Acclimatization, Ischemia and TMS

On page 61 of Healing Back Pain, Dr Sarno makes clear that he believes the underlying pathophysiology of TMS is the result of oxygen deprivation in the patient's nerves, tendons and muscles. "This state is known as ischemia, that is, the tissue involved is getting less than its normal complement of blood. This means that there will be less oxygen available for those tissues than they are accustomed to and the result will be symptoms - pain, numbness, tingling and sometimes weakness".

I was wondering if my experience of sleeping at higher altitudes this summer confirms this process of oxygen deprivation causing TMS symptoms or no? Well, each time I've driven up to Tioga Pass and slept at nearly 10,000 ft msl, I've noticed on the first night that my sciatica and lower back pain have increased then gone down as I've acclimatized over the next three nights or so. This occurs when I've been having little or no TMS symptoms down in the SF Bay area at sea level and was feeling fine on the drive up to altitude - no tingling feet, no sciatica in the left leg, no lower lumbar pain or stiffness. Some of my symptoms undoubtedly have to do with the high altitude period, like waking up often during the first night. Feeling restless etc. etc. But I also begin to feel TMS pain in my leg on the left side when I'm sleeping on a foam pad that presses on the IT band. Also, if I exercise vigorously on my first day at altitude, I'll get pain in my leg, knee and back. However, if I do the same exercise after three days of sleeping and living at high altitude, there is no pain. Same goes for walking and hiking. If I start hiking uphill on a steep trail the first day at altitude, my sciatica and lower back pain flare up. Three days later I stride right up the hill without any pain whatsoever.

Each of my five trips to altitude this summer have also coincided with an ongoing reduction in my TMS symptoms, so it seems to me that the acclimatization process (and just getting into better shape perhaps?) has played a part in expanding my range of pain-free motion. Of course, some of my symptoms no doubt have to do with the process of acclimatization to high altitude, but they do seem to confirm Dr Sarno's ischemia hypothesis.

There is also a psychological component to this: Just being outdoors in the High Sierra brings you into a relationship with a beautiful aesthetic experience that overwhelms any tendency a TMSer might have to engage in an obsessive neurotic inner dialog between the inner child and the inner parent. This makes sense too: If you're overwhelmed by the task at hand of climbing a trail up to 12000 ft and looking at huge vistas that sweep away for miles and miles, it's very hard to focus on keeping your repressive emotional dialog intact. Swept away? Blown away? Overwhelmed by the experience of nature?

You can certainly see how British Romantic poets, like Wordsworth and Shelley, felt attracted to the Lake Country and the Swiss Alps as places where they could go to escape England's grimy industrial cities and dream big dreams about reconciling inner and outer states of consciousness. See Marjorie Hope Nicholson, Mountain Gloom and Mountain Glory, for all the scholarly particulars about how in the late 18th century people began to regard nature in a new light.

 

Noticed this same intensification of TMS symptoms when I stayed up at Tioga Pass near 10,000 ft this summer: my sciatica, more lower back pain, more leg pain during the first night and slowly diminishing thereafter over a five-day stretch. One thing I notice that I didn't mention in my first entry was that I seem to get frequent urination only at night when I first go up to altitude. However, this is another TMS symptom too, often associated with lower lumbar pain and sciatica. I did notice that the minute I got back down to my house in the Bay Area yesterday that all my TMS symptoms during the day and night disappeared when I got to sleep in my own comfortable little bed! I do wonder how much these increased TMS symptoms are due to the stress of changing my environment both physical and psychological? Seems to me that TMS does have a lot to d0 with inability to change and adapt to new circumstances among people who are not that psychologically robust for one reason or another: emotionally conflicted childhood, recent loss of income, death in the family, being fired etc etc etc as Holmes and Rahe chronicled in their study of life stress events. I wonder if I still feel psychologically protected by my dead parents in their old house and feel more exposed when I get away on my own in the mountains?

 

Bruce, a really great posts. Thanks for sharing it.

On the same subject, I've been always been fascinated with Wim Hof aka The Ice man, who has used an ancient Himalayan meditation called 'Tummo,' or Inner Fire, he says he is able to generate inner heat for the pupose of acclimatization.

http://www.dailymail.co.uk/news/art...ive-freezing-conditions-breaking-records.html


http://ayurvedic-healings.com/?p=997

 

There is certainly an ironic reversal at work here too: When my parents were alive and constantly battling, I found that staying up in the mountains soothed me and mellowed me out, made me feel more centered and self-sufficient. However, now that their house is my house, I find that living in it calms and sooths me whereas I feel more exposed and psychologically vulnerable up in the High Sierra and perhaps therefore more subject to TMS symptoms in an area where I used to find health and safety. Paradoxes never end, do they?!

Certainly sounds like Mr Hof has learned how to control his autonomic nervous system! Interesting how Dr Sarno believes that the autonomic nervous system under psychic stress is what lowers the oxygen level slightly in nerves, muscles and tendons and that's what causes the aches, pains and stiffness characteristic of TMS.

I did notice that when I worked for Outward Bound in my early 30s, hiking 750 miles and running 3 marathons in one summer, that I was much more impervious to cold and freezing temperatures. I could walk around in a t-shirt and sandles when everyone around me was complaining how cold they were. Obviously, you can do a number of things both physically and psychologically to toughen up you autonomic and autoimmune systems and make them more robust. I think that's why you should keep pushing your physical and psychological boundaries if you want to recover from TMS.

 

Bruce, have you heard of Tummo meditation? I've just been reading up and apparently, some say, mindfulness is used to calm the stress response, but Tummo restores the auto immune system. I'm trying to find some evidence

 

I get a little edgy when the moon is full, but otherwise I like Chicago's four seasons and look forward to the next.

Don't let weather condition you to feel pain. I think that comes from TMS emotions.

 

Changes in altitude, temperature and weather are just physical stressors that can trigger TMS symptoms if you've already internalized conflicted emotions. Triggers are highly variable from individual to individual, according to how you were programmed when TMS were started. You're right, Walt: it's the underlying emotions that are the real source of TMS aches and pains.

My point though is that increased TMS symptoms at high altitude seem to confirm Dr Sarno's hypothesis that a slight decrease in oxygen delivered to the muscles, nerves and tendons is what causes TMS aches and pains.