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Alan G. What percentage of back pain is TMS?

Discussion in 'Ask a TMS Therapist' started by javierjaq, Sep 6, 2014.

  1. javierjaq

    javierjaq New Member

    This question was submitted via our Ask a TMS Therapist program. To submit your question, click here.

    In your "opinion", what percentage of ALL people who suffer from back pain would get diagnosed with TMS? What exactly is involved PHYSICALLY in a diagnosis? Thanks:)
  2. Alan Gordon LCSW

    Alan Gordon LCSW TMS Therapist

    Good question, Javier. Different TMS physicians would probably give different responses. Of the TMS docs I work with, some are more conservative in their diagnosis of back pain as TMS (I'm guessing around 70%-80%), and some are less conservative (90% +). I've had several clients who have flown around the country visiting multiple TMS physicians, hoping to get a consensus.

    The trifecta of Schechter/Schubiner/Rashbaum seems to be a popular one for clients with unlimited frequent flier mileage.

    I've been referred some clients where I was told by the TMS doc, "I think it's partially TMS, but may be partially structural as well," but their pain ended up going away, so clearly it was all TMS.

    It's not an exact science, but if you're lucky enough to see a TMS physician and you get the TMS diagnosis, it's a pretty safe bet that that's what you have.

    The examination differs between TMS physicians as well. Some check for the tender points on the back that Dr. Sarno references in his book. Most if not all of them will conduct a standard back exam to determine if the physical symptoms match the MRI findings (assuming the patient has an MRI). Finally an inventory of psychological stress is taken, to help determine if there was a psychological trigger for the pain, and whether the client has traits often found in TMS patients.


    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.

    Forest likes this.
  3. Steve Ozanich

    Steve Ozanich TMS Consultant

    That's a good question. The question is, what % are diagnosed with TMS, not what % actually have it.

    Since the TMS docs don't all talk to each other, and Dr. Sarno was so protective of his patients, it's impossible to know. But I'll take a guess and say that 80% of the back pain sufferers get diagnosed with TMS, but that 99.9% of them actually have TMS. In my experience 2 people were diagnosed with TMS by 2 different TMS docs as having a real structural spinal problem, but they had TMS and healed nicely.

    So the rule of thumb is to error on the side of caution, which makes professional sense. The TMS docs are brave men and "woman." They stick their necks out every day to go against the status quo to say, "no...this is not physical...this is emotional." That takes great courage. If they're wrong they face hellfire all around.

    But of course the bigger source of confusion will always be generated in the person's beliefs. This is most evident in the placebo trials, whether in the shoulder, knee, or even the vertebroplasty fiasco. Those people who have had "successful" back surgery could simply be responding to their deeper belief that it actually worked, and may have never needed it. We may never know, but for certain, all the new evidence is pointing toward the fact that surgery isn't doing anything. But, of course there will be rare times when the structure many need repaired, odd things do happen. But I would hazard a guess to say that there are still many folks being operated on that have TMS.

    Dr. Hoffman has an interesting response when the person wants the TMS diagnosis. He's replied, "what difference does it make if I give it to you?...you're still the one that has to decide if you have TMS or not." Good point, only the person can ultimately decide if they have TMS, the physician can only clear you of existing potential dangers. YOU are the one and only one that can decide if you have TMS.

    You certainly can't have both TMS and a structural problem, Dr. Sarno would go ballistic if he heard that.
    nowtimecoach and North Star like this.
  4. North Star

    North Star Beloved Grand Eagle

    Your comment on the trifecta/frequent flier miles cracked me up, Alan. :D

    And as always, good to hear from you SteveO.
    nowtimecoach likes this.
  5. Steve Ozanich

    Steve Ozanich TMS Consultant

    Hey, I just had a message pop-up that I was awarded an "I Love It" trophy from the Wiki. What is it? Can I take the cash in lieu of award? Can I bring a date to the red carpet ceremony? Does any know of any dates I can take to a red carpet ceremony? I'm gonna have to buy a new suit, or at least put on some pants.

    It's important to understand that it doesn't matter what the doctor tells you, it only matters what you believe. Of course, it's important to see a doctor so that she or he can let you know if you have something that's terribly out-of-balance and needs medical intervention, in order to protect your life. Always protect your life first.

    But beyond medical clearance and the advice from an experienced and trained physician, the only thing that truly matters in healing is your deeper belief. Some people get the TMS diagnosis and don't believe it, so they struggle in pain. Others get a diagnosis that they have a structural problem, and they don't believe it, and they heal nicely with TMS-healing.

    Others, have nothing wrong with them but get a horrifying diagnosis from their doctor and they rapidly get worse, because they believed their doctor. Why wait for someone else to tell you that you can heal? Take charge of your own life. You have more power to heal than you realize. We've bought into the notion that we're helpless victims of our body. Our body is only taking orders from our thoughts (the signals we send it). Change your perception, and begin to see inward for the answers.

    Belief is the key to healing, but also to life. Beliefs are the primary indicators of our outcomes. But remember that these are unconscious beliefs. Believing something at the conscious level has little meaning. The "entire" person must believe two-gether. Unite a divided mind.

    That's what I believe.

  6. Alan Gordon LCSW

    Alan Gordon LCSW TMS Therapist

    Amazing, I just got that same trophy last week. My left brain said, "Who cares, this is just a gimmick." My right brain said, "I win!!!!!!!!!!!!"

    Trophies are the best.

    I agree with Steve, in many cases I send people to a TMS physician more as a psychological intervention than a physical one.

    North Star, nowtimecoach and Forest like this.
  7. Steve Ozanich

    Steve Ozanich TMS Consultant

    When I one this well-deserved lifetime achievement award today, my left brain said, "How am I going to thank all the people who made it possible?" My right brain said, "I wonder if it's shiny?"

  8. nowtimecoach

    nowtimecoach Well known member

    Nothing like great senses of humor to help any painful dilemmas! Thanks Alan and Steve!
    "But beyond medical clearance and the advice from an experienced and trained physician, the only thing that truly matters in healing is your deeper belief."
    This by far has been the most important piece of my healing journey. I think it relates to everything - how do I believe - what do I believe? Do I believe the lies that TMS throws at me... "Your back hurts because you're sleeping on a hard surface." Ummm no if I believe that the pain has an emotional component - I look a little deeper and say "Nah, I think I have back pain because I'm irritated and angry that I'm sleeping outside instead of inside the new camper van... and that I may be resentful and angry with myself because I may have made a bad purchase.":( And because I didn't have anyone to distract me from my angry thoughts or energy, my TMS decides to visit and distract me. Funny how when my friends showed up and I got engaged with conversation and hiking, the TMS went away.:rolleyes:
    But if I had any shred of belief that the TMS pain was structural, I would have been running to the advil, which doesn't even work anymore or wanting to go home and get treated by some chiropractor, massage therapist, acupuncturist, etc. But instead I believed that I was being distracted and sat with the feelings = let myself be distracted by fun and friends and wa=la the episode ended. The TMS lost. YEAH!!!
    Eric "Herbie" Watson likes this.
  9. Steve Ozanich

    Steve Ozanich TMS Consultant

    Hi Nowtime, it was a great pleasure talking to you a few months back, you're a great lady. I hope you're doing well.

    You nailed it here. When I do consults I always tell people to "shift their awareness." The only way to heal is to get the mind's eye off the body. "As long as he is preoccupied with what his body is doing, his symptoms will continue." The good doctor, HBP/MBP. But folks don't seem to get it. Many spend all day thinking about what their body is doing. I did it too.

    There are good ways to shift awareness. One is through a daily secondary transparent act, another way is through finding a deep passion/purpose that is more important to you than you, and another way is to talk to friends and family.

    I remember when my back pain shifted to my ankle and I was on crutches for SI-ankle pain. My ankle swelled as it always did when tension shifted (never let anyone tell you that there's no swelling with TMS, there is, it's common). I was in so much ankle pain that I couldn't even think. my head was spinning with deep pain. One day, some folks came over to visit me. I began to talk to them and I suddenly noticed that my ankle pain was gone. I had shifted my awareness away from body and onto something else and my pain disappeared. I knew then that paying too much at-"tension" was what fed the beast.

    Starve the beast by taking away it's sustenance.
  10. Tennis Tom

    Tennis Tom Beloved Grand Eagle

    I went to a TMS doctor, he took x-rays and I was dismayed and shocked to the hip-bone when he pronounced that I had "significant arthiritis" of the hip--"arthritis" is so mundane--periformis syndrome, IT band disfunction, or trocanteric bursitis sound so much hipper. I went back a second time to the same doc a while later because--I can't remember why because--and he told me it was both TMS and, arthritis. That's when I came up with: "TMS is the volume control for the pain".

    I traveled 'cross state to another TMS doctor, who looked at my x-rays and perfunctorily said I had arthritis and to get a hip replacement "sooner then later"--I cried in my car in the LA rain afterwards in a pleasant Beverly Hills alley afterwards. That was 10 to 15 years ago--it's been later--I've been stuck and hobbling ever since--but I have a big serve and playing doubles I can cover my half of the court if my partner can cover there's.

    This thread has a lot of humor in it, but my right hip doesn't seem to want to share in the laughter--my asshole of a hip or there abouts.
    Last edited: Sep 12, 2014
    North Star likes this.
  11. Walt Oleksy (RIP 2021)

    Walt Oleksy (RIP 2021) Beloved Grand Eagle

    Tennis, your big serve and playing doubles is proof that you don't need a hip replacement.
    That's become one of the "medical flavors" of the month, along with dentists who suggest root canals.
    I have friends who got root canals and think they did it because it is currently in fashion.
    North Star and Tennis Tom like this.
  12. njoy

    njoy aka Bugsy

    SteveO, I think you just made Comedian of the Year, as well.
    Forest and North Star like this.
  13. javierjaq

    javierjaq New Member

    Thanks so much for the replies all!

    So Steve Ozanich, in essence, one does not need a diagnoses for TMS?

    Most important is to accept and believe?
  14. Steve Ozanich

    Steve Ozanich TMS Consultant

    JavierJaq, you do not need a TMS diagnosis to heal. I never had one, and the majority of people who heal have never had one. There aren't enough doctors out there that even know about TMS to be giving the diagnosis.

    The important thing is to see a doctor to check for potentially dangerous signs. I was doing a show last year and the guy on before me was Rocky Bleier, the former Pittsburgh Steeler. He was promoting his book too, where had back pain and found out he had cancer. He's ok now as far as I know, but I had to go on that show and be very careful with my words explaining TMS. Early on I also ran into a guy that had an aneurism in his spine causing his back pain. So, these things need to be ruled out by general medical exam, and imaging.

    As far as the TMS diagnosis, it's only for the patient. Dr. Sarno knew most of the time that the person had TMS before he examined them. He did the exams because the patient wanted it, to make them happy. It built up their confidence.

    So it comes down to the person. He needs to look at his imaging reports, his personality, his current life events, etc. and come to his own conclusion. The TMS diagnosis often speeds up healing because it adds to the person's confidence. But there are some that get the diagnosis and still don't accept it. So it all comes down to the person accepting, and believing that his body is ok.

    One of the problems I see in healing, is that people wait for others to tell them they can heal. I decided on my own that nothing was going to stop me from healing. The reverse is also true in memetic-infection. People fall prey to the symptoms that are currently around them, which defines their reality. But when people are in deep need they latch onto anything to survive.

    One of the things Dr. Sarno regretted was telling people that healing occurred in 2-6 weeks. He didn't realize how many people were then going to use that time-frame to define their own healing reality.

    We shouldn't let others choose our lives for us. But then again, we're all being influenced daily by those around us. Their actions give us permission. To do, or not to do, that is the question.
    Forest, Seraphina and njoy like this.
  15. javierjaq

    javierjaq New Member

    Thank you Steve. Appreciate your time along with the others in the forum. I appreciate the patience you all have. I am seeing myself as "another guy here who is again stuck on the acceptance stage". But you all are very supportive. Gracias :)
  16. bnunofield

    bnunofield New Member

    Hello Alan, I Did go to doctor Schechter on September 16th and a good physical and after reviewing all the medical records, he did diagnose me with TMS. He followed Dr. Sarno and I had the points where there as pressure points and pain. I did know prior to going that's what I was dealing with TMS. Now I have some work ahead of me. Thank for the referral to Mr. Bloom I like him. I thank you so much for calling me. I really appreciate it and I am going to continue to reading your posts and watching your videos . Hi everyone

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