and footwear, and that that seems to suggest that the problem is structural and related to having the right support. My feet feel uncomfortable and unbalanced when I stand barefoot since the arches collapse so much. But at the same time, the pain seems very inconsistent. I used to get bad pain when waking up, but now I mostly get it when I stand and walk for an extended period of time. Sometimes my feet will start burning with pain while I'm sitting down and I'll have to take off my shoes until it goes away. Also, the pain started right before a major life transition, when I decided to quit my job in the USA to move permanently to China (it began about 6 months before I came here). And I've had days where I barely notice it and feel like it's gotten better. I guess I'm having a hard time accepting that the pain is not due to my flat feet and the strain this puts on my tendons. With my knee, I had an MRI and have been diagnosed with synovitis and chondromalacia in the kneecap. I can hear a crunching sound whenever I squat, and also have a variety of sensations aside from pain, including tingling, feeling a strong pulse, and a general feeling of "fullness". Certain activities definitely make the pain worse, especially going down stairs, which is accompanied by a snapping sound. It seems like there is definitely something physical going on, so I've wondered if I should treat this issue different from other others and focus on a more conservative treatment of rest, icing, PT, etc. I have tried those things and they do help so some extent. At the same time, I know at least SOME of the pain is psychosomatic. For instance, after my first x-ray when the doctor said he was signs of osteoarthritis (which turned out not to be case), the knee pain grew unbearable for several days (and spread to my lower back as well!). More recently, I experienced a lot of pain relief while being home in the USA this summer, and the pain suddenly came back when I returned to China last week. I can' t figure out if it's because of psychological or environmental factors (In the USA I drove my car everywhere, was doing regular PT sessions, didn't have too much activity going on; in China I live in a 3rd floor apartment with no elevator, I walk a lot and use public transport, and I was carrying heavy luggage when I arrived, etc.). So, those of you with experience, can you give me some insight about how to interpret the different pain signals I'm getting and know how to respond appropriately?