TMS, RSI or Rheumatoid Arthritis?

About 7 weeks ago, probably a week or two after I started working at my new job as a software developer, I started noticing that the inside of my right knee started hurting about a week into working. I thought this may have been related to me playing soccer one of those afternoons, so I ignored it expecting the pain to subside soon. After about a week, I started noticing a pain coming on in my right forearm. I didn't really suspect much of it, and as it was close to the end of my shift, I worked through the pain until I was able to get some relief at the end of the day when I was able to leave. So at this point, it's the next day and I return to work and notice I have pain in both my knee and forearm now. But the pain is only present in my knee when I'm standing, not walking or running, and the pain in my forearm really only comes on when I begin using the mouse.

At this point, I start getting very concerned, and I'm googling all of the symptoms that I'm experiencing. About a week goes by and I start getting muscle twitching and dry eyes I notice that moving my arm in certain directions causes numbness to go into the tips of my fingers when I was doing nerve flosses. Also, the pain is now in my wrist, and no longer in my forearm as much, and my fingers begin feeling stiff. I become hyper-aware now, and I'm consistently at my job monitoring, and watching videos / reading through forums trying to compare my symptoms to anyone that may have a similar situation. Nothing seems to be adding up. I hadn't been working at this job that long, I can type a crazy amount at a very high WPM and I don't have that much pain, but when I go to use the mouse, I get an incredible amount of pain, and my muscles on the ulnar side of my hand/wrist start to tense up making it feel like my pinky is not properly gripping the mouse.

After a couple of weeks, I decided I'd had enough, and because I don't have health insurance yet, I went to the urgent care to get checked out. This was after I had about 3-4 nights where I wasn't able to sleep at all. I suspected this was from the stress of not knowing and I also decided to quit marijuana cold turkey because it would cause the knee pain to flare up beyond belief to excruciating levels of pain. It was like I could predict it was going to happen every time I smoked, so I haven't smoked since. Interestingly, this was occurring about 3-4 months prior to this pain that began to onset without the marijuana in my knee, so I'm not sure if they're related.

The doctor at the urgent care said that it didn't seem like there was anything wrong structurally from what they could find, and after doing an X-Ray on my wrist and checking for crepitus and crackling in my knees/wrist as well as symptoms of carpal tunnel syndrome through a series of tests, she deemed that I likely had a case of tendonitis or that I may have sprained my wrist and maybe had a meniscus tear in my knee.

So I wore a leg stabilizer for a couple of weeks, which allowed me to begin walking without as much pain and I began wearing a night splint, which I am not sure how much it helped, but still occasionally wear. After noticing some improvement in my leg, I decided to remove the stabilizer after about 2 weeks, and I was able to get into a chiropractor. She said I have a 17-degree lateral pelvic tilt and a definitive leg discrepancy causing me to put extra weight on one leg which likely is the cause for the pain just when I'm standing still.

It's now about to be about 8 weeks since the onset of these symptoms, and I've begun to feel similar symptoms not as severe in my left hand/wrist. There has been no swelling at all that I can tell around my hands, wrists, fingers, or knee. I started reading Dr. Sarnos The Divided Mind, and I emailed Dr. Schubiner this prompt as well as he suspects that it's likely TMS.

I'm just at a loss for direction. I want to really believe that it is TMS, but the pain is so severe at times, that it makes me think otherwise, the other likely culprit based on what I've been feeling so far is Rheumatoid Arthritis but my symptoms are not really adding up. Like I said, I have not had any noticeable swelling, my fingers feel stiff a lot at times, but there's really no loss of mobility/flexibility and my symptoms get worse throughout the day and are usually best in the morning before I go to work. Also, I notice that the symptoms tend to flare up almost right when I sit down at the computer and begin working or use any computer for that matter. I started using a wrist rest for my mouse pad and it's allowed me to work with a bearable amount of pain while taking frequent breaks, but I think the pain is catching up to me with the wrist pad as well.

Any guidance or information would be great. I am going to a doctor's appointment in August, so hopefully, I am able to get a diagnosis if it's structural or an underlying disease that I'm not aware of. There's been no history of arthritis in my family on either side, but I've had an extremely rough past year having lost a great job, having to move across the country twice, and getting blackmailed by 2 different business partners while simultaneously going into massive debt and not knowing how I was going to pay rent/bills. To add fuel to the fire, this job is paying me sub-optimally for the work I am doing but I just had to accept a job that was able to give me experience in this field, and move me in the right direction while allowing me to pay my bills.

 

Hi @camnaz and welcome to the forum. It sounds like you landed in the right place, and with an opinion from Dr Schubiner, no less! This is great news, because your symptoms have "TMS" written all over them, which means you are not dealing with some pathological condition that suddenly started when you started your new career - although it's highly likely that your new career was the trigger that set off the TMS mechanism in your brain!

You are ready to "do the work" as we say around here! We have two free programs which are completely self-managed and don't require any kind of sign-up or registration - all you need is to have at least read one of Dr Sarno's books, which you have done.

For people who are really new to these ideas, I usually recommend the SEP, the Structured Educational Program on the main tmswiki.org site. I have some advice about effectively doing the SEP that I like to give out (so yes, this is cut/pasted from my notes):

The most important advice I can give you about doing the SEP is to take it slowly, and do not let your brain urge you to race through it. One or maybe two sessions per day, along with some time to read posts here on the forum (especially in the Success Stories subforum) is enough. Trying to get through the SEP quickly will NOT result in faster healing. Take it seriously and let the information have time to sink in. Above all, when you get to the writing exercises, do them with a commitment to be 100% honest with yourself. Your fearful TMS brain will try to convince you that you can ignore things that come up - do not let it do that, and write them down anyway, no matter how uncomfortable it makes you. You'll need to keep your "lists" for a short while so that you can write about the topics, but you don't need to keep any of your writing. They call it "journaling" but it's not actually "keeping a journal". By throwing away what you write, you can give yourself the freedom to write whatever comes up from your unconscious repressed emotions and memories, without editing it.

It is very common to experience worse symptoms as you continue to do the work! People report worse symptoms, new symptoms, old symptoms returning, increased anxiety, and sometimes even depression. This can be tough to face, but the good news is that it is proof that a brain mechanism is at work, not any actual physical pathology. Give yourself extra compassion during this time, maybe take a short break from the lessons and do some research on therapeutic breathing and mindfulness techniques, and start practicing those.

As I personally experienced when doing the SEP, it's important that you do not skip over something as "not important", because even small things from our childhoods have significance for various reasons. Finding those things and relating them to your role in the adult world, especially your current stress, is the goal. My own experience of doing the writing exercises in the SEP is that I did not uncover anything shocking or horrifying from my childhood, but I did figure out how my lifelong anxiety developed, and I was able to identify times when I felt isolated due to the way my childish protective brain interpreted childhood experiences and family dynamics.

Okay, that's it! Good luck, and let us know how it's going, especially if you have questions or concerns or just need some reassurance as you proceed.

 

Thank you for this response. I've been slowly accepting that TMS is likely the primary cause. However, I still need to get a blood test done, and rule out anything structural by a general physician. The urgent care doctor told me to stay off my knee and wear the leg stabilizer but I didn't think it helped much even though it provided some relief while I was wearing it. I think it could be structural in my knee along with TMS. I have a 17 degree lateral pelvic tilt and can tell after workouts and standing that there is significantly more tension in my right leg, and the chiropractor says there is a noticeable leg discrepancy still. She asks how I feel after every session, and it hasn't changed much. The fear seems to be getting perpetuated when I try to work because I know that damage to my wrists would impede my ability to effectively do my job as a programmer, and it causes me to catastrophize. Since writing this, my pain has come down. But there feels like tension on my fingers, like they're being pulled down at times, and other times it feels like stiffness. The fingers that will be stiff change frequently. The last 2 days it was my ring finger in my left hand and the tip of my middle finger, as well as my left index finger. Today the stiffness stopped in my ring finger, and has shifted to my right index finger, thumb and pinky. It's so strange how it keeps shifting between my hands and fingers, and makes me fixate on it making me question if it's rheumatoid arthritis, which seems like the only other thing to cause intermittent stiffness in fingers, but like I said no swelling. I purchased unlearn your pain, and will continue reading the divided mind. I'm thoroughly convinced regardless of my condition, that I will be able to reduce my pain and stiffness from these methods, and have faith in the process.

 

As a former (retired now) software developer myself, I understand the stresses of this profession.

After I learned about TMS, I no longer buy into the RSI diagnosis for the software developers, they are not high-speed typists or lumberjacks. Their stress is not on their hands, their stress is on their brains.

What you have, as Jan said, has TMS written all over it. In my case, in addition to pain I had swelling, neuropathic pain and stiffness to the point of severe muscle contractions in my both hands. All was TMS. I am symptom-free now.

Be patient, do not give up, do all the emotional work needed and stop obsessing over specific symptoms and their location. Good luck!

 

Did you rule out Rheumatoid Arthritis? The fact that swelling is involved, would be very concerning to me. In fact, I'm not sure if I have swelling at this point, I do not necessarily notice a difference in the size of my fingers, and my knuckles all feel normal. My mind keeps telling me it's something very bad, but the symptoms are not aligning with what I am reading online for RA. I will have pain shift between different fingers in a matter of minutes, sometimes even seconds, as well as areas in my hand that rheumatoid arthritis typically doesn't affect. However, yesterday, my left knee started to have the same pain as my right knee in the same location but it has subsided mostly today. I started freaking out because I was basically reassuring myself that it is arthritis. I went to the gym and just started doing a normal workout, and the pain began to diminish in my hands and knees. I almost never have "morning stiffness" and my fingers never feel like I'm unable to make a fist, just tension and stiffness as the day progresses. Ironically, my pain is usually at its best in the morning and at night. I do feel quite fatigued, I have been trying to get better sleep, and I notice that I feel a lack of energy most days, relying heavily on coffee to do my job and not drop my head at work. I pick up after about 3PM. My doctor's appointment is on August 21st, and I'll request some bloodwork to be done.

I really appreciate your response, very reassuring to know other software developers have gone through a similar situation. What's interesting is my hand was having severe contractions (right) which spread to my left after a couple of weeks, and I convinced myself it was because of the apple Magic Trackpad, so I switched to a mouse. I found that my pinky and ring finger have a loss of sensation or an inability to grip the mouse, so I got a mouse wrist pad and brought in my Logitech G Pro Wireless from home which is more ambidextrous, and a mouse I never had issues with. I noticed it helped a little, but I would reassure myself and keep using the mouse and gradually the pain in my hand has gone away a good amount, but the stiffness and tension remains. About a week ago, I switched back to the Magic Trackpad, and the weird sensation where my fingers would start to contract and curl in has started to dissipate, and I'm able to use it just fine without any pain now.

I feel like I'm moving in the right direction, but the symptoms of my knees have really been stressing me out. I just don't know why it would happen all on my right and start to migrate to my left in both my hands and knees. What gives me some peace of mind is that there is really no pain when I am sitting, lying down, or walking/running. There are random moments of like 10-15 seconds I'll be standing and there will be almost no pain, and slowly I'm like oh nice, my knees feel okay and the pain sensation begins to set in and slowly amplifies the longer I stand until I sit back down and it goes away.

One thing I want to add, as far as emotional work, are you referring to more knowledge on TMS, journaling, or my inward attention to the emotions I'm experiencing/have experienced relating to the physical manifestations of the pain? This has no doubt been the hardest period of my life. In 2022 I had to move across the country after a business partner completely switched up on me who was also my roommate, and it happened again 2 months later with another business partner who lived in LA, was trying to get me to move and then canceled the moving company last minute when his project I helped him fund flopped. I had to come back to Michigan, and I've been under immense financial burdens, and shortly thereafter lost my job in the crypto market downturn. I had to struggle to work extra hours for 3 months, smoked crazy amounts of weed to relieve the anxiety from the day, and then in May started my first real software development job, and Since then it's been hell. The job itself is very challenging, and my manager just added fuel to the fire. It was about 2 weeks since I started getting the knee pain, and it's just gotten worse since then. Very unlikely to be anything other than some type of system issue or mental issue.

 

Yes, I did get checked for RA markers, it came back negative. You can do it, too, but tests are not likely to cure you, learning more about TMS will.
I don't like advertising my book on this forum, but it was written for people like you. I have been down this rabbit hole you are going into, you may want to read it. It might save you from more pain and wasted time.

https://www.amazon.com/dp/B0834Q46SM (Amazon.com)

 

Dr.Schubiner is one of the leading mind/body -tms Doctors. He’s in Michigan.

I highly recommend @TG957 book!

 

Getting very concerned. It's now in both knees on the inside, when I'm walking, and has started to become intermittent in my elbow. Feels like stiffness in my elbow but no loss of range of motion. I feel like I'm spiraling, I've been getting more invested in paying attention to my emotions and tuning into how I feel and everything just seems to be getting worse. It seems odd that TMS could occur in so many different locations simultaneously. However, I am also noticing that as the pain increases in one area, it begins to decrease it another. The symptoms are all moving around to these areas and rotating very frequently, it's very distressing.

 

Did you ever have blood tests done? And have you done any emotional work? If not, start with the SEP on the main tmswiki.org site.

 

This is the best, really the only logical argument that what you have is TMS. TMS is a misfiring of the nervous system. Nervous system is EVERYWHERE, as a result it may send signals to you to any location in your body. Dr. Sarno makes it very clear that when one symptom of TMS disappears, another one shows up. The only way to break the non-ending loop of TMS symptoms is to follow Dr. Sarno's method.

 

I'm going to my first doctor's appointment on Monday after having waited so long. I will request blood tests to be done then. I tried journaling a couple of weeks back and felt it didn't do much. I keep telling myself I'm okay, trying to think of things that happened over the last year that got me to the levels of stress prior to when my pain started appearing and trying to be outcome indifferent. I will start with the SEP.

 

I feel like I'd have prominent signs of RA if that was the case. I don't have morning stiffness, there's been no visible swelling, not once anywhere. I don't really have fatigue now, my right eye has been giving me issues for a couple of weeks and I notice red in my eyes that randomly shows up, so I'm not sure what that's about, the pain started in my right knee and has since spread with the 2nd spot being my forearm and going up into my hand and then to my left hand. I find it odd that the pain wouldn't start in a joint in that instance if it was RA. Also, the pain tends to decrease significantly when I'm at the gym. But again, they say exercise helps RA, so it's just very conflicting information I'm getting online.

 

Doing the emotional work requires going back a lot farther than last year, which is why you need the guidance of a program. Don't rush it, don't skip anything, and be aware of your brain trying to convince you to do both of these things in order to avoid examining certain life events and family history. That's where you developed your stress mechanisms.

 

And stop consulting with Dr Google!

 

To be honest, I've been almost scared to think about the dark parts of the last couple of years deeply. They were some of the most challenging times in my life besides right now. Literally, the last 7 or so years have been extremely exhausting. My parents got divorced, had to move in with a new family abruptly, and had traumatic events with my dad that occurred in the midst of this. Senior year is when I started turning to marijuana for the first time. After the onset of covid, I got what I thought was long covid. I was smoking heavily during this time, and all of a sudden I started to develop a lower chest pain on my left side. I also realized that at the same time, I was having severe panic attacks induced by anxiety. The height of this was when I was in my basement for 30+ days without seeing the outside world much because I had to quarantine, and the emotions and anxiety had reached the point where I thought I was going to die. I've had lifelong asthma, and I was very convinced that this stomach issue might be something wrong with my lungs, and that I needed to get back on Advair and urgently get checked out. I could physically feel my breaths getting more and more shallow and would notice that as I started to get more concerned, the worse it got. I started doing CBT, and breath work, and over the course of a couple weeks noticed tremendous benefits. I can't exactly remember when, but I remember one day there was no more pain in my abdomen. Within a couple of months of this, I cannot remember the exact timeline because life at this time was a blur, I started to get the same knee pain in my right knee that I'm experiencing now. This lasted for months, and I remember I thought I'd be like that forever. One day, I didn't even realize once again, but the pain was no longer there. I can't even give you a day or time, I just was living life normally maybe. However, a couple of months go by, and I start disassociating/having derealization episodes. I believe this was largely triggered by the marijuana, which sent me into panic episodes, yet I carried on. In retrospect, it doesn't really make sense. It's like it happened for such a while, but I didn't get up in arms and spiral about it because I felt that I might've been more stable living in my mom's house knowing that I could take things easy in a remote role. Now, working in an office 40 hours a week and having debt and bills and rent, I feel very pressured to ensure that my health is optimal for me to be able to live and survive.

As I mentioned previously in the thread when I finally decided to quit smoking this year because this initially was how this pain was being induced, shortly thereafter it then started to persist when I wasn't smoking, the same way it had in the past. It's just so odd, how could something that's supposed to be anti-inflammatory cause pain, and shooting pain at that in my whole leg? I strongly believe that combined with this new very stressful job was the catalyst for this to begin happening to the extent that it has. It feels like I cannot get enough time to just calm myself down, I wish I could go back to my old job that was remote, but those times are far gone. I would go back to my sales job at Best Buy, but it doesn't provide enough income for me to live off of. This software developer job was like a final attempt at something stable and I actually despise it, to be honest. I dread going to work every day, which probably isn't helping my cause. Sorry, this is turning into a bit of a rant, but quite therapeutic as it is reminding me of a lot that I've been going through. I really appreciate you taking the time to read into my pain and desperation. This community has been most helpful in my journey so far, and I'll be forever grateful in the days that I can finally be without this persistent pain.

 

There is nothing odd in your symptoms or how they develop. Every word in your posts screams fear, anxiety and TMS - all of it. Again, you need to stop worrying about your symptoms and start focusing on your very negative emotions and figuring out how to process them in safe way so they would not trigger pain. You need to do the emotional work and go back to the source of your fears. The more you obsess with RA, the more likely your symptoms will increase. It is nice that you appreciate our response, but reading your posts is not what we are here for, we are here to lead you to the right path. I will not respond to your posts anymore because everything that Jan and I have been saying falls on deaf ears. Doing the same thing over and expecting different results is insanity. Unless you change your approach to your pain, nothing is going to happen.

If you don't mind, a bit of a professional advice from someone who spent 40 years in the IT industry doing just about any job in it. Hating your job alone can cause chronic pain. Your choices between sales at Best Buy and software development are not the only two available to you. Consider technical support for the software company, you seem to prefer working with people rather than staring into a computer screen.

 

Doctors office just called me, they said my blood tests look great, nothing abnormal or any cause of concern whatsoever. This is very relieving to hear. I'm going to lean into TMS much more aggressively now as I have no indicators for RA other than stiffness. The pain I've noticed I have some control over. As soon as I divert my attention, the pain begins to subside ever so slightly until I reaffirm it's presence. I've been able so relieve every pain for set amounts of time including my knee pain for maybe a minute or two at a time while standing. I get somewhat excited thinking it's finally starting to ease down but then the pain starts to climb again as I'm standing still not moving at all. I notice that it's a fear response, as I brace myself while in a state of positive thinking that the pain has dialed down, it starts up as I fear it will return again. I went to Cedar Point a couple days ago and walked for many hours and stood in line for hours as well, and the pain never really increased past a certain threshold, although it was shifting around a ton.

 

Also been in continued conversation with Dr. Schubiner over email, and the first thing he says in his response after I've been explaining my symptoms is you do not have RA. And that my mind is looking for ways to affirm that truth because it cannot turn towards anything else but the misinformation I've given it, and I can ignore what my brain is telling me, because it's not true. This was such a relief to hear. The confidence alone helped to calm me down, I realize how much I've been in my head the last couple of months, so much panic, nonstop worrying and attention diverted towards the symptoms. They also did an X-Ray of that knee where I first started getting symptoms and didn't see anything.

 

This is pure gold, @camnaz, thanks for posting it!