TMS

[Forest]

The following was a post from tezzasponger on our wetpaint forum. I thought I would post it hear, so more people could be involved in the discussion.

I have been suffering with back pain since 2006. When it first happened I went through the usual testing of an MRI and was diagnosed with a herniated disc at L3/L4 and L5/S1 which was worse at this level. It was about this time I started studying to be a physiotherapist.

As the months and years went by and I was in the middle of my studies, my symptoms started to travel into my legs (Sciatica). Being a a student of physiotherapy this scared me and I knew from what I being taught what was happening. The worry of what we call caudal equine compression was always on my mind always. My symptoms got worse then I went to a chiropractor where things improved.

I then moved overseas and my symptoms in my back went back to how they used to be. Until I came across Dr John Sarno book last year. I saw myself in the book. When all of this started I went thorugh a really bad break up with an ex and i was studying with stress at the time. I never did any extra activities that could cause my symptoms to get worse. Things got better. Every now and again I get attacks in my back and legs like I did a few years ago. I think back whats going on in my head thats causing it and it does go sometimes.

But this is where I get stuck, because I am a health professional, where I say don't bend, twist, don't run (I hate saying this now since reading Sarno book) and being aware of information that a bulging disc can cause paralysis. I always have that worry especially with the latter. I have that fear of picking heavy objects up as every time I do it hurts my back. I don't run on concrete anymore because of the above ( but I can run on grass and play touch rugby or soccer).

I really want to become a reservist in the Army as its some thing I wanted to do and my last chance to do it. Could someone give me some advice how to over come all the fear and the pain when it comes on. Any help would be appreciated.

Thanks

Hiya and Welcome to the wiki,

Your story is pretty similar to a lot of other people with TMS. It sounds like TMS fed on the increases of stress you have had in your life, i.e. taking exams and moving overseas. These are both really trying times so it makes sense that you would develop symptoms then. It sounds like you are already having some success with the approach which is great. However, it also sounds like you are reinforcing the pain sometimes. By this I mean, having fear of picking up heavy objects or running on concrete.

Can picking up heavy objects create pain? Yes, but the pain should go away fairly quickly, and most likely the main reason you have pain when you pick stuff up is because you fear that you will have pain. This is sort of the same thing with running on concerete. I would love to hear what the other runners have to say about this, but I tend to think that if you can play soccer and rugby you can run on any surface.

The good news is that you are in the right place and you are going about this the right way. First, check out Breaking the Pain Cycle. It is a terrific article all about how to address the fear we have about our symptoms. Also, check out the Strucutred TMS Program and the Success Stories, specifically the Sciatica ones, we have. I had severe pain for over 18 years. If I can get better, you can get better.

 

[tezzasponger]

Thank you Forest for the response and the advice. Of all the things that scares me the most is the picking up heavy objects and flexing my back, as soon as I do I get my symptoms in my left side and sciatica down the leg... which is annoying. And theses symptoms take time to go. I think about it before and after. Thats where I go wrong. Even thou its not doing harm there is that stupid doubt.

The psychological lessons I had in the past during my study days, I never understood them but now it all makes sense. The questioning when I first hurt my back " do you have pins and needles, numbness, gait disturbance, bladder and bowel "plus all this being reinforced to me during my studies at University has conditioned my brain just like the dogs in Pavlov study. This is why my symptoms progressed.

I do hope some runners can shed some light. Forest I will read those articles and keep you updated on my progress. Thank you.

 

[BruceMC]

But how many people are there incapacitated occupying hospital beds with a bulging disk that caused paralysis? The hospital beds and nursing homes around the SF Bay Area are just full of such patients, right? I think that's an item of medical mythology perpetuated by PTs and healthcare professionals to scare patients. Maybe I'm wrong, but it sure would be nice to have some solid statistics for the number of back pain patients who are bed-bound for life. Much more likely, such patients go through recurring cycles of pain after an initial back pain attack that keeps them fearful of doing something that will stir up the lower lumbar pain and sciatica again. Of course, Dr. Sarno would say this is part of the mind's strategy to keep you preoccupied with your physical symptoms so that you don't have to pay attention to unpleasant emotions repressed deep in your unconscious mind.

After completing the Structured Program a couple months back, my lower back pain and sciatica have gone down so much that I no longer limp from my car in the parking lot to the door of my gym. Also, I've gone from riding my bike with a leg that wobbled like a wet noodle to a much more normal pedal stroke (and it keeps getting better). I started getting better three years ago after reading Sarno, but it took a bunch of psychological exercises to go deep and get at the underlying emotional causes behind my back pain and sciatica. When I started out there were tingles in my feet and I couldn't even sit on a hard bench. It does seem like acquiring knowledge about the real cause of back pain does short-circuit the process I'm glad to say. Just takes a bunch of work!

 

[tezzasponger]

MorCommon thanks for your story. I have never seen anyone with complete paralysis who had a bulging disc. Let me tell you about some cases I have come across personally. I recall when I was student a patient who had a back problem, he had PT to start with which did not help. He went away on holiday whilst picking up his suit case to come back his back went into pain, then he could not walk. He arrived back in the UK went straight to hospital and was operated on immediately. The following day I assessed him and muscle power was all good. He managed to get up after a few days bt was walking around gingerly. Another time was a guy who was doing pyramids with his work colleagues (he was on the bottom and they went on top of him), he also had a few drinks, the next day he woke up sweating and could not walk. He went to ER Diagnosed with a severe hearted disc and had emergency surgery. He managed to walk but it was a struggle for a while. He did eventually manage to run a few times later on whilst having rehab. Before I read Dr Sarnos book I thought a lot about these cases especially the latter, cause one it scared me but also it did not make sense. I just could not get my head around how his disc just gone just from people being on top of him. It would be like having a heavy bag on your back. The bio mechanics of the back did not go with what happened. But once coming across Sarnos book then made me think these two characters must of had a lot of serious issues in their mind for them to be attacked this severely.

You mentioned that paralysis issue about it being a myth, unfortunately with medicine it goes on evidence, which I do find a hit and miss. The problem is we are trained to believe that a disc bulge has caused paralysis because evidence has said so. It just goes on whats written on the papers which have been criticted by numerous medical professionals. Then this gets past on to medical schools, universities and carries on. One thing I did notice (not so much where I am now) that health professionals are becoming more aware of the the mind body relations. I noticed this when my lectures would tell my fellow colleagues who they were treating especially the ones with recurrent back pain, even my physio during my time at uni would tell me about it. Unfortunately I did not know what he meant and I never took it on board. A far as I was concerned what I had been taught was black and white.

Thanks to Dr Sarno books and his TMS my way of thinking has changed. However, as mentioned in my previous posts there is always that niggle in my mind about the hernaited disc and the so called serious outcomes of what it can do. I just have to train my mind over and over and over just like pavlov did with the dogs. But I will get there with determination and perseverance.

 

[BruceMC]

Tezza, from reading Sarno, I too would suspect that both the episodes you describe functioned more like psychological "triggers" for those back patients you encountered. Stress had built up for a long, long time, then something as minor as picking up a suit case "triggered" back spasms. Sure, there was probably a herniated or bulging disk involved, but, as Sarno suggests, the unconscious mind probably located TMS pain at those sites. I talked to a doctor, for example, who as he was about to fly to Vietnam and enter combat in 1969, suddenly came down with back spasms. The Army doctors ordered immediate back surgery for a "bulging disk", but it didn't solve his pain problems. Wonder why? I would opine that the doctor was scared to death about going into combat and developed back pain to distract him from his fear, which he must have been trying to repress because he probably didn't want to be labeled a "chicken". But the pain never went away and now 40 years later he is still going into PT. I notice too that when I had a back pain relapse a few years ago in 2007-2008, it occurred after I took a fall on my butt out running on the game preserve near my house. Tripped on a root, flew through the air, and landed on my left side, the same side I'd had a herniated disk back in 2001. Of course, I figured I'd "hurt" the old injury site and that was why the pain and weakness in my left leg came back. However, now I realize that in 2007-2008 I had just finished a book that had been absorbing all my energy 24 hours a day and night for way over a year. At this same time I was also trying to court a trophy ballet dancer GF in San Francisco (no doubt pleasing my deceased macho father) and had just suffered a romantic rebuff. The odd thing that argues against a structural diagnosis is that after I fell, I got up, dusted myself off, and ran in a mile and half back to my car without any pain whatsoever. If I'd chipped a bone or ruptured a disk, that would certainly not have been possible. It was only a few days later out hiking that I felt a single sting in my sciatic nerve that then began to multiply over the course of the next 6 weeks until I couldn't stand or walk. Then, it gradually subsided until the day after I received a dear John letter from the ballet dancer's choreographer telling me I'd been a complete idiot and to get lost. The very next morning, just sitting on a bar stool in my breakfast nook, I suddenly developed totally debilitating back spasms, which were so bad I couldn't sit or walk. Well, you fill in the blanks: my fall and impact at the old injury site merely "triggered" TMS pain in my left hip, lower lumbar region and left leg. I think Steve Ozanich describes this TMS scenario as "Calm After the Storm": my work on the book and my obsessive relationship with the ballet dancer had absorbed all my self-imposed perfectionist traits and provided an outlet too for my inner "rage". When the book was completed and the ballet dancer gave me the boot, I was left holding the bag with nothing to do with my inner turmoil, which manifested as totally distracting TMS pain.

I notice something similar that happened too when I developed a so-called herniated disk following the death of my mother in January 2001. For five years, from the time both my parents collapsed, I'd been totally involved caring for her (she had dementia): working two demanding jobs, publishing books, going to ER with mother almost on a weekly basis, caring for my parents' house, managing my father's wrongful death law suit - tons of no fun responsibilities. Then, about 6 months after my mother died, when I inherited her house incidentally, I was struck down with a massive back attack after running. Again, the "Calm After the Storm". Obviously, caring for my mother and working myself to death had distracted me from my inner rage: I'm willing to bet a dollar to a donut that being good for so long didn't sit too well with my inner child, who was used to being selfish and having fun. Bet I was really, really mad inside about all that my late parents had put me through. As Dr. Sarno observes, the id and its desires aren't necessarily very "nice". My mother's death got rid of all my responsibilities and the inner rage started to come out, and that's the point where my back pain manifested.

We're all so used to looking for confirmation of structural diagnoses as far as back pain is concerned that we tend to overlook the obvious underlying psychological reasons for it. I bet picking up a suit case and participating in a pyramid party at work were only "triggers". If you asked those patients a few questions about their personal histories before the onset of symptoms, I would think you'd uncover a very different explanation for their back problems.

 

[Forest]

I just could not get my head around how his disc just gone just from people being on top of him. It would be like having a heavy bag on your back. The bio mechanics of the back did not go with what happened.

This is such a clear sign of TMS and of how our unconscious will try to find any reason to explain our symptoms, even if, as you mentioned, the bio mechanics just don't make sense. This may be going a bit far, but I wonder if the person at the bottom of the pryamid felt he was doing his co-worker's work. Then when he was at the bottom of the pyramid and actually carrying his co-workers, this thought began to emerge so his unconscious had to create pain to distract him. This is probably reading too much into it, but the unconscoious can be really tricky and I wouldn't be surprised if this wasn't too far from the truth.

We're all so used to looking for confirmation of structural diagnoses as far as back pain is concerned that we tend to overlook the obvious underlying psychological reasons for it

This is why making lists is so important. If we just spend a few minutes each day honestly looking into the psychological reasons for our symptoms we will be able to identify pretty much all of the stresses, past and present, that our behind our symptoms. The supposed structural reasons we use to explain our symptoms are sometimes so extreme that it won't take long for us to accept that these psychological reasons are actually behind our symptoms.

As always knowledge is the key