Painkillers

[sbmumford]

Is there a general consensus on this site about whether to use painkillers while grappling with TMS?

I've used Tramadol, a mild-ish opioid, when in enough pain that I cannot sleep, or cannot easily interact with people without the distraction of pain.

But I wonder - is this a crutch? Might it be retarding my recovery?

Dr Sarno mentioned somewhere (maybe the video of his lectures) that he did prescribe painkillers to help those with significant discomfort.

 

[Walt Oleksy (RIP 2021)]

Hi, sbmumford. You're right... Dr. Sarno does say that if pain is severe, it is okay to take medication. But he says to attribute any relief in pain to TMS emotions.

Most medication may relieve pain for a while, but continued use can create a dependency so that stronger doses are prescribed, and the patient becomes addicted. Opiates can be very destructive.

So, a pain killer may be a crutch, but a temporarily helpful one. The main thing is to believe 100 percent that the pain is from your emotions.

A non-addictive, non-opiate medication some take and find pain relief with is Voltaren Gel. Ask your doctor about it. It's the generic equivalent of Diclofenac.

 

[sbmumford]

Hi, sbmumford. You're right... Dr. Sarno does say that if pain is severe, it is okay to take medication. But he says to attribute any relief in pain to TMS emotions.

Most medication may relieve pain for a while, but continued use can create a dependency so that stronger doses are prescribed, and the patient becomes addicted. Opiates can be very destructive.

So, a pain killer may be a crutch, but a temporarily helpful one. The main thing is to believe 100 percent that the pain is from your emotions.

A non-addictive, non-opiate medication some take and find pain relief with is Voltaren Gel. Ask your doctor about it. It's the generic equivalent of Diclofenac.

Thanks. Perhaps the Tramadol's effect is a placebo effect, but I think that the power of opiates is that they simply make one feel 'OK' with the pain, regardless of its derivation, as opposed to anti-inflammatories.
I found profound relief through 2 cortisone shots, although I've noticed that these haven't been consistently effective in the past.
Dr Paul Gwozdz suggested to me that there might have been some tissue swelling that the shots addressed, as a result, if I understood him properly, of the TMS around my back and sciatic nerve.

 

[Saoirse]

Hi there I have to take meds to cope but I say when I am taking them and believe this pain is from emotions I am taking the meds to get me through the TMS symptoms.

 

[richard13]

Hey sbmumford, wishing you well. As Walt said, "it may be a crutch, but a temporarily helpful one". This is a personal, unique journey of healing; thus any idealized notion of process or timetable is a bit suspect...so whether taking painkillers is "retarding your recovery" may be unknowable.

In my case, the taking of painkillers may have actually accelerated my recovery in that I took them almost as an act of impatient spite after just starting the TMS process (I threw the Sarno book against the wall and then took a bunch of pills -- sound like underlying rage/frustration/despair?!?. The pills gave only slight, temporary relief and this only helped confirm the TMS etiology for me; so, I didn't take any more pills and committed completely to treating my mind and not my back. Later, I began to have short periods of spontaneous pain relief as if a painkiller had been taken, but it was my mind beginning to no longer maintain the chronic pain. Soon, these periods became longer and more frequent, until it was finally gone.

 

[sbmumford]

Hey sbmumford, wishing you well. As Walt said, "it may be a crutch, but a temporarily helpful one". This is a personal, unique journey of healing; thus any idealized notion of process or timetable is a bit suspect...so whether taking painkillers is "retarding your recovery" may be unknowable.

In my case, the taking of painkillers may have actually accelerated my recovery in that I took them almost as an act of impatient spite after just starting the TMS process (I threw the Sarno book against the wall and then took a bunch of pills -- sound like underlying rage/frustration/despair?!?. The pills gave only slight, temporary relief and this only helped confirm the TMS etiology for me; so, I didn't take any more pills and committed completely to treating my mind and not my back. Later, I began to have short periods of spontaneous pain relief as if a painkiller had been taken, but it was my mind beginning to no longer maintain the chronic pain. Soon, these periods became longer and more frequent, until it was finally gone.

Thanks, Richard, that makes sense. Not sure I have the willpower to commit totally to treating the mind over the body, but I'll keep working at it.
In fact I am a heck of a lot better than I was even a month ago, so perhaps the issue is working itself out little by little.

 

[Tennis Tom]

A non-addictive, non-opiate medication some take and find pain relief with is Voltaren Gel. Ask your doctor about it. It's the generic equivalent of Diclofenac.

I've been takeing the diclofenac sodium 75MG tablets twice a day for my hip arthritis for a few months finding it beneficial to lessen pain an improve functioning. There was a recent meta-study published in the Lancet that found this older tried and true med to be the best of all the NSAIDS--Tylelnol, Aleve, etc., it's cheap too. Short term, small doses of anti-depressants, have been found to be helpful for TMS pain too. Sarno recommends wine too, but don't take them together with the meds, I don't want to get yelled at.

 

[sbmumford]

I've been takeing the diclofenac sodium 75MG tablets twice a day for my hip arthritis for a few months finding it beneficial to lessen pain an improve functioning. There was a recent meta-study published in the Lancet that found this older tried and true med to be the best of all the NSAIDS--Tylelnol, Aleve, etc., it's cheap too. Short term, small doses of anti-depressants, have been found to be helpful for TMS pain too. Sarno recommends wine too, but don't take them together with the meds, I don't want to get yelled at.

Well, now I'm confused. I thought Sarno said that he doesn't believe NSAIDS do any good - except, I guess, as a placebo, because he doesn't think there is inflammation in TMS. Inflammation would be consistent with some sort of trauma to the tissues, and Sarno says that our backs are healthy with or without a disc herniation.
My impression is that the oxygen deprivation of TMS doesn't result in inflammation, otherwise Sarno would recommend cortizone shots, heat pads, etc, no? He always says, think psychological, not physical.

 

[Tennis Tom]

Hey, I'm on my way to a play in some tennis tournaments in the desert, Dr. Sarno wrote four books in his 50 years of clinical practice, he revised his theory and what TMS can effect as he learned more. He even changed the name of it from "Tension Myositis Syndrome" to THE MINDBODY SYNDROME. The mindbody evolves with the need to survive, adapt and grow. Most here recommend "HEALING BACK PAIN", but if you want the latest info the Good Doctor wrote, that includes other conditions then back, muscle and joint pain, read his last book "THE DIVIDED MIND".

 

[richard13]

Thanks, Richard, that makes sense. Not sure I have the willpower to commit totally to treating the mind over the body, but I'll keep working at it.
In fact I am a heck of a lot better than I was even a month ago, so perhaps the issue is working itself out little by little.

Hey sbmumford...glad to hear that you are feeling better and still working at it. It may be OK to be unsure about having the "willpower" to commit totally to a mind-based treatment; in my case, it was more "trust" than willpower. Some of that trust came from an intuitive knowing that Sarno's TMS material made sense (was "right") for me: I fit the profile (the need to be good/perfect, the frustration/rage/impatience when not, stress of modern existence, anxiety/depression. etc.); I had found that other modalities that focused on the back were only temporarily effective (including painkillers and NSAIDs); I found his historical examples of trends in mindbody "epidemics" logically compelling; on a pragmatic level, I trusted the testimonies of other long-term chronic back pain sufferers who were cured and Sarno's stated 85+% remission rate; and on a less pragmatic level, I was amazed by the synchronistic/coincidental experiences that had brought his material into my life.

I share a similar confusion about the earlier posting, but I have only read the early materials by Sarno as my TMS treatment occurred in the mid-90's, so my understanding may be out of date. I thought the NSAIDs were OK as a temporary placebo-like relief, or painkillers and anti-depressants (maybe they acted in the same way as the anatomical pain: as a distraction from feeling/processing emotions), if needed/desired short-term for functionality, but still the long-term focus needed to be on the emotional patterns (then in the mind, now in the mindbody?).

Anyhow, as a I said before, it is a personal, unique journey of healing and maybe confusion is something for some to experience along the way, and to be let go of, as, too, any need/desire to do the process "perfectly", or feel any shame if it is not going well. Maybe it is a larger exercise in self-compassion and self-acceptance. Wishing you well...r

 

[Tennis Tom]

...thought the NSAIDs were OK as a temporary placebo-like relief, or painkillers and anti-depressants (maybe they acted in the same way as the anatomical pain: as a distraction from feeling/processing emotions), if needed/desired short-term for functionality, but still the long-term focus needed to be on the emotional patterns (then in the mind, now in the mindbody?).

That's my take on it, they can act as a catalyst.

 

[ladyofthelake]

I took a tramadol most days for 2-3 years, a few times a year I'd take 2 in a day, like on a long car trip. Tramadol helped a lot with my pain and it gave me an energetic happiness I liked very much. But I really didn't want to be on a pain med and of course it didn't help 100% with the pain. I cannot quite remember now but when I started successfully challenging my TMS pain and saw the pain starting to diminish, I then had the problem of not being able to stop taking tramadol cold turkey because of withdrawal. It certainly wasn't anything like getting off heroin is portrayed in Trainspotting but for me withdrawal was irritability and profound fatigue. So I did a ridiculously slow taper off tramadol to continue to benefit from any placebo action that may remain for the tramadol and minimize withdrawal. I took 1/2 pill a day for a week. Then 1/4 pill a day for a week and altho it seemed silly I took 1/8 pill everyday for a week. During that time the pain was pretty minimal so this confirmed TMS in another way for me. A year ago tramadol was my bestest friend, now I recently took a 5 hour plane trip without tramadol and with no more than a hint of sciatica. I guess that doesn't answer your question except to say I don't think the pain medication really harmed me and that is how I got off of it.

 

[sbmumford]

Hey sbmumford...glad to hear that you are feeling better and still working at it. It may be OK to be unsure about having the "willpower" to commit totally to a mind-based treatment; in my case, it was more "trust" than willpower. Some of that trust came from an intuitive knowing that Sarno's TMS material made sense (was "right") for me: I fit the profile (the need to be good/perfect, the frustration/rage/impatience when not, stress of modern existence, anxiety/depression. etc.); I had found that other modalities that focused on the back were only temporarily effective (including painkillers and NSAIDs); I found his historical examples of trends in mindbody "epidemics" logically compelling; on a pragmatic level, I trusted the testimonies of other long-term chronic back pain sufferers who were cured and Sarno's stated 85+% remission rate; and on a less pragmatic level, I was amazed by the synchronistic/coincidental experiences that had brought his material into my life.

I share a similar confusion about the earlier posting, but I have only read the early materials by Sarno as my TMS treatment occurred in the mid-90's, so my understanding may be out of date. I thought the NSAIDs were OK as a temporary placebo-like relief, or painkillers and anti-depressants (maybe they acted in the same way as the anatomical pain: as a distraction from feeling/processing emotions), if needed/desired short-term for functionality, but still the long-term focus needed to be on the emotional patterns (then in the mind, now in the mindbody?).

Anyhow, as a I said before, it is a personal, unique journey of healing and maybe confusion is something for some to experience along the way, and to be let go of, as, too, any need/desire to do the process "perfectly", or feel any shame if it is not going well. Maybe it is a larger exercise in self-compassion and self-acceptance. Wishing you well...r

Thanks Richard, that's interesting, and I think you're right about trusting the general thrust of Sarno's thinking, even if the details remain elusive or fuzzy or contradictory.
It still puzzles me that some people have only to see or hear Sarno to have an immediate cure, while others struggle. This makes me wonder if there isn't an aspect of placebo to TMS too. That is, how much Sarno's own powerful personality effected his patients. Yet TMS is apparently still more effective than taking the route of operations. God knows it's better news than thinking that one's back is eternally fragile.
What worries me is that my recovery seems consistent with my recoveries in the past in terms of time - about 6 months to completely recover, at this rate. Can I use my understanding of TMS to prevent the next big episode in 3 years? Is the ultimate benefit of TMS for me the initiating of therapy, which I'm now doing, to increase my understanding of my own emotional life and history?

 

[sbmumford]

I took a tramadol most days for 2-3 years, a few times a year I'd take 2 in a day, like on a long car trip. Tramadol helped a lot with my pain and it gave me an energetic happiness I liked very much. But I really didn't want to be on a pain med and of course it didn't help 100% with the pain. I cannot quite remember now but when I started successfully challenging my TMS pain and saw the pain starting to diminish, I then had the problem of not being able to stop taking tramadol cold turkey because of withdrawal. It certainly wasn't anything like getting off heroin is portrayed in Trainspotting but for me withdrawal was irritability and profound fatigue. So I did a ridiculously slow taper off tramadol to continue to benefit from any placebo action that may remain for the tramadol and minimize withdrawal. I took 1/2 pill a day for a week. Then 1/4 pill a day for a week and altho it seemed silly I took 1/8 pill everyday for a week. During that time the pain was pretty minimal so this confirmed TMS in another way for me. A year ago tramadol was my bestest friend, now I recently took a 5 hour plane trip without tramadol and with no more than a hint of sciatica. I guess that doesn't answer your question except to say I don't think the pain medication really harmed me and that is how I got off of it.

LOTL, thanks for your honest reply. I completely agree with your take on tramadol - "energetic happiness" is spot on. I got off it after my last bout of back pain a few years ago more quickly - in fact, very quickly - when I read that it (and other opiates) suppress testosterone. I wanted that less than the energetic happiness, and of course found that eventually my body's own hormone balance began to restore some of those endorphins. I agree that addiction to tramadol should be taken very seriously and will revisit your method should I need to.

 

[Tennis Tom]

It still puzzles me that some people have only to see or hear Sarno to have an immediate cure, while others struggle. This makes me wonder if there isn't an aspect of placebo to TMS too.

Reminds me of a book title "MIND AS HEALER, MIND AS SLAYER". The power of suggestion. TMS is not a placebo, it is a real cure. An incorrect DX is the nocebo. The mindbody is the most powerful healer. ER medicine can perform miracles if you're in a car wreck, but today's allopathic medicine IS a car wreck, miss-dxing 80% of chronic pain . Your car gets more TLC from your mechanic then current assembly line medicine. If you can find a doc who remembers your name, keep him/her--all we are to the system now is our birth date.

In my experimentation with pain-killers, I tried trammies, taking one turned me into a zombie, I cut back to 1/2, but stopped the experiment after a few days, still have them in the med cab for a big-pain. I can't see being on them long term if it's TMS. Better to travel cross-country or around the world to get an objective opinion from a TMS M.D.--people travel around the world all the time--it's called a vacation--why not do it for your health?--combine it with a vacation.

I'm taking diclofenac 75 mg (Voltaren) tabs twice a day for my hip-arthritis, based on a recent meta-study findings in the Lancet, finding they are the best NSAID. I did have a great lesson a few years back having a bleed from too many Aleves, lost 50% of my blood--passed out and ambulanced to the ER for three days of tranfusing--if two Alleves a day are good then a handful must be better--NOT! They relabeled it shortly thereafter with better warnings--only take meds as directed by your doc or labeling. The good news was I was up and playing 48 hours after being released and played great--you could say I was blood doping--lucky they don't do drug or gender testing in Senior Tennis Tournaments.

Once again, instead of taking pain-killers long term for TMS--see a TMS physician for an objective DX or see a TMS practitioner to delve into the reasons your sub-c wants to keep protecting you from emotional pain, giving you TMS pain as a distraction.

 

[richard13]

It still puzzles me that some people have only to see or hear Sarno to have an immediate cure, while others struggle. This makes me wonder if there isn't an aspect of placebo to TMS too. That is, how much Sarno's own powerful personality effected his patients.

Yeah, that is interesting. I've shared Sarno's material with friends/colleagues for many years, and one did have an immediate cure. He's a woodworker/carpenter who had had bouts of chronic pain over numerous years...his final episode lasting many months. I gave him Sarno's first book to read. He said that he started reading and about 20 minutes later somewhere in chapter 2 the pain just stopped; he felt that the book confirmed what he had been thinking for some time. Some in our circle at first doubted his account, but he was the most "stand-up guy" among us (too, a couple of us had struggled for many weeks with our TMS treatment, and were maybe a bit jealous, as well as amazed) So, in his case it, I'm not sure if it is "the white coat placebo effect", or just having professional confirmation/approval of his own developing conscious understanding of the sub-/un-conscious source of his chronic pain (in his case, it would then be more the force of Sarno's authority than his personality, since he neither saw him lecture, nor heard his voice; he only read his words).

Can I use my understanding of TMS to prevent the next big episode in 3 years?

Seems possible to me if your awareness gained about the nature of the emotional/psychological component is maintained into the future. For myself, soon after the chronic pain had left my back, I had to repeat the TMS treatment multiple times, as my mind redirected the chronic pain to other areas of my body that were plausible sites due to past injury: shoulder/neck, elbow, and wrist. Fortunately, I knew from Sarno's material for this movement of pain to be a possible scenario and was able to immediately restart the treatment; it worked in a shorter and shorter period each time. After it left the final site, I continued my physically strenuous life/work-style and was pain free for a year or so until I strained my back doing some large stone landscaping. When what I expected to be merely a transitory pain lasted more than a week or so with no lessening/relief, I knew I needed to apply the TMS treatment again. Fortunately, it took only a few days the second time, instead of the many weeks it had taken the first time. Been lucky to be chronic pain-free the 15-20 years since that one return. Hope this helps.

 

[Ellen]

I took a tramadol most days for 2-3 years, a few times a year I'd take 2 in a day, like on a long car trip. Tramadol helped a lot with my pain and it gave me an energetic happiness I liked very much. But I really didn't want to be on a pain med and of course it didn't help 100% with the pain. I cannot quite remember now but when I started successfully challenging my TMS pain and saw the pain starting to diminish, I then had the problem of not being able to stop taking tramadol cold turkey because of withdrawal. It certainly wasn't anything like getting off heroin is portrayed in Trainspotting but for me withdrawal was irritability and profound fatigue. So I did a ridiculously slow taper off tramadol to continue to benefit from any placebo action that may remain for the tramadol and minimize withdrawal. I took 1/2 pill a day for a week. Then 1/4 pill a day for a week and altho it seemed silly I took 1/8 pill everyday for a week. During that time the pain was pretty minimal so this confirmed TMS in another way for me. A year ago tramadol was my bestest friend, now I recently took a 5 hour plane trip without tramadol and with no more than a hint of sciatica. I guess that doesn't answer your question except to say I don't think the pain medication really harmed me and that is how I got off of it.

I took 6 Tramadol a day for 20 years for fibromyalgia. I went through a significant withdrawal when I stopped taking it, even though I did it very gradually. I still miss the "energetic happiness" it gave me. It never really did anything for the pain, just improved my mood and energy level.

 

[CarboNeVo]

Tramadol works magic for me, it pretty much kills all the pain I have, though nowdays my pain is most of the time gone or very little thanks to Sarno and this forum in general.
I have a different opinion on tramadol though, for many of us it numbs the brains chatter, especially if you get euphoric states and it lifts your mood.. imho that is all you need to kill the pain, I believe more in Monte Heuftle's and Ezer's theory on TMS.. that it is a moment to moment repressive behavior rather than this one big repressed emotion that your brain is trying to hide from you.. (but that's another debate).
What I think that tramadol and opiates in general calm our brain, reduce this negative repressive chronic thinking - which creates inner tension in us and that actually makes sense.. it directly impacts negative emotions, anxiety and chronic repressive behaviors which are the seed for TMS pain.
If you do some research you will see that alot of people with chronic pain recovered after a doc gave them an antidepressant - imho that's another way how it affected the brain to reduce the pain.

 

[ladyofthelake]

[QUOTE="
I have a different opinion on tramadol though, for many of us it numbs the brains chatter, especially if you get euphoric states and it lifts your mood.. imho that is all you need to kill the pain, I believe more in Monte Heuftle's and Ezer's theory on TMS.. that it is a moment to moment repressive behavior rather than this one big repressed emotion that your brain is trying to hide from you.. (but that's another debate).
What I think that tramadol and opiates in general calm our brain, reduce this negative repressive chronic thinking - which creates inner tension in us and that actually makes sense.. it directly impacts negative emotions, anxiety and chronic repressive behaviors which are the seed for TMS pain.
[/QUOTE]
Wow that is a interest perspective regarding the brain chatter/cognition and TMS pain. Tramadol is both a mild SSRI and mild opiate-like drug. It always melted the pain away and made me so so so happy and calm. No NSAID did anything for my sciatic pain, ibuprofen or naproxen work fine for headaches, cramps or more recently, pleurisy but never that nasty nerve pain. There is still a part of me that really would like to take Tramadol every single day for the rest of my life but I'm aware that ISN'T WHAT I REALLY WANT. This TMS stuff is better overall and even more effective.

 

[ladyofthelake]

Tramadol works magic for me, it pretty much kills all the pain I have, though nowdays my pain is most of the time gone or very little thanks to Sarno and this forum in general.
I have a different opinion on tramadol though, for many of us it numbs the brains chatter, especially if you get euphoric states and it lifts your mood.. imho that is all you need to kill the pain, I believe more in Monte Heuftle's and Ezer's theory on TMS.. that it is a moment to moment repressive behavior rather than this one big repressed emotion that your brain is trying to hide from you.. (but that's another debate).
What I think that tramadol and opiates in general calm our brain, reduce this negative repressive chronic thinking - which creates inner tension in us and that actually makes sense.. it directly impacts negative emotions, anxiety and chronic repressive behaviors which are the seed for TMS pain.
If you do some research you will see that alot of people with chronic pain recovered after a doc gave them an antidepressant - imho that's another way how it affected the brain to reduce the pain.

Wow that is a interest perspective regarding the brain chatter/cognition and TMS pain. Tramadol is both a mild SSRI and mild opiate-like drug. It always melted the pain away and made me so so so happy and calm. No NSAID did anything for my sciatic pain, ibuprofen or naproxen work fine for headaches, cramps or more recently, pleurisy but never that nasty nerve pain. There is still a part of me that really would like to take Tramadol every single day for the rest of my life but I'm aware that ISN'T WHAT I REALLY WANT. This TMS stuff is better overall and even more effective.