Dr. Schubiner TMS and inflammation

lquigs

lquigs

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Question
Hi;
I have read The Divided Mind and am getting close to finishing Healing Back Pain by Dr. Sarno. I am a bit confused about what he has to say about inflammation. On page 151-152 he says that there is no inflammation in TMS, yet he says in other places, as do other TMS doctors on this website, that tendonitis is caused by TMS. But tendonitis is inflammation of the tendons.

Although I have experience chronic pain in different parts of my body, I have never had back pain. But tests have indicated I have tendonitis in various parts of my body, and anti-inflammatory medication does take the pain away. But after reading his books and working through the TMS website, I am certain I have TMS.

I'd appreciate it if you would clarify what he means by that statement.

Thanks!
 
Answer
I can see why you’re confused. In general, people with TMS do not have a pathological or structural problem in the body. A network of neural pathways in the brain is the cause of the TMS symptoms, whether the symptoms are pain, anxiety, fatigue, or depression. These neural pathways can cause changes in the body, such as muscle tension or a rapid heart rate. However, TMS doesn’t cause inflammation, which I would consider as a pathological, tissue damage process.

We see inflammation with infections, fractures or strains, such as occurs in tendonitis. I believe that Dr. Sarno is referring to the disorder that is sometimes diagnosed as “chronic tendonitis” or repetitive stress injury as being frequently caused by TMS. What frequently happens is that doctors who make those diagnoses are not familiar with TMS so that they assume there is inflammation, when in fact, there may be none. Inflammation is usually diagnosed by a clinical examination that shows redness, swelling, tenderness, and increased heat. When I see a patient with chronic pain and no actual signs of inflammation, TMS becomes a likely diagnosis. Anti-inflammatory medications are taken to reduce pain as well as to decrease inflammation. Therefore one cannot assume that there is inflammation in the body simply because they reduce pain.

Howard Schubiner, MD

Any advice or information provided here does not and is not intended to be and should not be taken to constitute specific professional or psychological advice given to any group or individual. This general advice is provided with the guidance that any person who believes that they may be suffering from any medical, psychological, or mindbody condition should seek professional advice from a qualified, registered/licensed physician and/or psychotherapist who has the opportunity to meet with the patient, take a history, possibly examine the patient, review medical and/or mental health records, and provide specific advice and/or treatment based on their experience diagnosing and treating that condition or range of conditions. No general advice provided here should be taken to replace or in any way contradict advice provided by a qualified, registered/licensed physician and/or psychotherapist who has the opportunity to meet with the patient, take a history, possibly examine the patient, review medical and/or mental health records, and provide specific advice and/or treatment based on their experience diagnosing and treating that condition or range of conditions.

The general advice and information provided in this format is for informational purposes only and cannot serve as a way to screen for, identify, or diagnose depression, anxiety, or other psychological conditions. If you feel you may be suffering from any of these conditions please contact a licensed mental health practitioner for an in-person consultation.

Questions may be edited for brevity and/or readability.

 
Howard Schubiner MD said:
Answer
I can see why you’re confused. In general, people with TMS do not have a pathological or structural problem in the body. A network of neural pathways in the brain is the cause of the TMS symptoms, whether the symptoms are pain, anxiety, fatigue, or depression. These neural pathways can cause changes in the body, such as muscle tension or a rapid heart rate. However, TMS doesn’t cause inflammation, which I would consider as a pathological, tissue damage process.

We see inflammation with infections, fractures or strains, such as occurs in tendonitis. I believe that Dr. Sarno is referring to the disorder that is sometimes diagnosed as “chronic tendonitis” or repetitive stress injury as being frequently caused by TMS. What frequently happens is that doctors who make those diagnoses are not familiar with TMS so that they assume there is inflammation, when in fact, there may be none. Inflammation is usually diagnosed by a clinical examination that shows redness, swelling, tenderness, and increased heat. When I see a patient with chronic pain and no actual signs of inflammation, TMS becomes a likely diagnosis. Anti-inflammatory medications are taken to reduce pain as well as to decrease inflammation. Therefore one cannot assume that there is inflammation in the body simply because they reduce pain.

Howard Schubiner, MD

Any advice or information provided here does not and is not intended to be and should not be taken to constitute specific professional or psychological advice given to any group or individual. This general advice is provided with the guidance that any person who believes that they may be suffering from any medical, psychological, or mindbody condition should seek professional advice from a qualified, registered/licensed physician and/or psychotherapist who has the opportunity to meet with the patient, take a history, possibly examine the patient, review medical and/or mental health records, and provide specific advice and/or treatment based on their experience diagnosing and treating that condition or range of conditions. No general advice provided here should be taken to replace or in any way contradict advice provided by a qualified, registered/licensed physician and/or psychotherapist who has the opportunity to meet with the patient, take a history, possibly examine the patient, review medical and/or mental health records, and provide specific advice and/or treatment based on their experience diagnosing and treating that condition or range of conditions.

The general advice and information provided in this format is for informational purposes only and cannot serve as a way to screen for, identify, or diagnose depression, anxiety, or other psychological conditions. If you feel you may be suffering from any of these conditions please contact a licensed mental health practitioner for an in-person consultation.

Questions may be edited for brevity and/or readability.

Click to expand...
 
Hi Dr Schubiner,
I have inflammation and a great deal of pain on the top of my foot. There is swelling, lots of pain, color change, but no heat. A new podiatrist (that I like) took x-rays and said she thought it was caused by the orthotics (for flat foot caused posterior tibial tendonopathy). She was not alarmed and is sending me for a follow up MRI. I was pretty sure I have MBS until I read your post. I am taking an anti-inflammatory and icing (10 days) but am seeing minimal improvement.
Thank you,
Lynn
 
Hi Lynn,
You might try to ask this question by starting your own thread in the Support section, or Ask a Therapist. Down here it isn't getting much attention!
Andy B.
 
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