At the end of my rope with sciatica / piriformis syndrome

I've been fighting sciatica / piriformis syndrome symptoms for the last 6 months and was doing well during the day but not so well at night. A couple of weeks ago the pain started ramping way up at night and some during the day, and now I can't sleep more than an hour at a time without having to get up and walk around for 1-2 hours. I'm starting to lose my mind from sleeping 3 hours a night and the increased day pain.

I know it is TMS (I have 30 years of experience with a litany of manifestations) but I think I need some meds to get me over the hump of pain so I can sleep and think clearly. Without meds I can no longer use psychological strategies (Sarno and Claire Weekes based). I got some weak muscle relaxant from the urgent care place yesterday and it barely helped.

This past week has been hell. I'm afraid I'm going to lose my job or give into suicidal thoughts if I don't make progress in the next few days.

I've found this forum and the old TMS help one very useful over the years and really appreciate everyone in this community. Please let me know if you have any suggestions.

Thanks so much!

 

There is nothing wrong with taking meds. Period. BUT just be mindful ahead of time that most good sleeping help stuff might agitate your depression. I Still occasionally take something, and I have been pain free a long time. Not sleeping messes with the whole thing. But the morning after I gotta hammer some extra nuclear coffee to get going.

This is all about us taking back control. Just like with the meds, when you know consciously what you are doing, it gives us a sense of agency and we tend to get UN-depressed.

You are right when you say you've been fighting, but Re: The real fight is the time we sit and have a contest of wills with the pain . Sarno even called it as such in the back of Mindbody Prescription.

I went through some really dark stuff last year and can sympathize with the suicidal thoughts thing....A Bro from this forum called me and just getting to unload with someone who 'got it' was the turning point. If you ever just need someone to talk to, PM me and I will send you my contact stuff... I always have time for People with this shit.

peace

 

Thanks so much Baseball65! Your message is very helpful and heartfelt. I especially appreciate the offer to talk. You are very generous with your time. (I've read countless posts of yours over the years.)

 

Hi @JanAtheCPA,

Thanks for your response! I have not done the SEP. I have historically focused on directly following Sarno's advice from all his books. Recently, I reviewed a lot of the available programs, including the SEP, and decided to go through Kevin Martillo Viner's book "The Mindbody Syndrome (TMS) A Path to Recovery and Freedom". So I am currently doing that.

 

I had been making pretty good progress by following a blend of Sarno and Claire Weekes' approaches. Days were getting better and better, but I was still having trouble when sleeping because my mind was less regulated by strategies. Then my sleep got disturbed by a minor cold (pretty sure it wasn't TMS) and the fact that I pushed too hard to exercise, which resulted in sore muscles (which my brain latched onto as a justification to ramp up my pain). Once my sleep was disturbed, I started spiraling out of control. I was off work at the time, so I spent a lot of time going through the available programs. I returned to work this week and didn't have much time to devote to it, so I settled on Kevin's program late last night / early this morning. My wife is pushing me to go the conventional doctor route as well, which obviously could be a problem if I bought into a physical diagnosis (which I don't), but which could help if I need to go onto disability.

 

One component to your story could simply be nervous system disregulation,
When you had your cold, did you fear not getting well ( or getting “worse”) .. it could also simply be you were sick and your system wan’t regulated enough.
What do you enjoy to relax?
What “pressures” do you often feel from your wife (your perception of what is pressure) eg. To follow a path that you do not feel is right for you?

 

@Cactusflower,

Thanks for your thoughts.

I can see nervous system disregulation being an issue. The cold was pretty minor, the only problem was it caused post-nasal drip that screwed up my sleeping. I didn't fear it as much as be annoyed by it. I didn't know it was going to contribute to a major downslide.

For fun I read, watch TV, play with my dog, and play chess. It is hard to do those things since the pain started 6 months ago, and very hard since it got worse. Even when I can do them, I don't really enjoy it much because the pain is dominating my thoughts.

I don't generally feel pressures from my wife. She is super supportive. It is just that she likes to see all sides of an issue and doesn't want to be too quick to rule out physical explanations.

@JanAtheCPA,

You are very perceptive, and I can provide more information if it would be useful. I like succinct communication by default, but I have a long TMS history.

While I have been moving quickly to adjust my strategy, it is driven by the insane amount of suffering I have gone through over the last week. I was much more patient and deliberate from the beginning of this bout in late October until a week ago, while the suffering was still bearable.

I mentioned disability because I barely was able to get through 4 days of work this week (I took today off), and if I can't work regularly, then I will have to go on disability. I just want to have a plan that addresses the reasonably possible scenarios.

By its very nature, I can't say whether I have a "serious unconscious emotional conflict".

The emotional writing you described is very similar to the journaling approach that Kevin suggests in his book. I plan to follow his book, and hopefully will start the writing tomorrow.

I don't want there to be a physical explanation (because I'm comfortable with the TMS explanation, and who wants to be physically broken?), but if it there is sufficient evidence, I will accept it.

I went to a TMS doctor (Harold Goodman) in the December - February timeframe. He confirmed that I have TMS.

Today I saw my primary care physician and he said I have a herniated disk. He can tell from my symptoms and an MRI is unnecessary because it would just confirm his diagnosis in which he is certain. When I said "what it the MRI doesn't show anything", he said "then I would assume the MRI just missed it". Gotta love it!

I told him that I thought the cause was stress due to changes in my responsibility at work, and he said no, it is a herniated disk. Any stress I feel from the time when this began is a coincidence.

Thanks for your help!

 

I was told by many doctors that my symptoms were carpal tunnel syndrome. It was confirmed by EMG test, so steroid treatment and subsequent surgery were recommended. I ignored their recommendations and listened to the TMS doctors. I fully recovered. If you need meds to start your TMS healing, do so. But remember that meds are not a solution; they are a temporary measure. But unless you stop doctor shopping and go all in on TMS, you will never recover.

 

Hi Recursion,
Sorry to hear you're struggling this much.
I've got a few suggestions. Getting some traction that could help you with clear thinking and the development of a clear path forward seems critically important.
You mention 30 years of experience with TMS showing up in your life. How did you work through this in the past?
And, do not start with, "This time is different--it's much worse." Try to forget that for now.

What parts of the forum helped you in the past? What can you do today to get back in that groove when your symptoms lessened or disappeared completely?
At the same time, what new suggestions can you accept? The Structured Educational Program? Emotional writing (JournalSpeak)?

It might seem logical that if you barely got through work this week--and it could get worse--so you need a plan that includes disability as a contingency.

Think this through clearly! TMS is a distraction to keep our focus on these physical symptoms. The distraction works completely if you take the drastic step of going on disability-and keep in mind that there is nothing physically wrong with you.

This makes no sense! A TMS doctor told you it was TMS. Two months later you're going to consider buying into a herniated disc diagnosis. And, then haggle with the primary care doctor about stress as a cause--you already know how he's going to respond to that!! That conversation is for the TMS doctor. I don't think it's intentional or anything, but you're setting yourself up for failure with those kinds of steps in a row.
If you've had 30 years of TMS, you've had diagnoses in the past that were pure TMS.
You mentioned that you favor the classic Sarno (combined with Claire Weekes) approach. Sarno was abundantly clear on herniated discs.

And, wow, the fun activities you mention are not highly physical activities. A lot of folks struggle with getting back to cycling or running or just long walks. You mentioned reading, watching TV, and playing chess. If the pain is keeping you from those low-intensity activities, you are really in a crisis situation. Take this moment as seriously as you possibly can. Identify it as the crisis that it is. And, use that energy to devote yourself to the work that will get you better.

I wish you well!! Hang in there. And, be good to yourself.

 

@Recursion
Whenever my symptoms get a lot worse in the night, there is some new reason. (Or, an old reason I haven’t been willing to see yet.) Something could be really bugging you— and it might be tricky to find. It might be in a place where you think everything is great. Your pain is trying to tell you something. Btw, Sarno and Dr Weekes are a great combo! If you hang in there, you’ll make it out of this. Read success stories!

 

I appreciate all the great feedback! At the risk of appearing defensive, I am going to clarify a few points that appear to be misunderstood. I think it is worth the risk because I'd like any feedback that I get to be as relevant as possible.

@TG957, thank you, I understand and agree.

I am absolutely all-in on TMS. I don't believe I said anything implying otherwise (see my response to @Bonnard below for further clarification).

In order to get meds that would allow me to start my TMS healing, I needed to go to my primary care doctor because the urgent care one did not meet my needs. I also wanted to loop my primary into my situation because I have a yearly physical coming up and I didn't want him to freak out that I wasn't keeping him in the loop. Now that my needs are met, I don't plan to see any additional doctors. I don't think that I am doctor shopping, but perhaps it is splitting hairs.

@Bonnard, thanks for your input. I may attend your chat today.

I've had TMS since I had severe growing pains when I was a child 45+ years ago. I've had many TMS equivalents since that time and the time when I learned that I have TMS, which was about 30 years ago when I had severe neck pain. My life was becoming so restricted that I was sufficiently desperate to consider things outside the mainstream. I had an initial "book recovery" just by reading reviews of Healing Back Pain (HBP) on Amazon. That gave me the confidence to go all-in on TMS, which led to a resolution of the neck pain. From that point on, I've been all-in on TMS, and used Sarno's techniques to great success on many subsequent issues. However, I never achieved the true goal of preventing new issues from arising. I believe that requires better strategies for dealing with life stressors, and I have been working on that, but got derailed by the severity of my current situation.

General discussion and success stories.

I've started following the approach in Kevin's book, as I mentioned previously.

I'm very open-minded on this, but I'd like to minimize switching approaches because I think that will be counterproductive. I've reviewed the SEP, but it doesn't resonate with me as much as Kevin's book. His approach to journaling is very similar to emotional writing.

I know there is nothing physically wrong and I don't view it as a matter of distraction. If I can't perform my job because my symptoms are too severe, I have a few options:

1. Get fired
2. Call in sick until my TMS approach reduces my symptoms to a reasonable level
3. If #2 is insufficient, go on disability until my TMS approach reduces my symptoms to a reasonable level

I'd like to avoid #1, so I will start with #2.

Regarding my interaction with my primary care doc, you said:

You misunderstand. I'm not at all buying into the herniated disc diagnosis. I merely described the interaction with the doctor and used sarcasm (poorly apparently) to illustrate that the the doc predetermined his diagnosis without data.

He asked what I thought the cause was and I told him. I don't like lying to people. He is new as my primary doc because my previous one changed practices, and this was only my second appointment ever with him. I wanted to get a feel for how open he'd be to the idea of the mind impacting the body -- apparently not at all open.

I was asked what I do for fun, not what I do for exercise. When not in crisis, I lift weights. When in crisis, I walk.

I am taking this extremely seriously and devoting all my energy to it. Thank you for your comments!

@Diana-M, you said:

I think what is bugging me is that right before my symptoms onset in October, I was give a major new responsibility at work. I did not want it and had to add it to my current responsibilities. That drove my stress level way up.

I've struggled to reconcile Sarno and Weekes because they seem somewhat at-odds on the surface and Weekes' focus on anxiety requires translation to physical pain. That is one reason I am transitioning to Kevin's book: it is a modern and single coherent approach.

I read a lot of success stories. Thanks for the support!

 

Yes! Nice move--absolutely worth whatever risk there is of appearing defensive.
Discussing/debating/disagreeing and speaking your own understandings and truths is so good.

(The only time that doesn't apply is the dreaded "Yes, but..." stuff that is a great way to stay stuck.)

 

@Recursion

We have had quite a few similar experiences, especially some of the difficulties you've run into.

Wow, I haven't heard of that kind of 'book recovery'. Seems like it arrived initially just by reading reviews of Healing Back Pain!

I have had a similar experience of never being able to prevent new issues from arising. My thinking has changed on that, as I see so many others struggle with recurrences of symptoms. I now think it's kind of part of things...
I agree on picking a program and going with it--in this case, Kevin Martillo Viner's book/program. That's one classic response to TMS that can be counter-productive, to keep looking for the one perfect program or resource and to keep jumping around & chasing that.

I went through something similar with my work. I didn't even realize it was TMS at the time. I believed there was something really wrong with me, and I went on a reduced schedule for 4 weeks. If I identified it as TMS, I might've handled it differently. It set me back and allowed me to rest more, but did not help with progress on my symptoms. It did help me keep my job though--I get the predicament you're facing.
It's a really hard place to be--the choices you describe. I think the strong responses you're getting are because you describe (very well!) the difficult situation you're in, and folks really relate and want to help.

As for the discussions with your doctor, yeah, it's worth checking to see if the primary care doc. is open to a mindbody approach. I haven't had much success there--even when I had a doctor who was open to stress as a cause, he stopped right there, and wouldn't get past the traditional diagnosis and treatment (when I knew full well it was TMS).

Weekes wrote from a different perspective than Sarno. I agree that there are differences there...

As for TMS being a distraction, I do think it's our brains presenting a distraction that keeps us focusing on the physical symptoms and trying to keep us away from stresses/emotional pain/repressed stuff/trauma, etc...

Your success story, when you write it, is going to be amazing!! Hang in there.

 

Yeah, it kind of blew my mind. It gave me the confidence to persist through the ups and downs and doubts that creep in until I beat the neck pain for good.

It's funny because in some ways going to work helps because it brings a sense of normalcy, structure, and productivity. I also enjoy feeling like I'm good at the work and not crippled by TMS. On the other hand, the stress makes the pain worse. I don't generally have a desire to be out of work to recover from the TMS, but if I can't perform due to an inability to function for 8 hours in the office, then I don't have a choice.

I certainly appreciate the empathy.

Thanks so much for your support!

 

Here is an update since I last posted on Saturday a week ago. If you don’t care about the details, just read the executive summary.


Executive Summary

My piriformis pain intensity is now manageable without pain killers, but sleep is getting worse and now I can’t sleep for more than 30-60 minutes before I have to get up and walk around, waiting for the pain to subside. Repeat 5-6 times per night, totaling about 3-4 hours of sleep. I’m not going to be able to do this much longer. Please give suggestions!


Saturday & Sunday (April 26-27)

I had gone to urgent care on Thursday for my pain and they gave me an antibiotic because based on my urine test they thought I might have a UTI. On Sunday they said test came back negative and I should stop the antibiotic.

With pain meds from primary care doc, I stabilized my pain and sleep enough to face work on Monday. Got 4-5 hours of sleep each night in 3-4 chunks since I can’t sleep more than 1-2 hours without pain making me get up and walk around.


Monday

I have a lot on my plate. I lead two teams and have several projects of my own.

I come into work to find that while I was out, I was given an urgent high-priority task from the company President to write a key part of a proposal for a new contract. This is the sort of task I hate. It needs to be done by the end of the following week and requires me to drop everything else that is not critical. I get really stressed-out because I have to figure out what I am going to write while catching up from being on PTO on Friday. I can’t just abandon my teams for a week. They have critical tasks that need my input.

I start to notice the lymph node on the right side of my neck hurting. Piriformis pain isn’t too bad during the day, but spikes when I try to sleep. I get 4 hours of sleep in 3 chunks.


Tuesday

Stress continues to grow as I tried to figure out a plan for the proposal while juggling other projects. Customer cuts my proposal timeline by 3 days so I need to be done within a week. President makes suggestions on my proposal inputs indicating that he doesn’t think I know what I’m doing.

By the end of the day, I feel that I have a decent plan and sources for writing. The lymph node is hurting worse. Piriformis pain and sleep same as Monday except I’m very stressed that I haven’t started writing. In the middle of the night I decide my writing plan needs to be overhauled.


Wednesday

I go to physical therapy evaluation for my piriformis just so I can tell my primary care doc that I went. I haven’t done any of the exercises and am going to cancel the follow-up appointments.

Inside of throat is very red and swollen. I don’t have any symptoms suggesting contagion. I’m worried that I may be reacting to the new meds. My wife calls my doc and they have availability but I tell her I don’t have time to go.

Finally some good news: I make tremendous progress on the proposal!

I feel much more relaxed at night, but sleep is unchanged.


Thursday

Wake up in a bit of a panic because I can barely swallow due to swelling and pain. Feeling very run-down but no other symptoms. Go to work and make progress on writing. At lunch I have to take a 20-minute nap in the car because I can’t stay awake.

I have to address my throat so wife meets me at doctor for afternoon appointment. Doctor is in such a rush that he confuses the timeline with my piriformis and says “You know you have a herniated disk, right?” I tell him I went to PT, so he is appeased. I get him to focus on the throat and he says it is not the meds, I have tonsilitis, probably from a previous strep throat (perhaps the minor cold I had a couple weeks ago?). Unrelated to my back, just bad luck. Not contagious.

I go back to work. By the end of work, I feel almost delirious with pain and fatigue. Wife says the doctor is closed but didn’t send antibiotic prescription to pharmacy. Fortunately, it shows up before pharmacy closes at 8 pm, and I take it. I have a rapidly climbing fever. Pretty confident I’ll be calling in sick for Friday but resist texting my deputy at home.


Friday

Wake up feeling dramatically better. Vow to stop taking all pain killers so I can be in touch with my body. Go to work and get my proposal almost complete.


Friday Night – Now

Starting to stress about a meeting with President and VP on Tuesday where we are going to talk about my role in the company. On the one hand, I don’t think I am being leveraged well and would like to be more involved in some projects, but on the other hand, I’m unraveling due to my pain & sleep and don’t want them to know. The meeting has already been rescheduled 4 times because they are so busy. I hope we just get it over with.

Friday & Saturday nights, I sleep about 3-4 hours in 5-6 chunks. I’m not going to be able to do this much longer. Please give suggestions!

Hopefully this will help some of my fellow sufferers think, “well, I’m glad I’m not him”

 

The idea that you “can’t use” Sarno or Weekes methods because of symptoms is essentially another symptom. I was bed bound in pain with electrical shocks, had seizures, and suffering from terrific anxiety ready to do myself in, and I used Sarno and Weekes .. and am much better.
Perfect?
It’s taken me a few years to get here.

Sleep is a hard one but anxiety will keep an anxious brain churning and keep the nervous system running in overdrive. Seems like you are just not in the Sarno mindset right now, still chasing “fixes” from Dr. and PT. Some folks just need to let their mind run its course when it comes to those things..it needs to find 0 other alternatives before it can buckle down and do the work.
Sleep is a hard symptom, but it can be overcome when it can no longer take up such importance in your life to “succeed” in sleeping.

You ask for suggestions. My #1 is to drop day to day monitoring of your symptoms and use that time to do the work of Sarno and Weekes. Even if it’s once a week, begin. If you can post this you can absolutely do the work. There is clearly a deep concern with confidence: at work and with being able to do this work.. anxiety..