Suspecting nerve damage or pinched nerve. Could it be TMS?

I’m a 45-year-old female in reasonably good health. I’ve always been physically active playing tennis, aerobics, walking, etc.

Three years ago, I was dealing with low back issues – spasms and a mild burning sensation radiating to my butt. No pain in my legs. I didn’t have pain all the time but it got triggered by sitting for more than 20 minutes, standing for more than 20 minutes, sneezing, coughing, or any other jerky movement. MRI indicated minor disc bulges in L5/S1 and L4/L5. I tried medicines, PT, injections, but nothing helped. Five months ago, a pain specialist suggested Radio frequency ablation in my low back. I did that. After that, my symptoms got amplified. I’m a bit better now but I still experience the burning sensation on the left side of my low back and sometimes it radiates to my butt. During a flare up, I feel like something is swollen there. Again, I don’t have pain all the time but it gets triggered by those things I mentioned. When the pain comes, it stays for a long time. As a result, my quality of life has been compromised greatly.

Anyway, I’m 90% sure that I have TMS. My questions are:

1. My symptoms seem like nerve damage or pinched nerve or something. Could this still be TMS?

2. In addition to the MRI, should I consider other tests to rule out structural issues?

3. If yes, what tests should I consider? EMG?

I want to be 100% sure that it’s TMS. Otherwise, I know my brain is going to play tricks on me. Any thoughts or advice?

 

Dr. Sarno would expect us to make sure there was nothing serious going on so why not ? I started out with butt pain radiating into my foot. After all the treatments (before I understood TMS) I am worse. Afterwards that's one thing currently diagnosed is tendonitis and gads thats painful. "So what to do about nothing" as the Master would say. Get on with life and think psychological !I have continued pain that shifts from one but cheek to the other...now knee and foot pain ? I want off the medical merry-go-round so I must dig deep as you should to figure out what the emotional issues are.

 

Hi there,

Sounds like you’ve been thoroughly medically worked up.
Minor disc bulges are an incidental finding, most people have them. Truly damaged nerves result in unchanging, consistent sensory and/or motor loss and this doesn’t fit with your symptoms. This also would have shown on mri if anything was severely affected. I wouldn’t worry about EMG as your doctors didn’t recommend it. If in doubt consult with a TMS doctor but you don’t have any of the danger signs I’d worry about when referring someone for more testing. Try the TMS approach and see what happens!

 

Can you have just

MBPT...I beg to differ with you on one point. I had sensory symptoms in the same spot for almost 2 years when I was younger. One day I realized it was gone. I never knew it was TMS because nobody knew what TMS was. I am having the same symptoms from 20 years ago again...and very slowly it's going away, but it's changing to other areas in my lower extremities. Never really had motor symptoms other than muscle twitches and maybe just a little motor.. The feeling Pree is talking about (feeling like something is swollen) is exactly what I feel in my butt...like sitting on a marble than it shift to the other side, or I feel it in my back. I believe inflammation is created by the mind too to throw us off. TX.

 

Sorry what is your question? Yes I agree inflammation can absolutely be driven by neural pathways/ TMS , no question about it! I’ve also experienced that.

To clarify, I mean that a rare truly structural nerve injury that isn’t TMS would be unchanging and consistent in terms of symptoms overa long period of time, I have seen that occasionally as a practicing PT, usually due to a trauma or more severe circumstance. The above situation sounds most likely to be TMS.

 

To answer your question...I had pain twice on the bottoms of my feet that slowly dissipated and went away (sensory). I now have pain in areas of my medial knee and top of the foot that have been diagnosed as (chonromalacia and foot tendonitis). This is all newly checked out with x-rays and an exam to make sure. Of course it will be diagnosed as structural because they need to be paid. They want me to buy new supportive shoes and a little PT for 5 weeks. Do I think it's TMS ? Yes because I get crazy symptoms like tingling that come and go, or nerve pain in my toes that comes and goes....and pain that just shifts around.

 

Yes given that chronic pain attributed to chondromalacia patella and tendonitis are known TMS variants, plus the shifting around of your pain, this sounds like TMS. Of course a non-TMS doctor will say it is structural But these diagnoses are known to be TMS in this community.

 

Went and bought a pair of New Balance shoes. The guy fitting me felt my knee (is a massage therapist) and said the bad knee was warmer and slightly swollen ? So I am assuming it could still be TMS.....x-ray look good. They want me to do a little PT ? What do you all think ?

 

Hi Pree,

 

Hi Pree,

I am not qualified to say if your situation is TMS or not, however, there are real circumstances where there is a pinched nerve or other symptoms which are nerve caused. One of these is nerve entrapment which does not always show in tests but can occur from scar tissue forming from previous injuries, especially if one is athletic or, the nerve being routed in an unusual place.

Some feel that the moving around of sensations from one part of the body to another is "the mind playing tricks on you..."
one alternative explanation is that ones body simply does not like pain so it adjusts to avoid it. This can put different stresses on other parts of ones body which in turn can cause sensations to different parts of ones body.

Unfortunately, the reason that they know nerves can become entrapped because of differing routes in the body or in scar tissue is through autopsy which is inadvisable to go through as long as one is still horizontal, LOL.

Wishing you well!

 

I severed a nerve (thumb) and I am sure there is plenty of scar tissue. NO PAIN from that. I have stretched my thumb and bent it in many ways...NO PAIN. Even when it was healing there was NO PAIN. That is what keeps me going with TMS. Like the great doctor said there is nothing more painful than TMS. If a nerve was being compressed or whatever it would become numb or even die. Hope that makes sense. I am trying to tell my brain there is no reason that I should have pain from a spinal fusion this late in the game.

 

Glad to hear your all thumbs!!! Yes, in the case of back surgery, it is not common to have nerve entrapment though it can happen, Here is an article that might interest you and if you like search the resources listed.

As far as I know usually when there is numbness it indicated compression, when the nerve is dying or in danger of dying it created extreme pain. A toothache is a good example.

https://www.spine-health.com/treatment/back-surgery/causes-failed-back-surgery-syndrome (Causes of Failed Back Surgery Syndrome)

 

Strangely I have no numbness, tingling and can feel everything ! muscle strength is good & reflexes are normal....TMS TMS TMS.

 

Sounds like TMS, I've been playing tennis for 15 to 20 years with hip pain. The pain comes and goes depending on how big of an a-hole my opponents are or my dubs partner. Have you read any TMS books? If not, and you want to get better without the risks of surgery or ill effects of various voo-doos, read your Sarno, anyone of his books will answer your questions. Dr. Sarno says pinched nerves don't cause pain--they go numb. I had the RF ablation treatment recently, a friend had it and it sounded logical and they got "cured"--did nothing for me--Dr. Sarno says "surgery is our the best placebo".

Sounds like you've been checked out for anything serious, like "cancer" or "the tumor". On your images they found what the Good Doctor calls, "GRAY HAIR OF THE SPINE"--normal structural anomalies--no one has a "perfect" spine, but the white-coats hang their mis-dx'es on them and make them sound convincing.

See a TMS physician for an objective mindbody dx--there's a list of them at this site.

Read the good books.

Sleep on it.

Continue exercising, especially tennis, and try not to let the bastards get you down.

 

Yes, according to the Sarno TMS literature, it is very rare for a nerve to get "pinched" although it is one of the most common dx'es by white coats who are in denial of the psychosomatic causes for the majority of all pain. He says it would take the opening that a nerve passes through to be VERY closed up to be able to actually squish a nerve enough to shut it down. He says when a nerve is truly damaged it becomes numb and does not transmit pain any longer--it's in the books--check the indexes for "pinched nerves".

 

That doesn't sound too HOPEFUL. According to the Sarno literature--and this site is dedicated and devoted to the Good Doctor's theory that most pain IS TMS/psychosomatic. Dr. Sarno says most "pinched nerve" and "degenerated disc" dx's are mis-diagnoses due to the medical/industrial complex's denial and refusal to accept chronic pain to be of psychological origin. Get checked out by a doc and if you can find a TMS trained physician that would be the best for an objective mindbody dx. Don't go jumping for the surgical route until you've explored the emotional causes.

 

Is there ever a scenario where lumbar spinal compression/nerve root 'impingement' can actually be the cause of numbness & tingling in the foot? My neurological symptoms are very consistent and seem to be very consistent with the radiologists' findings. My previous success treating my own TMS 20 years ago involved pain that switched sides & seemed to have a mind of its own. I have no illusions of a surgical solution/magic bullet, and firmly believe all of the muscle tightness, inflammation, & chronic crushing LBP is TMS. Yet the neurosurgeons seem to be having lots of success resolving the nerve thing. The studies I'm reading are making it hard to pin 100% of the successful outcomes on the placebo effect. I don't deny its power nor the fact that there are probably thousands of unnecessary back surgeries performed every year on TMS patients. Yet at what point do you say 'I've done all the TMS work & tried everything else - when do I start to consider surgery as the only option left. If I wind up benefitting from a placebo effect, that's OK with me - if it means I'm pain-free, I don't care how I get there.

 

I think because this time around my symptoms are so consistent & line up perfectly with what is 'accepted' to be caused by an impinged nerve root at L5/S1. I had another neurosurgeon assure me that 'it is not psychological', though I don't know why I would expect anything different. The surgery being recommended is no joke - they want to fuse L4/L5 & L5/S1 With the discectomy. No chance I'm doing that. Though I am considering a microdiscectomy just on L5/S1 if they can manage it without a fusion because the numbness/tingling/weakness in my left leg is driving me nuts. I don't expect much of an impact on the overall LBP, but I also have become concerned about the weakness part - and the potential for loss of motor function. At this point my docs are literally scolding me about delaying the surgery any longer, but by the time I can get off of Prednisone long enough to satisfy the doc & get the insurance company to play ball, I'll be old & gray anyway so at this moment I am leaning towards giving up on the medical establishment 100% because all I'm doing is wasting a ton of time & money without any real progress. I do continue to notice unconscious tightening of muscles in my lower back - I do it when I'm 'relaxed'. While the severity of the pain does change, I can't feel anything in my big toe & the neurological symptoms are constant in the left leg - so I guess I've been contemplating the surgical path because nothing else seems to have any effect. The more I read about the efficacy of these procedures however, the more skeptical I become...

 

SteveO had foot drop. Don't do it.

 

It's just so darn 'mechanical'. The nerve symptoms & radiating pain increase as the surrounding muscles become fatigued after doing a little too much for the day. That's the only pattern - I can't link it to any specific emotion or mood & all of the TMS treatments that had helped me in the past haven't made a dent. Perhaps it's the lingering doubt keeping me from realizing any benefits but it is hard to figure out who is right when I have very experienced people arguing both sides - that this 'structural abnormality' is very unlikely to be what is causing the symptoms and yet the pins & needles & constant itching is far beyond annoying. Either way the surgery looks like too great a risk. The part that worries me is that I am about all out of alternatives.