New onset sciatica?

[Hopeful_Alexandra]

Hi everyone,
It's been YEARS, and like so many of us when our TMS is well managed, we're out living our lives and forgetting to check in with others here on the forum/community. Thanks so much for all your help in the past, and again if you are able to offer words of encouragement or insight for my current situation.

I'll TRY to keep it brief. Last week I began to experience what has now become full blown sciatica in my left leg. It was not quite out of nowhere, but almost. I've had back issues over the years with occasional flares, but nothing like this. Recently, I started taking up line dancing again which I just adore. I had two full nights of dancing last week and noticed a little twinge/tweak/slight pop in my butt-leg which was reminiscent of occasional pain in that area. Coincidentally, it was that night that I had been feeling especially good about being able to dance so freely again after having to stop in the past because of various pain issues.

I have been seen by Schubiner about 10 years ago and given the classic TMS diagnosis. I believe my MRI shows disc degeneration at L5 S1 and a herniation. Now, at that point when I was evaluated I had never had the degree of pain in my leg that I'm having now, so part of me wonders if I really did something physical to injure myself (maybe vigorous dancing was enough? But it's not CrossFit, for goodness sakes).

To get into the emotional-psychological side of things, interestingly enough last week also marked my full return to work from a medical (stress) leave. I narrowly avoided hospitalization for a mental health criss in December and attended an intensive outpatient program. I'm still in therapy now (DBT intensive) and was working part time, but I'm not able to extend part time beyond this week. (In practice, my line of work allows for a very flexible schedule, so the "full" return won't be too bad and I can still take it easy as needed-but I wonder if my subconscious knows this?) I also experienced a pretty big blow in having to fight for a promotion that should have been easy/obvious, and if I hadn't been successful would have jeopardized my whole career. My grandmother's house, one of the few safe places for me as a child, also sold last week.

There are various personality traits and patterns I'm continuing to work through in therapy--goodism, perfectionism, and two recent new diagnoses of ADHD and OCD in addition to the bog standard depression and anxiety. My job is in a 'helping' profession and I often feel unacknowledged (and conflicted about wanting/needing the acknowledgement!)

Right now, I'm about 70% convinced it's TMS. Maybe it's a combo of slightly pinching a nerve at dance and then the psychological overlay causing the persistence of intense symptoms. In the mornings, the pain is excruciating. I had been trying to avoid focusing on the physical, but have had to do some stretching and take painkillers to even be able to walk (and even then, it's with a slight limp). Ive been journalling and sending messages of safety and listening to success stories, so maybe it just takes time. I don't know.

I know sciatica/pinched nerves can be tricky to determine if it's TMS or "physical", but I also know that others have healed from seemingly as extreme symptoms (looking at you, Steve Ozanich!). i also made a physio appointment for next week just in case and mostly to appease my partner who is very worried.

Thank you so much for reading; it helps even to type it all out.
Alexandra

 

[HealingMe]

Hi, Alexandra! What is incredible is that you've already been given a diagnosis of TMS by a leading TMS practitioner. And dancing causing all of this? Not a chance; the body is over 300,000 years old. Your body is incredibly resilient. Remind yourself daily.

With that being said, it does take some time for the brain to catch on once you've done all the journaling, sending messages of safety, etc. Everything is working/integrating silently in the background -- I've no doubt about that. In my opinion, it's okay to take painkillers and stretch gently to warm up before you walk right now. You're showing compassion toward yourself and that's exactly how you heal. Keep doing what you're doing. Even start up a "proof sheet" -- this is super helpful to look back on to see the inconsistencies in symptoms (i.e.: severe pain only in mornings).

You're doing great. Be patient.

 

[Adam Coloretti (coach)]

To get into the emotional-psychological side of things, interestingly enough last week also marked my full return to work from a medical (stress) leave. I narrowly avoided hospitalization for a mental health criss in December and attended an intensive outpatient program. I'm still in therapy now (DBT intensive) and was working part time, but I'm not able to extend part time beyond this week. (In practice, my line of work allows for a very flexible schedule, so the "full" return won't be too bad and I can still take it easy as needed-but I wonder if my subconscious knows this?) I also experienced a pretty big blow in having to fight for a promotion that should have been easy/obvious, and if I hadn't been successful would have jeopardized my whole career. My grandmother's house, one of the few safe places for me as a child, also sold last week.

Sounds like way too much of a coincidence to me! Slight twinges are completely normal, but it seems as if your subconscious latched onto it, perhaps due to pressure from the above changes/events. I can't be sure obviously but I'd be leaning that way

 

[Hopeful_Alexandra]

Hi @Adam Coloretti (coach) and @HealingMe , thanks for your wise words. Today is excruciating and I can’t move at all from my heating pad without extreme pain. I had to leave work early. I don’t know what to do and am considering trying the ER at least for stronger pain meds. Does this still sound like TMS? Can it really hurt this badly and not be a major spine issue ? Thank you

 

[Cactusflower]

Hi @Hopeful_Alexandra
I just wanted to touch base about painful esp. back issues.
I was bed bound for two years from painful back issues. Before that I had a bought of several months of similar pain.
I was diagnosed with a few normal abnormalities and a neuro-surgeon eventually told me I should not be in that amount of pain.
It's always wise to get an opinion if you can feel more secure about your pain not being structural. Before the neuro-surgeon I saw a few specialists who would never tell me the truth about the pain. They would offer solutions but now, looking back, it was clear they didn't feel patients were comfortable with a Sarno-esque diagnoses and avoided talking about emotions or thoughts, personality traits etc.
Back to the pain, which I still have from time to time, and most specifically sciatica. I see a physical therapist who has opened their eyes to the TMS side of chronic pain, and believes that we can hold our bodies in such rigidity that pain can begin - but in general, he sees this pain as a reflection of our internal suffering - something else is truly going on that is simply reflecting itself physically (and to be clear, I now only see him once every 2nd month because our 1/2 hour sessions are about retraining the nervous system from old habits and not really any kind of exercises or physical treatments).
Siatica can be debilitating. My neighbor suffered from debilitating siatica when caring for her mother alone, during end of life stages and then again, right before her daughter got married (her daughter had been left at the alter before - so a lot of stress and emotions!).
So to answer you, YES! TMS can hurt unbearably - I suggest you might read the book Defying The Verdict By Tamara Gurin ( @TG957 on this forum) who did not have siatica but another incredibly painful TMS condition and has recovered.
My own journey has been long, and I do still have pain but am very functional, and I continue working thought TMS in my daily living. I have a "team" for support when needed, the TMS coach I used and can always call, an EMDR therapist I can always call and my PT. One thing I have learned not to do is to contact any of these people when I am desperate, searching and very worried because that feeds the TMS beast. I'll usually wait at least a few days to a week and if things are still at the same level one email to one of these people usually gets my brain to accept the current situation, to slow down and work my way back through the TMS maze.

I believe you are ALREADY working your way through the TMS maze, but today, are getting stuck in the panic reaction mode. Can you give yourself a day to just be? Can you stop pressuring yourself (especially to please your partner) in getting "well" and being "well" immediately? Can you find a small space within yourself that can be OK with being uncomfortable right now? That means taking care of yourself and if you think medication will help you stop the freak out (the freak-out is the suffering, not the physical discomfort!) then why not? An ER visit might mean not only medications but some testing and if that eases your mind, then do it. Talk to the Dr's and nurses and tell them that you are open minded about it NOT being structural. If you are unsure, then give yourself a little time to think about it. Go home, attempt to get comfortable in any way you can and see what happens.

Do the things that help calm your nervous system and help a racing, panic-ing mind. Explain to your partner the TMS symptoms of panic, worry, freak-out, racing thoughts etc. and ask for some grace and 0 pressure about what is going on - the exact same thing you would offer them if they were going through a spot.

 

[HealingMe]

I agree with the above reply. Give yourself a time limit before you rush to the ER or doctor. In the meantime, are you able to calm yourself with something you like doing?

 

[Hopeful_Alexandra]

Hi @Hopeful_Alexandra
It's always wise to get an opinion if you can feel more secure about your pain not being structural.

Thank you for your response. I found a summary of my MRI results from about fifteen years ago showing L5-S1 disc degeneration and a herniated disc. Unfortunately this coincides exactly with my symptoms of intense leg pain (and a bit of back pain). I say "unfortunately' because I grabbed my copy of Hanscom's book hoping that it would be good news for me, but he gives this specific example of a case where surgery is indicated.

What I don't "get", though, is what I did last week to have caused sciatica for the first time (over the years I would have the occasional tingle but nothing like the extreme pain I'm in). Could my more vigorous exercise have caused the disc to herniate further (or something similar?)

I could try to get in for an "updated" MRI, what do you guys think? @HealingMe @Adam Coloretti (coach) as well if you have time. It will be at least half a year here in Canada to get in.

Thank you

 

[Cactusflower]

My suggestion is to call your regular Dr. if you have one (know that can be an issue sometimes in Canada) and let them know about your pain. Talk to them about the MRI but ALSO do the TMS work, since it seems like you have little other choice.
Sometimes it's the little other choice that is really helpful in these situations. Do the things that Dr. Schubiner guided you to do. If you are really feeling panic and worry try to chill and just breathe. On my roughest days I'd pop on headphones, some super chill instrumental music and just lay there with my eyes closed and breathe. Perhaps tomorrow you can do some of the things Schubiner suggested. Take it slow.
And if you find that you start to respond to the TMS work, then you can always cancel the MRI - no harm done. Just keep your mind and heart open to the fact that this *might* not be physical.
I think you are spiraling, and that is emotional and mental suffering. That is where the true TMS work begins - it's the mental suffering that is really the problem, far beyond all the physical hurts which will most likely feel better. After all, you have been through this before and it absolutely worked in your favor. A great guage as to how TMS-y this all is, is to reflect on your current mindset and emotional state. Are you anxious, in a panic, is your mind whirling - those are very TMS-y things and those are the things you can begin to sort out now with the TMS practices you learned from Dr. Schubiner. If you've forgotten, his book is a great reminder and I believe he just released an updated version.

 

[Adam Coloretti (coach)]

What I don't "get", though, is what I did last week to have caused sciatica for the first time (over the years I would have the occasional tingle but nothing like the extreme pain I'm in). Could my more vigorous exercise have caused the disc to herniate further (or something similar?)

I'm no spinal expert, but I think you not "getting" it is valid and a good instinct. Herniations heal for the most part, so I'm not taking much from a 15 year old MRI. I think it's more likely that in that time period it's sorted itself out (or at least as much as it needed to, the body is clever like that), and only you can speak on the intensity of your activity but it sounds unlikely that line dancing would cause re-injury.

Coincidentally, it was that night that I had been feeling especially good about being able to dance so freely again after having to stop in the past because of various pain issues.

The emotional environment that you described last week seems too much of a coincidence - I also don't think these thoughts that night were a coincidence at all. I think it's a strong possibility that your subconscious was a bit anxious at all that dancing and brought back symptoms in that area almost as a warning - in other words saying "I'm just going to test her out and see if this is really safe, I'll send a slight sensation and test for her reaction". It's more likely to me to be TMS given that it started with a twinge, and then your reaction probably pushed it over the top (as you felt threatened by the possibility of having the dancing taken away from you again - which I completely understand). I think what I just quoted and how good you were feeling that night about being able to dance freely is potentially a big tell re TMS (it goes to the emotion attached to the activity and what was on the line). Not that it would rule out TMS, but if you had a moment of agony whilst you were dancing itself, that would be different to me. Likewise, if this was the 20th time that you'd danced twice a week and this happened I'd be more suspicious of a structural cause, that may sound counter-intuitive because our brains go to "I'm thinking it may be structural because of the very fact that it was the first time I did it twice a week so my body isn't used to the intensity", but that doesn't hold much water when the activity isn't super intense and can actually be evidence the other way as it speaks to fear and hesitation (which supports TMS).

I could try to get in for an "updated" MRI, what do you guys think? @HealingMe @Adam Coloretti (coach) as well if you have time. It will be at least half a year here in Canada to get in.

You would probably get different answers to this (and I think they are all valid) - the way I think about it is obviously if your MRI is similar or if you've improved then that's probably going to lead to you being absolutely sure it's TMS and give you the peace of mind you need to heal (as if it's similar, why would you not have any pain for that long and it randomly happen? - I say "need" you don't technically need it from this source - you can definitely heal without it). Having said that, there may be other incidental findings as we will all have more findings in the spine (or most of us will) as we get older, and there's no start date to that (you're more likely to have incidental findings at 30 than you are at 20). It sucks that it will take 6 months (and that presents its own challenge because then you might be tempted to wait 6 months before engaging with the TMS process, when you could recover in that time if it is TMS). It's a question that's difficult to give a direct answer - if you trust your TMS knowledge and trust that you will be able to interpret results through a TMS informed lens (which means you won't overreact at potential findings) then if you could get the MRI tomorrow then yes I would in your position. The time barrier throws other considerations into the mix. Hopefully that analysis makes sense as that's really all I can give you there (my thought process - it's your call)

 

[Hopeful_Alexandra]

I'm no spinal expert, but I think you not "getting" it is valid and a good instinct. Herniations heal for the most part, so I'm not taking much from a 15 year old MRI. I think it's more likely that in that time period it's sorted itself out (or at least as much as it needed to, the body is clever like that), and only you can speak on the intensity of your activity but it sounds unlikely that line dancing would cause re-injury.



The emotional environment that you described last week seems too much of a coincidence - I also don't think these thoughts that night were a coincidence at all. I think it's a strong possibility that your subconscious was a bit anxious at all that dancing and brought back symptoms in that area almost as a warning - in other words saying "I'm just going to test her out and see if this is really safe, I'll send a slight sensation and test for her reaction". It's more likely to me to be TMS given that it started with a twinge, and then your reaction probably pushed it over the top (as you felt threatened by the possibility of having the dancing taken away from you again - which I completely understand). I think what I just quoted and how good you were feeling that night about being able to dance freely is potentially a big tell re TMS (it goes to the emotion attached to the activity and what was on the line). Not that it would rule out TMS, but if you had a moment of agony whilst you were dancing itself, that would be different to me. Likewise, if this was the 20th time that you'd danced twice a week and this happened I'd be more suspicious of a structural cause, that may sound counter-intuitive because our brains go to "I'm thinking it may be structural because of the very fact that it was the first time I did it twice a week so my body isn't used to the intensity", but that doesn't hold much water when the activity isn't super intense and can actually be evidence the other way as it speaks to fear and hesitation (which supports TMS).



You would probably get different answers to this (and I think they are all valid) - the way I think about it is obviously if your MRI is similar or if you've improved then that's probably going to lead to you being absolutely sure it's TMS and give you the peace of mind you need to heal (as if it's similar, why would you not have any pain for that long and it randomly happen? - I say "need" you don't technically need it from this source - you can definitely heal without it). Having said that, there may be other incidental findings as we will all have more findings in the spine (or most of us will) as we get older, and there's no start date to that (you're more likely to have incidental findings at 30 than you are at 20). It sucks that it will take 6 months (and that presents its own challenge because then you might be tempted to wait 6 months before engaging with the TMS process, when you could recover in that time if it is TMS). It's a question that's difficult to give a direct answer - if you trust your TMS knowledge and trust that you will be able to interpret results through a TMS informed lens (which means you won't overreact at potential findings) then if you could get the MRI tomorrow then yes I would in your position. The time barrier throws other considerations into the mix. Hopefully that analysis makes sense as that's really all I can give you there (my thought process - it's your call)

thank you, thanks to both of you for replying. I’m currently writhing in pain laying on the floor in the hospital’s ER. The pain just got too severe.

I’m intrigued that you said, Adam, that I can heal without knowing what an MRI might show. I guess because there seems to be some debate about whether sciatica is TMS, I thought I might need an MRI showing basically no other major damage (from baseline 15 years ago) to be confident in treating it as TMS. Would you mind expanding?

also, when you wrote your thoughts about my dancing, I realized I have been dancing quite a lot more- but before that, several months ago, I golfed regularly without so much as a twinge in my back. Hmm
M

 

[Adam Coloretti (coach)]

I’m intrigued that you said, Adam, that I can heal without knowing what an MRI might show. I guess because there seems to be some debate about whether sciatica is TMS, I thought I might need an MRI showing basically no other major damage (from baseline 15 years ago) to be confident in treating it as TMS. Would you mind expanding?

Sure, so I was more trying to be impartial and appreciate that possibility - the evidence can be overwhelming at times where someone wouldn't need a scan (especially once they start recovering using mindbody techniques - the progress speaks for itself). Would I want a scan if I were you? Yes, especially given that the last one was 15 years ago. Once you understand TMS theory, the main negative of getting a scan (misreading it and overreacting to physical findings, which could be coincidental) largely decreases in risk. Once it does, you're better off knowing where you stand in my opinion. Like I said too, you could get the scan and things have cleared/healed (at least those past findings that would equate to your symptoms).

The findings equating to your symptoms is definitely a key factor, I don't want you to feel like I'm dismissing that. The TMS guide says the following about sciatica which I wanted to share (written by Drs Schubiner, Clarke, and Schechter):

"Symptoms attributed to this condition are not likely to be PPD (TMS same thing) when the symptoms (particularly when there is numbness or weakness in addition to pain), physical exam and imaging studies all correspond to the presence of the same compressed nerve root. Symptoms are more likely to be PPD when symptoms (particularly if pain only), physical exam and imaging studies fail to correspond with each other. A typical example would be the presence of a mild nerve compression only on the left side in a patient whose pain is on the right side."

The above was more of an exploration of TMS factors by me based on what you said - but this is very relevant also. I note the use of the word likely (you were diagnosed by Dr Schubiner also, so direct confirmation from him after having reviewed your circumstances is far more powerful than these general guidelines). I guess the next relevant question is whether there is numbness or weakness too? I note too that one can have a herniation and it not compressing a nerve (it can just be in open space) from my understanding, which would make this redundant.

Getting the scan would leave us in a better position though so we wouldn't need to speculate

 

[HealingMe]

The emotional environment that you described last week seems too much of a coincidence - I also don't think these thoughts that night were a coincidence at all. I think it's a strong possibility that your subconscious was a bit anxious at all that dancing and brought back symptoms in that area almost as a warning - in other words saying "I'm just going to test her out and see if this is really safe, I'll send a slight sensation and test for her reaction". It's more likely to me to be TMS given that it started with a twinge, and then your reaction probably pushed it over the top (as you felt threatened by the possibility of having the dancing taken away from you again - which I completely understand).

Yes, I think this is what likely happened here.

 

[Hopeful_Alexandra]

Hi everyone, thanks for your replies! I ended up going to the ER because I could not move without screaming in pain. Doc gave me gabapentin and hydrocodone and recommendations for Tylenol, Advil etc. Said it looks like an acute ruptured disc. A bit of weakness on the affected side (foot not as responsive when doc checked it).

I’ve emailed Schubiner and hopefully I will hear soon.

there are people who have healed from this using TMS methods, right? I recall stories about people being bed bound from the pain (which is basically what I am now). I just don’t know what to do during this acute phase, even from a non-TMS perspective. Should I be attempting to get up and move around even in pain? I did make a physio appointment and I see them on Wednesday. I’m worried about further damaging the discs if this IS the type of non-Tms sciatica outlined in rhe TMS guide that Adam quoted.

thank you so much

 

[Hopeful_Alexandra]

I can’t believe that just 10 days ago I was considering training for a half marathon and now I’m walking with a cane!

 

[Cactusflower]

"I can’t believe that just 10 days ago I was considering training for a half marathon and now I’m walking with a cane!"

Ahhh, running and training for marathon running is a lot of pressure

Here is a link to Miriam from Pain Outside The Box's website and a blog post about discs. I think she provides some valuable and very Sarno-esque insites. https://www.painoutsidethebox.com/tms-back-pain

Note that you have and are still searching ONLY for the physical cause of your pain. The pain your are experiencing is absolutely real - but so is your fear, panic, anxiety etc. TMS work helps the symptoms of fear, panic and anxiety - they are all part of the TMS symptom paradigm.

 

[BaxterBean]

@Hopeful_Alexandra Sorry to hear about your situation - it's so frustrating when we think we've "dealt with" TMS and then to have a flare-up/relapse that is this severe! With the going back to full-time work after a medical leave, sale of your grandmother's house and other big emotional "hits", though, the flare up seems pretty classic. In the past, one of my worst flares of low back TMS symptom was when I had to go back to work full time to a job I really didn't like after a couple years of consulting because I needed employer health insurance. It took me a month or so to realize/remember that the emotional impact of that transition (anger at the broken US healthcare system, anger at myself for not being able to come up with another work alternative, etc) was actually the cause of the symptoms and, as soon as I did, the pain resolved.

I can also attest to what Cactusflower and others have said re TMS being able to cause really severe pain. I had an acute low back episode in March that sent me to urgent care twice, was on muscle relaxants and anti-inflammatories, and I was still in terrible pain. I will say that what shifted things for me this time was getting the MRI and seeing that nothing had changed from one I had 6 yrs ago. Within 2 days of seeing that clear evidence on the MRI, my pain was dramatically reduced and I stopped the meds, and after a few more days the pain was completely gone. Of course, I had also started doing emotional work/journaling, getting support from this forum, and actively using other strategies to reinforce the TMS diagnosis. But as a researcher who relies a lot on "logic", seeing that MRI made it impossible for my brain to convince me that there was any physical reason for the pain, so the TMS wasn't serving it's purpose and rapidly resolved.

It's a different process for everyone, of course, but if getting an MRI or other tests to firmly rule out physical causes would give you reassurance and relief, it may be helpful with your healing process by allowing you to fully focus on the emotional aspects.

 

[Hopeful_Alexandra]

Thanks again, everyone. I agrée that getting an MRI in this circumstance makes sense. I won’t be able to get one for at least two weeks (and that’s the private pay option here in Canada…). What I’m wondering about is what I should do in the interim? On the off chance that it IS the nonTMS sciatica, I’m planning to rest as much as possible (and the pain won’t allow me to do much anyway). I think I’ll do some journaling as I don’t see how that could hurt, though I recognize the inherent conflict between bed rest and a TMS approach. I just don’t see what other choice I have given the MRI timeline …?

and @Cactusflower what I meant with the half marathon comment was just how active I was only 10 days ago. But I see what you mean about the pressure!

 

[Cactusflower]

I had a privately purchased MRI through the neuro-surgeon I saw. I had more “damage” according to their tech. They noted small cysts and tumors, more compression and other issues. So just a warning for what a tech can note - they can not diagnose. When the doc. looked at it he said it’s pretty on par with anyone my age: the cysts and tumors like small stuff was normal and benign, my neck was a concern (but never had a problem with it) and I have a few issues that cause occasionally pain/ symptoms but not chronic. He could see old “diagnoses” but assured me they were no problem. I’m just mentioning this because had I not have read Sarno, I world not have been in the frame of mind to fully grasp what the doc. said. I’d have hyper focused on the image seared into my mind.
He also assured me that even if I have disc problems they are considered to heal.
I think your situation is the best it can be. You know to be kind to yourself, to be patient, that you have tools like journaling, meditation, this forum for support, Dr. Schubiner. The Structured Educational Program free on this forum has great journaling prompts if you want z lil’ extra.

Take care!

 

[Rusty Red]

Please be careful with the Gabapentin, especially if you have never taken it before. It can have some nasty side effects. I know it works for some people but hate that it's the go to these days.

 

[Hopeful_Alexandra]

Thanks, everyone. I was examined by a PT yesterday who said it’s most likely a disc herniation causing the pain (take with a grain or salt, I know) but could also be from super tight buttocks muscles. She also said (good news) that I don’t have loss of strength or coordination on the affected side.

I’ve been journaling and trying to keep my nervous system calm.

I’m getting an MRI tomorrow and have made an appointment with Dr. Stracks for next week. Side note, anyone have any experience with him?
Thanks again, Alex