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TMS

Decision_Decisions

Shiny_Rock
Joined
Apr 29, 2016
Messages
257
As a follow up to my comment on @Spring Day's recent thread, I thought I would make a new post to maybe reach more people. (@SparklieBug)

So there are several names for mind-body pain, like MBS (mind body syndrome), TMS (tension myositis syndrome), PPD (psychophysiologic disorder). And @Gabbycat is correct, the pioneer of this line of thinking is Dr. John Sarno, but the neuroscience has evolved so much since he wrote his books in the 90's and 2000's. So while I would encourage reading/listening to his books, the science behind his theories didn't totally resonate with me, and that was Ok. The new data coming out with more advanced neuroscience makes a lot more sense to me personally.

I'm not an expert but I have read and listened to a lot on the topic. I also definitely have TMS (my preferred way to refer to it) myself and have healed my own chronic pain. Just briefly, I had back/hip pain, mild but bothersome from a couple of years. Then I had a really stressful time at work and I developed what I thought was a repetitive strain injury in my wrist. So between both these pains I decided to finally go to PT and learned strengthening exercises for my back/hip, which totally worked...as long as and only if I did the exercises religiously. Then during this time my wrist pain got really bad. Then it started moving around, to my elbow, then to my shoulder. Then, crazily, I started getting a sensation of pressure and numbness in my cheek. This pain absolutely consumed me and became such a huge focus of my life. I sent to specialists, had an MRI, had nerve tests, PT, braces, massage, heat, TENS machine, acupressure, etc. My MRI showed a small bulge and slight stenosis. My nerve test showed mild nerve impingement. I was in my mid/late 30's and just didn't understand how so much was wrong with me and I could have all this pain.

My research led me to Sarno's books which I listened to on audio book, multiple times in a row. And I did more research and found tons of other resources. And then I started working through the methods, most notably the 21 day Pain Recovery program I reference below. One of the biggest things for me was to stop fearing the pain, stop fearing doing certain things, and get my life back. So I got rid of all my ergonomic supports, stopped doing PT and the exercises at home, and stopped limiting my activity over fear of doing more damage. And as crazy as it sounds, within a few months I was 100% pain free. And that was 3.5 years ago.

I am not a neuroscientist so I can't completely understand how the brain works, but basically, for lots of chronic pain, as well as other conditions such as migraines, fibromyalgia, chronic fatigue, it can be learned neural pathways in the brain the cause the pain, not actual structural issues. All pain is actually experienced in our brain, but this is not to say that the pain is "all in your head". It is 100% real pain that we are not making up. But our brains can get stuck in this cycle of fear and preoccupation over the pain, which actually activates the same areas of the brain that experience pain in the first place, which just makes those neural pathways stronger.

This can happen in people with no structural issues at all. Or it can happen in people that had an accident/injury that should be healed and no longer causing trouble. Or it can happen to people that have "normal abnormalities", things like disc bulges/herniations or stenosis that the majority of people actually have whether or not they experience chronic pain.

I will list a variety of resources below that people can use to start learning more about TMS. In my personal experience, the single most important thing to start unraveling neural pathway pain is to believe, at least a little, that it could possibly be what is going on for you. If your pain is not 100% constant, it may be neural pathway pain. If it comes and goes and there are times when you forget about it because you are enjoying yourself or otherwise deeply engaged in something, it could be neural pathway pain. If it moves around and is not always in the same place, or flares up when you're stressed, it could be neural pathway pain. And people that develop neural pathway pain can have some personality traits in common, like being hard on yourself, perfectionism, and being hyper vigilant. It can also be associated with trauma, although that is not necessary and was not the case for me.

I share this because learning this literally changed my life and broke me out of a scary cycle that was starting to consume me. I can completely understand that people reading this can easily dismiss it. It is so hard to accept that something that has consumed you, stolen joy from your life, and cost you a ton of money, could be within your control to change. And when pain is really bad, it becomes such a part of your life that it is almost hard to imagine who you are without it. I understand all of these things 100%. But I am so passionate about this that I just have to put it out there even if it only helps one person learn a little bit more.

So with that, here are some resources:

Books (there are surely tons, but I didn't need to read too many)
- Dr. John Sarno's books on Back Pain
- Dr. Howard Schubiner's books - "Unlearn your Pain" , and also "Unlearn your Anxiety and Depression"

Websites
- TMS Wiki (The TMS Wiki) - this in an absolutely amazing resource with an incredible helpful forum (like this one!) to get you started on all things TMS
- Unlearn Your Pain home (unlearnyourpain.com)

Podcasts
- Tell Me About Your Pain (by Alan Gordon of the Pain Psychology Center)
- Like Mind Like Body (affiliated with Curable)

Apps/Programs
- 21 Day Pain Recovery Program (Pain Recovery Program | TMS Forum (The Mindbody Syndrome) (tmswiki.org)) - this is what I did that worked for me personally
- Curable (paid subscription but minimal for an entire year)

Professional Help
- The Pain Psychology Center (http://www.painpsychologycenter.com) (if you've got $$ - they don't take insurance)


Currently I am pain free but I am experiencing unpleasant physical symptoms of anxiety that are also part of TMS. So in the coming months I am planning to work through Dr. Schubiner's Unlearn your Anxiety and Depression book and also may try the Curable app.

If anyone is curious about this I would love to see this thread used as a sounding board for people to help each other. And my sincerest well wishes to anyone that may be on this journey.
 

SparklieBug

Shiny_Rock
Joined
Feb 23, 2013
Messages
378
Fantastic information, @Decision_Decisions! Thank you so much! I will copy and send this info to my family members and do some reading for myself, simply out of curiosity to understand more.

I firmly believe (from observing family/friends with pain) in the neural pathways concept! I think neural pathways also get created for things like habits/patterns of behaviour, as well. Our brain and the subconscious are so fascinating in how they can override or undermine our logical mind.
 

House Cat

Ideal_Rock
Premium
Joined
Feb 22, 2009
Messages
4,465
For the mental disorder of PPD, this treatment makes sense.
 

meely

Brilliant_Rock
Premium
Joined
Jan 2, 2014
Messages
1,657
This looks really interesting, I’ve scanned through but will be coming back later to read your post more thoroughly, thank you Decisions
 

House Cat

Ideal_Rock
Premium
Joined
Feb 22, 2009
Messages
4,465
Just confused if you're referring to postpartum depression in your post? I just want to clarify that when I say PPD above I mean psychophysiologic disorder, not postpartum depression.

I’m talking about psychophysiologic disorder. This is something that should be diagnosed by a mental health professional. The treatments you refer to are for this mental disorder, not for pain caused by actual physical and degenerative issues. This is why I said your recommendations are good for the mental disorder.
 

Decision_Decisions

Shiny_Rock
Joined
Apr 29, 2016
Messages
257
I’m talking about psychophysiologic disorder. This is something that should be diagnosed by a mental health professional. The treatments you refer to are for this mental disorder, not for pain caused by actual physical and degenerative issues. This is why I said your recommendations are good for the mental disorder.

I'm glad we're talking about the same thing! I'm not sure if you're a clinician so I don't want to step on any toes if so.

From my research and also personal experience, having TMS/PPD does not necessarily mean that there could not be some structural "abnormalities", or a history of accident/injury. As I said, my own MRI and nerve tests did show some issues. They just were not at the root of my pain. So I don't want anyone reading this to think, "well, my MRI showed X so this can't be what's happening to me".

Additionally, there are MD physicians that will diagnosis this. As well as mental health professionals. It's my understanding that many clinicians were never trained in mind body theory. If your chronic pain is long standing and you do have structural issues, but these theories still resonate with you, it makes sense to try to be seen by a physician trained in this who can go over your files/imaging and give you a second opinion. The TMS wiki lists many different clinicians:


And not to advocate that people go rogue or ignore medical advice, but my TMS was never diagnosed. It's just that as I learned more I realized this is what was happening with me. And I made my own changes and gained additional knowledge which led to my recovery.
 
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