Worsening of back pain symptoms — regardless of TMS work

[HelloKitty!]

Hello everyone,

My name is Paul, I’m 27, and I’ve been struggling with what I believe is TMS for about six years.

It initially started as occasional back pain during a period of severe anxiety. However, the pain was intermittent and only became chronic about two years ago, when my anxiety had largely subsided. I primarily experience pain in my lower back, on either side of the spine, and occasionally in my upper back.

At the time, I knew nothing about TMS. An MRI showed a disc protrusion and some disc space narrowing in my lumbar spine. However, most of my pain was muscular, and at least one orthopaedic surgeon diagnosed me with myofascial pain syndrome due to numerous trigger points in my lower and upper back. I tried physiotherapy, manual therapy, strengthening exercises, stretching, and mobility work, but none provided lasting relief.

About a year and a half ago, I discovered TMS and started applying the mind-body approach changing my perception of pain, strengthening my belief in diagnosis, doing journaling, practicing meditation (even before it was big part of my life), focusing on achieving my goals and following my values in life.

I’ve experienced considerable improvements since then. My occasional knee pain has disappeared, my headaches have almost completely resolved, and several other minor pain issues have also subsided. For example, when I developed sudden ankle pain without any apparent injury, I simply acknowledged it, continued my activities, and didn’t give it much attention. It eventually disappeared.

Unfortunately, my back pain has remained persistent.

Interestingly, around the time my back pain started improving, my anxiety returned. I recently began working with a therapist, and as my anxiety started decreasing again, my back pain became significantly worse.

Previously, I generally didn’t react to occasional pain, continued exercising and living normally, and reminded myself that it was likely TMS. The symptoms would usually subside gradually, sometimes within days and sometimes over several weeks. I would also like to mention that even while having anxiety I had periods of back pain, but it was not so intense and persistent.

However, about two weeks ago, around the time when my anxiety started subsiding, alongside my usual lower back pain, I started experiencing more persistent pain in my buttock and hamstring, accompanied by tingling in my left foot. The upper back pain became more severe as well.

I visited a physiotherapist who checked my reflexes and found them normal. An X-ray also showed no further disc space narrowing compared with my MRI from two years ago. The doctor said that my case is very mild despite me being in severe pain.

Nevertheless, these new symptoms have made me anxious and uncertain about how to approach the situation.

What if this is actually a structural problem, such as lumbar radiculopathy or sciatica, rather than TMS? Should I modify my lifestyle or avoid certain exercises, particularly weightlifting that I have been doing, or should I continue my usual activities and approach these symptoms as part of the mind-body process?

Thank you for sharing your experiences and insights!

 

[Cactusflower]

Siatica = TMS and disc problems are common, most people don’t have the type of pain that distracts them from usual activities or creates a distracting fear or obsession. Self-education is part of understanding TMS.
A huge part of TMS is how our physical body holds stress, habits we learn can also contribute: how we brace, and hold ourselves tightly;, mentally, emotionally, spiritually and physically.
Pain is also commonly increased as we begin to delve into the things that we brace against. It’s often why people begin to utilize somatic practices: meditation, somatic tracking, breathwork, yoga, nature, and other forms “being” - learning to be still without doing anything, without judgement or effort and paying attention to their bodies - taking a break from living in their head for a few moments.
I have also not had a straight path to healing, it comes and goes but as I learn to react less to sensations and allow them to be present with less headspace, they seem to take up less headspace and I don’t notice them so much.

 

[Adam Coloretti (coach)]

What if this is actually a structural problem, such as lumbar radiculopathy or sciatica, rather than TMS? Should I modify my lifestyle or avoid certain exercises, particularly weightlifting that I have been doing, or should I continue my usual activities and approach these symptoms as part of the mind-body process?

It sounds as if your neurological exam is normal and your findings aren't correlating to your symptoms, so I wouldn't necessarily assume any of this. It's one thing if the specialist is diagnosing you with this (it might still be TMS in that case) but it's another if everyone you've seen isn't really buying it (myofascial pain syndrome is essentially TMS with a fancy label).

The fact that your anxiety switches in a not insignificant way with your back pain is another great piece of evidence. Whilst I cant diagnose you and be sure, you look like a very strong candidate for this being TMS

 

[HelloKitty!]

Siatica = TMS

In some cases I believe yes, especially considering many success stories on this website, but I am not sure that in all of the cases. Let's say MRI showed disc herniation pressing on the nerve and the patient experience pain corresponding to the MRI image

It’s often why people begin to utilize somatic practices: meditation, somatic tracking, breathwork, yoga, nature, and other forms “being” - learning to be still without doing anything, without judgement or effort and paying attention to their bodies - taking a break from living in their head for a few moments.

In general, you could say that I lead a contemplative lifestyle: I practice meditation, keep a journal, do physical exercise, spend time in nature, and so on. And it is deeply upsetting and discouraging to me that, despite applying the principles of TMS a year and a half, and putting in all this effort, I am still in pain, and my symptoms actually seem to be getting worse (at lease according to last two weeks).

It sounds as if your neurological exam is normal and your findings aren't correlating to your symptoms, so I wouldn't necessarily assume any of this. It's one thing if the specialist is diagnosing you with this (it might still be TMS in that case) but it's another if everyone you've seen isn't really buying it (myofascial pain syndrome is essentially TMS with a fancy label).

Yes, the neurological examination is normal, but it is difficult to establish a clear link between the findings and my symptoms. The last doctor I consulted initially attributed my symptoms to a disc protrusion (even though the pain is felt primarily in the muscles). Later, after an X-ray revealed mild scoliosis and a straightening of the natural curvature of the lumbar spine, he shifted the explanation to those findings—even though research does not support a connection between mild scoliosis and back pain. Every doctor I have seen has stated that the MRI results show nothing dangerous, that the condition is treatable, and that physical therapy or manual therapy should help—yet, that has not been the case.
Given that neither physical therapy and exercise nor the TMS approach have led to recovery—though I did notice that when I was fully absorbed in meaningful activities and responded to the pain without fear, continuing with my tasks, the intensity of the pain would decrease—I am at a loss as to what to do next. What would you suggest me to do?