Day 4 My "Normal Abnormality" and My Pain

[WesternShores]

Since my back pain flared up in December, I have tried Chiro, Physical Therapy, and have been seeing an Orthopedist.
I had an appointment with my Ortho yesterday, and the recent MRI confirmed I have a big old disc herniation at L4-L5. Thankfully, he was not pushy about any particular treatment. He is not pushing surgery at all, though said it was a possibility if I really wanted it (I don't). He also mentioned more PT (which wasn’t giving me results and is expensive) and epidural steroid shots (I said no, but I might come back to you in a few weeks).

I decided not to mention TMS to him, because I didn’t want to stick my neck into an intramural medical debate, and I didn’t want him to poo-poo TMS when I really am starting to believe that it’s my issue. He had no issues with me just wanting to let nature run its course, and he agreed with the idea that “motion is lotion” so he was all for me exercising. Good enough for me.

I think the thing I am struggling with right now is how I can have such an obvious abnormality (the L4-L5 herniation pressing on a nerve) and yet that’s not the real problem? I kind of get the “herniation as spark” and “TMS as fuel” concept. Still, seems like that "nerve press" SHOULD hurt like crazy.

To answer the journal question, I guess it is disheartening that I didn’t feel like I could have a completely honest TMS convo with this doctor, whom I respect. Maybe he would have responded positively? But I didn’t want to risk him telling me that “TMS is garbage” or something like that and setting me back by making me feel uncertain about this course of treatment.

Overall though, I feel confident about this course of action. Even feeling the pain differently in certain ways this week that make me think I am progressing. That's an encouraging sign.

 

[Diana-M]

Hi Western,
Have you read Healing Back Pain or The MindBody Prescription, by John Sarno? He 100% addresses why you can have a disc like this that isn’t the real problem.

There are very few doctors who are willing to even entertain TMS. It basically flies in the face of their medical training. But there are some. Dr. Howard Schubiner and Dr. David Hanscom (a back surgeon). Both have written books and have healing programs for TMS. They could definitely help you solidify your belief in TMS. You need to have a solid belief in order to heal. But it sounds like you’re almost there.

 

[Adam Coloretti (coach)]

I think the thing I am struggling with right now is how I can have such an obvious abnormality (the L4-L5 herniation pressing on a nerve) and yet that’s not the real problem? I kind of get the “herniation as spark” and “TMS as fuel” concept. Still, seems like that "nerve press" SHOULD hurt like crazy.

Hi! This is an opportunity (with a doctor whom you respect) to lean on their expertise. If the pressing of the nerve was an issue, then symptoms or not that's something that would need to be addressed. There are some things in the spine which produce no symptoms, but are urgently operated on because they could easily lead to very serious issues.

That's all to say that if the orthopedist (a good one) isn't worried about the pressed nerve (from a structural perspective), then I wouldn't be either. He is probably assuming that the disc will heal itself (most do) and will release off the nerve as a result. As Dr Sarno said too, pressed nerves don't tend to produce pain beyond the short term (as the compression interrupts this), it will often produce numbness/tingling instead. I would be encouraged by this fact and say to myself "well the orthopedist isn't concerned about my back or the pressing of the nerve, and if it was that serious then he would be concerned whether it caused symptoms or not, I'm comfortable moving forward with the idea that the symptoms are caused by TMS (assuming the evidence is there) and that my back is ok/safe".

Hopefully that makes sense, let me know what you think

 

[Volcano1963]

@WesternShores, i was/am in a similar situation after having a very detailed discussion w/ my doc about my second set of MRI/XRay imaging (1st was focused on my hip, 2nd on lower back). My MRI shows a cyst that is perfectly positioned to be the source of my sciatica pain. I had to wait 10 days for my appointment with the doc to look at/discuss the imaging results. During that time i had continuing experiences of pain-free breakthroughs. These were building a strong foundation of “belief” in the process & power of uncovering repressed emotions as a way of healing my physical pain. Seeing the cyst was like an earthquake to that foundation. What has helped me rebuild my “belief” in the MindBody approach as the healing process for me has been reading about the studies that show that many people have these kinds of physical “abnormalities” and don’t have pain. The scientific studies have shown that disc bulges, lumbar degeneration, and other spinal abnormalities can exist with no associated pain or movement dysfunction. It reminds me of the CT scan I had a couple years ago (for diverticulitis that sent me to hospital after days of fever & vomiting). In addition to the diverticulitis the CT scan showed a dense 13 mm patch in my kidney (a kidney stone). I freaked out and thought it was a big deal but my doctor was very nonchalant about it saying that MRIs often reveal little “patches” that don’t cause any problems. They explained that unless subsequent scans suggest uncontrolled growth (like cancer) they just ignore these “abnormalities.” The dense patch in the kidney was still showing in the MRI scan. i wish i still had access to the CT scan to see if the cyst at L2-L3 was already there too (causing no problem/pain) but unfortunately I don’t. I suspect it was already there especially now that i’m watching my pain shift from sciatica to a more immunological dynamic (itchy skin allergy-like symptoms).

 

[WesternShores]

Hi Western,
Have you read Healing Back Pain or The MindBody Prescription, by John Sarno? He 100% addresses why you can have a disc like this that isn’t the real problem.

There are very few doctors who are willing to even entertain TMS. It basically flies in the face of their medical training. But there are some. Dr. Howard Schubiner and Dr. David Hanscom (a back surgeon). Both have written books and have healing programs for TMS. They could definitely help you solidify your belief in TMS. You need to have a solid belief in order to heal. But it sounds like you’re almost there.

Hi Diana-M,

Yes, I've binged Sarno's books the last few weeks. I buy in to it pretty well at this point, but as an engineering type, it's hard for me to completely embrace the notion that my repressed emotions are driving the pain when there seems to be a clear mechanical cause. I get it on one level, but when it HURTS, it sure FEELS LIKE it's because of the L4-L5 issue. I think I just need to continue to change my way of thinking.

 

[WesternShores]

Hi! This is an opportunity (with a doctor whom you respect) to lean on their expertise. If the pressing of the nerve was an issue, then symptoms or not that's something that would need to be addressed. There are some things in the spine which produce no symptoms, but are urgently operated on because they could easily lead to very serious issues.

That's all to say that if the orthopedist (a good one) isn't worried about the pressed nerve (from a structural perspective), then I wouldn't be either. He is probably assuming that the disc will heal itself (most do) and will release off the nerve as a result. As Dr Sarno said too, pressed nerves don't tend to produce pain beyond the short term (as the compression interrupts this), it will often produce numbness/tingling instead. I would be encouraged by this fact and say to myself "well the orthopedist isn't concerned about my back or the pressing of the nerve, and if it was that serious then he would be concerned whether it caused symptoms or not, I'm comfortable moving forward with the idea that the symptoms are caused by TMS (assuming the evidence is there) and that my back is ok/safe".

Hopefully that makes sense, let me know what you think

Adam - Great points. It was relieving when the Ortho didn't push back on my plan to "do nothing" and was fully on board with the "motion is lotion" approach. He was insistent that if I started feeling numbness in my groin or started getting incontinent, that I contact him immediately. So I see there is a threshold for where it would cross into "this is an actual physical issue".

 

[WesternShores]

@WesternShores, i was/am in a similar situation after having a very detailed discussion w/ my doc about my second set of MRI/XRay imaging (1st was focused on my hip, 2nd on lower back). My MRI shows a cyst that is perfectly positioned to be the source of my sciatica pain. I had to wait 10 days for my appointment with the doc to look at/discuss the imaging results. During that time i had continuing experiences of pain-free breakthroughs. These were building a strong foundation of “belief” in the process & power of uncovering repressed emotions as a way of healing my physical pain. Seeing the cyst was like an earthquake to that foundation. What has helped me rebuild my “belief” in the MindBody approach as the healing process for me has been reading about the studies that show that many people have these kinds of physical “abnormalities” and don’t have pain. The scientific studies have shown that disc bulges, lumbar degeneration, and other spinal abnormalities can exist with no associated pain or movement dysfunction. It reminds me of the CT scan I had a couple years ago (for diverticulitis that sent me to hospital after days of fever & vomiting). In addition to the diverticulitis the CT scan showed a dense 13 mm patch in my kidney (a kidney stone). I freaked out and thought it was a big deal but my doctor was very nonchalant about it saying that MRIs often reveal little “patches” that don’t cause any problems. They explained that unless subsequent scans suggest uncontrolled growth (like cancer) they just ignore these “abnormalities.” The dense patch in the kidney was still showing in the MRI scan. i wish i still had access to the CT scan to see if the cyst at L2-L3 was already there too (causing no problem/pain) but unfortunately I don’t. I suspect it was already there especially now that i’m watching my pain shift from sciatica to a more immunological dynamic (itchy skin allergy-like symptoms).

Hi Volcano1963 - Thanks for sharing. I agree that we are in a similar boat. I am still a relative newbie to the Sarno/TMS mindset, so stories like this, and my doctor's own reaction to my situation, help me reinforce the belief that TMS treatment is the right approach for me. I do think I'm making progress, and feel good about staying the course with the Structured Education Program. I am getting better at believing that it's all in my head, though sometimes when the pain is bad, it gets very frustrating and exhausting, haha.

 

[Adam Coloretti (coach)]

Adam - Great points. It was relieving when the Ortho didn't push back on my plan to "do nothing" and was fully on board with the "motion is lotion" approach. He was insistent that if I started feeling numbness in my groin or started getting incontinent, that I contact him immediately. So I see there is a threshold for where it would cross into "this is an actual physical issue".

Perfect

 

[Mountaingoat123]

@WesternShores I am in a similar position. I really want to believe that it is TMS but looking at the MRI just makes it hard. Especially because my pain is always in the exact same places in the S1 dermatome. And some pain and in my foot it is occasional tingling with occasional numbness. So I always wonder if the herniation just has never resolved and continues to press on my nerve after more than 1.5 years of pain. But i just really really dont want to do another MRI that will probably only scare me or show that it got worse... But then i started my evidence sheet...writing down everything that points to TMS....that helps... I just always wonder and have this internal debate:
e.g. the numbness only occurs in the morning when getting up and sometimes when walking om flat ground. Yesterday I was running and no numbness, when hiking...no numbness... but I had a walk through town with a friend and I was distracted and all of a sudden my foot starts tingling and goes numb.
So i tell myself that these are inconsistencies...but then I question myself again: What if it occurs due to certain postures and has a biomechanical cause?
It is always this internal debate going on..

 

[Volcano1963]

What if it occurs due to certain postures and has a biomechanical cause?
It is always this internal debate going on

Oh Yeah @Mountaingoat123 ! Lately I’m deep into that debate too. For me the debate continues with the acknowledgement that “I” am choosing my posture, how I stretch out my body (or not), my level and type of exercise. I see how all these choices are affecting my biomechanics. It feels like such a chicken and egg sort of thing. Especially when the emotional issues are so deeply seated and all I want to do is curl up in a ball and escape into binge-watching netflix.

This last week I’ve taken comfort in watching a wound on my hand close up and heal itself day by day and now today totally healed over. Kinda miraculous really. This gives me comfort because it allows me to have faith that the tissues that are out of whack from my stress-induced biomechanical misalignment will take care of themselves. I want to have faith that as soon as I remove the stress-inducing pressure, my body will grow/heal tissues as needed to get into more healthy or efficient alignments. Getting to this point has been hard for me because my accommodation to unpleasantness in life has seemed so virtuous (“look on the bright-side”, “give them the benefit of the doubt”, “they are doing the best they can and don’t mean to hurt me”). It’s hard and scary to release the pressure on the lid of status quo.

 

[Mountaingoat123]

Oh Yeah @Mountaingoat123 ! Lately I’m deep into that debate too. For me the debate continues with the acknowledgement that “I” am choosing my posture, how I stretch out my body (or not), my level and type of exercise. I see how all these choices are affecting my biomechanics. It feels like such a chicken and egg sort of thing. Especially when the emotional issues are so deeply seated and all I want to do is curl up in a ball and escape into binge-watching netflix.

This last week I’ve taken comfort in watching a wound on my hand close up and heal itself day by day and now today totally healed over. Kinda miraculous really. This gives me comfort because it allows me to have faith that the tissues that are out of whack from my stress-induced biomechanical misalignment will take care of themselves. I want to have faith that as soon as I remove the stress-inducing pressure, my body will grow/heal tissues as needed to get into more healthy or efficient alignments. Getting to this point has been hard for me because my accommodation to unpleasantness in life has seemed so virtuous (“look on the bright-side”, “give them the benefit of the doubt”, “they are doing the best they can and don’t mean to hurt me”). It’s hard and scary to release the pressure on the lid of status quo.

I totally understand that... being uncomfortable can somehow become part of what is normal and part of ones identity. Changing the circumstamces can mean leaving a comfort zone