Sorry if this is a newbie question or in the wrong place. I've recently discovered TMS and read Sarno's books. I've had bad back pain for over a decade now. I know that I'm supposed to get an appointment with a doctor to rule out a serious physical issue, but there's something I don't understand. Let's say I go to a doctor and get an MRI and he says that I have bulging discs, herniations, bone spurs, etc, and then advises surgery. Given that we know those things don't necessarily lead to pain, how am I to know if they are really the source of my problems instead of it being psychogenic? Ideally I would go to a doctor that has a deep understanding about TMS, but there are only psychologists on the "Find a TMS Doctor" list for my state. Any advice is greatly appreciated.
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Worried about knowing what to do with a Dr. diagnosis
Lavender
Well known member
I am in agreement with your dilemma because if one takes the advice for surgery and the pain continues afterwards, the doctors can say that it is the neuropathway of chronic pain from the brain that is firing and has been exacerbated by the pain of the actual surgery. One physicians on the forum will not operate until the nervous system had been calmed down through other means. ( Sorry to say they haven’t worked for me however.)
Good luck and welcome to the forum.
Good luck and welcome to the forum.
MindBodyPT
Beloved Grand Eagle
Hi Dark,
Welcome to the forums! It's a tough spot to be in for sure. Any good TMS doc will tell you that like 99% of things that come up on spinal imaging don't cause chronic pain. There are a few exceptions of course (tumors, infections), but most of us will never have them. If you get ambiguous results i'd highly recommend making the trip to a TMS doctor for peace of mind. Even if it's a long trip out of state it might give you the reassurance you need to avoid surgery.
That being said, everyone's line with this is different. As a healthcare professional myself I was confident enough in my TMS diagnosis I never needed a TMS doctor to confirm what I already knew (and I did get an MRI showing herniated discs). For others though, the TMS diagnosis from a doctor is worth a million bucks. Good luck!
Welcome to the forums! It's a tough spot to be in for sure. Any good TMS doc will tell you that like 99% of things that come up on spinal imaging don't cause chronic pain. There are a few exceptions of course (tumors, infections), but most of us will never have them. If you get ambiguous results i'd highly recommend making the trip to a TMS doctor for peace of mind. Even if it's a long trip out of state it might give you the reassurance you need to avoid surgery.
That being said, everyone's line with this is different. As a healthcare professional myself I was confident enough in my TMS diagnosis I never needed a TMS doctor to confirm what I already knew (and I did get an MRI showing herniated discs). For others though, the TMS diagnosis from a doctor is worth a million bucks. Good luck!
Thanks MindBodyPT! Its almost like people should be warned against seeing a regular doctor because they will usually find something and recommend surgery, and then the patient would have to go against a trained professional's opinion. The whole point of seeing a regular doctor first seems to be to give you peace of mind that there is no "damage" to your body, yet a regular doctor will fill your head with worry about what is on the MRI.
Do you think it would be good to go to one of the "TMS educated" psychologists that are near me first? Can a psychologist rule out one of those rare physical issues?
Do you think it would be good to go to one of the "TMS educated" psychologists that are near me first? Can a psychologist rule out one of those rare physical issues?
MindBodyPT
Beloved Grand Eagle
Yes the current medical system definitely has major issues! It can be very hazardous as many things that in reality are "normal abnormalities" have been pathologized in recent decades. TMS work hopes to shift medicine away from this viewpoint over time.
The psychologist cannot make a medical diagnosis. They could reiterate what Sarno and other TMS docs say in their books but they won't really be able to comment on an MRI. Many TMS therapists consult with a TMS doctor for this reason. As a PT, I also cannot formally make a medical diagnosis but I have told patients before that there is nothing remarkable on their MRIs from a TMS standpoint and given them the information on TMS that I have. Almost any herniated or bulged disc, stenosis, arthritis or spondylolisthesis (among others) will be considered a normal abnormality by TMS theory. Many people on here have had imaging showing all of the above and have no pain or other symptoms. A tumor, infection or new fracture would be extremely obvious on imaging and your doctor would have an appropriate treatment plan, and would also come with other symptoms.
Also remember that back pain for a decade is considered chronic pain...it is HIGHLY likely this is TMS as almost all chronic pain is TMS in the absence of other serious pathology . You'd certainly have other symptoms if you had something like a tumor or fracture or something more serious! I truly believe that all chronic pain in the absence of these serious/rare conditions is TMS.
So do what feels comfortable to you, you could always go to a general practitioner if needed instead of an orthopedic doc (who is WAY more likely to recommend surgery). Or if you feel confident enough in your TMS diagnosis given the duration of your pain you could proceed with TMS methods.
The psychologist cannot make a medical diagnosis. They could reiterate what Sarno and other TMS docs say in their books but they won't really be able to comment on an MRI. Many TMS therapists consult with a TMS doctor for this reason. As a PT, I also cannot formally make a medical diagnosis but I have told patients before that there is nothing remarkable on their MRIs from a TMS standpoint and given them the information on TMS that I have. Almost any herniated or bulged disc, stenosis, arthritis or spondylolisthesis (among others) will be considered a normal abnormality by TMS theory. Many people on here have had imaging showing all of the above and have no pain or other symptoms. A tumor, infection or new fracture would be extremely obvious on imaging and your doctor would have an appropriate treatment plan, and would also come with other symptoms.
Also remember that back pain for a decade is considered chronic pain...it is HIGHLY likely this is TMS as almost all chronic pain is TMS in the absence of other serious pathology . You'd certainly have other symptoms if you had something like a tumor or fracture or something more serious! I truly believe that all chronic pain in the absence of these serious/rare conditions is TMS.
So do what feels comfortable to you, you could always go to a general practitioner if needed instead of an orthopedic doc (who is WAY more likely to recommend surgery). Or if you feel confident enough in your TMS diagnosis given the duration of your pain you could proceed with TMS methods.
fern
Well known member
I am still learning, too, but here's what I'm working on. First, I think it always helps to talk to a doctor and get tests, no matter how much or little they know about TMS. Even if they recommend a treatment that you're hesitant to try. Even if it takes more than one visit to get all the tests done and rule out anything truly dangerous. Hearing that it's not cancer or a broken back or whatever is the important thing. What you do with the diagnosis you get is up to you.
Unless your doctor (whom I think you should always see) tells you there is something dangerously wrong with you and that you must have a particular treatment RIGHT NOW or risk serious damage/illness, there is plenty of time to explore your healing options. In the Pain Recovery Program on this site, we learn that most people don't buy into the possibility of TMS 100% from the start. The bits of evidence we gather in the process of reframing our relationship with pain help strengthen the case that it's TMS over time, which enhances our ability to reframe our pain, and on and on in a positive feedback loop. I don't think you have to 100% say "The bulging disc isn't the issue," right from the start. You can say something more like, "I know I have a bulging disc and my doctor recommends surgery, but I want to spend the next few months (or year or however long) approaching it from a TMS perspective and see what happens." And then throw yourself wholeheartedly into TMS work in spite of whatever doubt you may have, for as long as you're comfortable waiting. Again, unless your doctor says you are truly about to injure or harm yourself if you don't act NOW, you have time to take a TMS approach *even if* there is still something niggling in the back of your mind wondering if it might be the disc causing you pain.
Does that make sense? It doesn't have to be all-or-nothing right away. You can accept that the bulging disc (or whatever) could conceivably be the cause of your pain while also taking time to gather evidence for TMS, build a case, and start reframing your pain and see what happens. You could even change your mind a year later and decide you want to revisit your doctor's diagnosis because the TMS approach is proving unsatisfactory. Or, ideally, the slow dance of evidence-gathering, reframing your pain, and listening to the subtle feelings/worldviews/fears that dwell in you right under the surface will prove to be life-changing and healing.
It's not necessarily ignoring the doctor to get a diagnosis and decide to wait before you try any conventional treatment. Unless you're given a dire warning, there is time for ambiguity, experimentation, and a slow dance toward healing. And if it turns out it wasn't TMS, you haven't harmed yourself by trying that approach - in the end, if nothing else, your self-understanding and approach to pain in general will be transformed for the better, even if your back isn't healed.
I know some people prefer a more black-and-white approach, but I like standing back and watching all of the possibilities ebb and flow and talk to each other until clarity arrives. Hope something in here was helpful!
Unless your doctor (whom I think you should always see) tells you there is something dangerously wrong with you and that you must have a particular treatment RIGHT NOW or risk serious damage/illness, there is plenty of time to explore your healing options. In the Pain Recovery Program on this site, we learn that most people don't buy into the possibility of TMS 100% from the start. The bits of evidence we gather in the process of reframing our relationship with pain help strengthen the case that it's TMS over time, which enhances our ability to reframe our pain, and on and on in a positive feedback loop. I don't think you have to 100% say "The bulging disc isn't the issue," right from the start. You can say something more like, "I know I have a bulging disc and my doctor recommends surgery, but I want to spend the next few months (or year or however long) approaching it from a TMS perspective and see what happens." And then throw yourself wholeheartedly into TMS work in spite of whatever doubt you may have, for as long as you're comfortable waiting. Again, unless your doctor says you are truly about to injure or harm yourself if you don't act NOW, you have time to take a TMS approach *even if* there is still something niggling in the back of your mind wondering if it might be the disc causing you pain.
Does that make sense? It doesn't have to be all-or-nothing right away. You can accept that the bulging disc (or whatever) could conceivably be the cause of your pain while also taking time to gather evidence for TMS, build a case, and start reframing your pain and see what happens. You could even change your mind a year later and decide you want to revisit your doctor's diagnosis because the TMS approach is proving unsatisfactory. Or, ideally, the slow dance of evidence-gathering, reframing your pain, and listening to the subtle feelings/worldviews/fears that dwell in you right under the surface will prove to be life-changing and healing.
It's not necessarily ignoring the doctor to get a diagnosis and decide to wait before you try any conventional treatment. Unless you're given a dire warning, there is time for ambiguity, experimentation, and a slow dance toward healing. And if it turns out it wasn't TMS, you haven't harmed yourself by trying that approach - in the end, if nothing else, your self-understanding and approach to pain in general will be transformed for the better, even if your back isn't healed.
I know some people prefer a more black-and-white approach, but I like standing back and watching all of the possibilities ebb and flow and talk to each other until clarity arrives. Hope something in here was helpful!