New symptom (RSI) after 5 years of Chronic Headaches - TMS?!

hi, i have a question and hope maybe some of you can help me out.

i’m 33 and have been dealing with chronic headaches for almost five years now, which for the past few years i’ve felt pretty sure are TMS. it all started after my covid vaccination in may 2021. at first i had pretty normal side effects, like dizziness and a feverish feeling, but then it kind of turned into chronic headaches.

in the first months and years i did all the usual tests and workups: blood tests, different alternative medicine approaches, various off-label medications, and so on. after about a year and a half i came across TMS, and it honestly felt like it fit my situation perfectly, which was really reassuring. thankfully i never had to deal with fatigue. my symptoms have been there every day and are definitely very annoying and limiting, but i’ve also always had symptom-free hours, for example during exercise or sometimes while bathing. still, in five years i haven’t had a single completely symptom-free day.

after finding TMS, i read a lot of books and tried different coaches and programs. the approach that made the most sense to me was Dan Buglio’s, because it felt less like obsessing over meditation or strict routines and more like adopting the mindset that there is nothing to fix, that it’s okay, that you meet the pain without getting angry at it, and so on.

unfortunately, that and other things never really worked the way i hoped, and i keep wondering why, because compared to other people my symptoms don’t even seem that severe. i can work out, i’ve traveled, i’ve worked, so i’m doing a lot of things that should basically signal safety to my brain. i’m physically fit too. so i keep wondering why i can’t seem to get past these last 15 percent, or why i’ve basically been stuck on a plateau for five years.

at the same time, i’ve definitely noticed that my emotions play a huge role. when i’ve been sad, dealing with relationship problems, breakups, or a lot of stress, the symptoms got noticeably worse. so there clearly does seem to be some kind of trigger.

last year, after a very difficult breakup, i decided to step away from work for a few months to see whether that would help. i traveled and also started a psychosomatic rehab program. now all of that is over, and unfortunately i’m at a point where i’d say i actually feel a bit worse than i did five or six months ago, which feels really strange. even during rehab i had a lot of headaches, even though i didn’t really feel especially uncomfortable there.

and this is the main reason i’m posting now: i think i may have developed a new symptom. up until now it was mostly headaches, dizziness, body aches, a bit of tinnitus, and also this recurring pain at the injection site from the vaccine, which is one of the reasons i felt so convinced this had to be TMS.

but a few weeks ago, maybe five weeks ago, i noticed a slight weakness in my right hand while playing piano. i’ve played piano and guitar for almost my whole life, and i also work out, and i’ve never had problems like this before. at first i didn’t think much of it and just kept going, but there was still this uncomfortable feeling in my right hand.

then i came home from rehab and just continued life as usual, and i noticed the weakness seemed to get a bit stronger. i’ve also been doing regular workouts for about a year now. nothing extreme, just normal workouts, and i kept doing them during rehab too. the strange thing is that during rehab my headaches were worse, but i was doing less laptop work, and i’d say also a bit less guitar and piano than usual. i still worked out, but not hard, actually a bit less intensely than normal. so that was basically the time when this new symptom first showed up.

then after i got home, it got worse. work started again too, even with reduced hours, and i noticed i suddenly even had pain while typing, first on the right side and then slightly on the left too. my first thought was, shit, what is this now, RSI or something? then i read that RSI can also be TMS, which reassured me a bit. i stopped exercising for a week or two, but then thought that probably didn’t make much sense, so i just started working out again and tried not to give it too much attention.

at the same time, i was also under a lot of emotional stress. a lot came together at once: going back to work, emotional stress involving a woman, feeling overwhelmed, pressure, all of that. i really have to say that in the last two or three weeks i’ve been putting a huge amount of pressure on myself. so in that sense it would make sense that this symptom is showing up now.

on the other hand, over the last five years there were definitely other times when i put myself under a lot of pressure, including before i even knew about TMS, and it didn’t seem this bad back then.

so now i’m at a point where i honestly don’t know how to move forward. i’ve started reading some new books and am also trying Nicole Sachs’ journaling approach, because i’ve never really tried that before and i do feel like i have a lot inside me that probably needs to come out. so maybe that makes sense. i don’t notice any real change yet after three days of journaling, but at least i actually enjoy writing things out.

my question is mainly this, and i guess i’m mostly looking for some reassurance or maybe just your honest opinion on how to handle the hand symptoms. i feel like i can still work, but i really do notice weakness in my hands when playing guitar, playing piano, holding my phone, and even mild pain, also when playing basketball. i’ve still continued my workouts, but i keep wondering what actually makes sense here.

i’ve scheduled an appointment with an orthopedist just in case, although i’m not even sure what they’re really going to tell me. and part of me thinks it would be a pretty huge coincidence if i suddenly had pain in my right hand and forearm, and now even a bit in the left too, even though i haven’t dramatically increased my workouts, haven’t played more piano or guitar than usual, and if anything have done the same amount or even less pc work than usual.

is that enough to say this is TMS? because right now i honestly feel like there’s a 95 percent chance it is. and if that’s the case, should i still keep training, playing guitar, playing piano, even if it hurts? or what would you guys suggest?

i hope this makes sense and that maybe some of you can help me out. thanks a lot.

 

Hi @yarborough

I hope you don’t mind—I found your post a bit long to take in fully, so I used Perplexity.ai to generate a summary. This is what it came up with, and I hope it’s a fair and accurate précis (my responses to your questions are after the précis):

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33-year-old with 5 years of daily headaches they believe are TMS (mind-body), triggered after a COVID vaccine. Symptoms fluctuate and clearly worsen with emotional stress, but haven’t fully resolved despite trying TMS approaches.

Recently, under increased stress (work + relationship), they developed new symptoms: hand weakness and pain (affecting piano, typing, workouts), now spreading slightly to the other hand. No clear physical overuse trigger.

They said they’ve scheduled an appointment with an orthopedist, but haven’t had it yet.

They also mentioned doing extensive medical tests earlier in the illness (blood tests, treatments, etc.), though that was mainly for the headaches rather than the new hand symptoms.

They’ve tried quite a broad mix over the years:

• Medical route: Blood tests, general workups, medications, and some alternative treatments early on.
• TMS education: Read books and learned about mind-body/TMS concepts.
• Coaches & programs: Worked with different TMS-style practitioners.
• Dan Buglio’s approach: Focus on mindset—accepting symptoms, not trying to “fix” them, reducing fear/anger toward pain.
• Psychosomatic rehab program: Attended a structured program during a break from work.
• Lifestyle exposure: Continued exercising, working, travelling—trying to signal safety to the brain.
• Recently started: Nicole Sachs-style journaling to process emotions.

Despite all that, they feel stuck on a plateau with only partial improvement.

They’re unsure if this is still TMS or something physical, feel stuck on a long plateau, and are asking:

1. Is it reasonable to assume this new hand issue is TMS?
2. Should they keep using their hands normally (exercise, instruments) despite pain?
3. What’s the best way to move forward after limited progress with prior approaches?

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Response to #1: It does sound like mind-body/TMS, but the proviso of this forum always is that you get medical clearance first as we are not medical professionals. (While you're waiting for that to happen, although I appreciate you will have referred to your hand pain/discomfort as "RSI" for quickness and ease of description, try not to think of it as Repetitive Strain Injury, which can reinforce the idea of a physical problem—when it's likely TMS-related instead.)

Response to #2: If using your hands for certain things brings on more of an “ouch!” type pain (a sharper, more warning-like sensation), then it’s sensible to be a bit cautious and use your judgement. If it’s more of an “ew” feeling—uncomfortable, stiff, or unpleasant but not truly painful—then it may generally be fine to carry on with your normal activities. Ultimately though, it’s your body, so it’s your call. (I once went for a consultation with an orthopaedic (upper limb) specialist about a frozen shoulder that had some arthritic changes on X-ray, and he explained that “ouch! vs ew” rule of thumb (pun not intended) for joint issues, so that’s where I got that from.)

If you decide to refrain from doing some or all non-essential things but then it turns out it's actually mind-body/TMS, unfortunately it's true that it might make your brain view and wire in neurplastically those activities as being “dangerous,” but that cannot be helped and you can work on that later by “baby stepping” your way back to doing them—“baby stepping” to “fly under the radar” and not scare your brain. (I've gone from totally bedridden to functioning pretty well by comparison by taking that kind of approach.)

Response to #3: I would suggest you try practising mindfulness/meditation/breathing techniques because of what you say here...

Whilst I get what you're saying and why you are saying it, and it can be good to do what gels with us personally as that means we are more likely to stick to it, the problem is that TMSing brains have the knack of directing away from and essentially rejecting exactly what needs to be done for us as unique individuals to change our life and particular mindset (because that's what recovery from mind-body/TMS requires; we're not working on our symptoms themselves). Practising mindfulness/meditation/breathing techniques doesn’t have to be strict or fuel for obsessing. I just tag some breathing techniques and mindfulness onto ordinary parts of the day—for example, I take a couple of minutes to practise mindful breathing (just lengthening a few of my out-breaths) when I visit the bathroom or when I’m waiting for my lunch to heat up on the stove. I'd encourage you to experiment with these kind of techniques. Something like practising tai chi or chi gong might hit the spot for you to calm your brain and nervous system.

On a personal note, for what it's worth, I once had excruciating hand stiffness and pain for many months; it was like a truck had run over my dominant hand (and I'm not exaggerating one iota—it was horrendous!). I believed it was mind-body/TMS and I just got on with things the best I could despite the disability. Dr Sarno said not to use aids of any kind, but I had no option because wearing a wrist and thumb brace enabled me to use a couple of my fingers—otherwise I couldn’t function. (I think the key thing was that I didn't view the brace as being in any way 'curative'.) So that’s what I did, and eventually, very gradually, the pain went away and hasn’t returned.