I recall about 2 years ago trundling off to see an osteopath due to my lower back and leg pain (sciatica). I was aware of the TMS concept at this time and was quite sure my pain was somatic in nature but to be honest as I was in the grip of health anxiety at this time and because I was somatising a load of other physical symptoms the back pain was more of a back burner concern for me so to speak. I remember saying to the osteopath before she examined me that I was sure my issue was stress, tension, emotional, somatic etc etc in nature but wanted her to give me a check over...of course gave her the full rundown of my pain locations and I probably naively expected her to tell me I was fine and to send me on my way. The examination was the usual thing, bend over and touch toes, measure leg length etc etc. Once she had finished she told me to bend forward again and whilst feeling my hips she seemed to take great pleasure and proudly declaring "yes, you do have a structural issue" she then said she could see that my hip/pelvis was either tilted or twisted and this would be placing a load on my SI joint which was clearly the result of my pain. I tried to challenge her with the usual percentage of people with similar issues who didn't have pain but she countered this in some many then wheeled out the skeleton and indicated exactly how bad my condition was. I recall asking her at the end of the consultation just how bad it could get and she said that she had seen people end up in wheelchairs due to the condition. Cheers, one massive nocebo seed planted right there! So, fast forward to about a year ago and my first consultation with the TMS therapist based here in the UK. He had sent me a questionnaire before the consultation so he had a full picture of my mental history with health anxiety, he knew that my parents had recently died and he knew that my character traits fitted the TMS profile like a glove. When I first met the TMS therapist he explained that he was also a sports physiotherapist who still applied this traditional modality to acute injury/pain but as he had researched a dissertation in chronic pain and also due to discrepancies he was finding with chronic pain diagnosis he now applied a TMS/stress illness modality to most if not all chronic pain presentations. The therapist examined me after I had told him that the osteopath has diagnosed the pelvis and SI joint issues and he clearly stated that my back, hips and SI joint were functioning fine and in good shape for my age. He indicated that whilst he believed it was true that these things could shift to a fine degree it was illogical to think that they could generate pain. He remarked that my range of movement was A1 and that my reflex response was fine. We sat down and talked through what had been going on over the last 3 years or so and he diagnosed me with TMS. So, two different appointments with two radically different opinions and outcomes...one overtly negative whilst the other offering almost a pretty guaranteed 'cure' if I could lose the structural fixation and more importantly I suppose lose the fear. I suppose I'm the same as most people who have been in this situation when everyday it is just like I have the two separate opinions doing battle in my head...on one shoulder I have the osteo screaming 'its structural you dummy' whilst on the other its the TMS therapist shouting 'repudiate the physical' on different days one will often win the battle but overall that nocebo of an opinion that the osteopath planted is totally winning out and controlling everything. I know I was stupid going to the osteopath in the first place as you don't go to the barber if you don't want a haircut but then again I feel I gave the TMS therapist all the evidence up front so I always feel on one level that as he is a TMS therapist well, he would diagnose TMS wouldn't he. Anyway, apologies for waffling on. I suppose what I'm trying to work out is just why the nocebo planted by that osteopath was so powerful. She was quite a young girl and for all I know I could have been the first person she had ever seen and was just itching to diagnose 'someone' with 'something' whilst I respect and trust the TMS therapist (I still see him, he still examines me and says I am A1) its just like the opinion of the osteopath overrides everything and as a result it just feeds into the fear, anxiety and doubt. Just reading this over I can see one thing is clear and that is that the answers do have to come from within. I suppose if you have never learnt to self sooth and comfort in your life once you get too middle age and are so used to trusting people you perceive to have power and the answers it can always lead into this doubt. Thanks for reading.