Chronic Pelvic Pain/Rectal Pain - Good Old TMS

This is a follow up to a previous post, entitled "Anal Fissures, Pains in the A$$ and Encouragement Needed".

I am reposting some of it, as it still applies...

I have a lifelong history of TMS from infancy colic to childhood tummy aches, teenage chronic earaches and sore throats, to young adult issues spanning the gamut from allergies to back pain. As an adult in my 20's my TMS manifested as IBS, Pelvic Floor Dysfunction (diagnosed at the time as "non-specific prostatitis"), all kinds of weird pains, all showing no definitive medical diagnosis. "Anxiety" was ALWAYS the main diagnosis, lol. I have endured much, including the death of both parents, and may other terrible traumas, but I've managed to survive and grow into the 50 year old I am now. I feel blessed, despite it all.

I skated through my 30's (relatively) pain free, but at age 42, in 2013, I had a nervous breakdown, resulting in severe Neck Pain, Back Pain, Shoulder Pain, TMJ pain, foot pain, panic attacks, crippling anxiety and depression, you name it. It took me years (and a lot of money and wasted time at chiropractors, PT's, neurologists and dentists, and well meaning but misguided healers of all kinds) before coming upon Dr. Sarno's work and it changed my life. I was able to heal 95% of my neck and shoulder pain, back pain, all of it...through serious introspection and self-discovery. I saw Dr. David Schecter, read all the TMS books I could find, became active on the forum, worked a bit with Nicole Sachs, and went full force with treating TMS. It took a lot of work, and I still get pain, but now I know what it is and can get out relatively fast. Dr. Schecter told me I have "TMS on steroids"...I fit the personality to a "T", pun intended. I am a perfectionistic, people pleasing, obsessive, repressed rage, catastrophic thinking, overthinking, 'gooodist' and I fit the perfect bill for TMS. I've had (and cured) pain from my toes to my teeth, my head to my stomach, my back to my hips, and beyond. I believe that almost all chronic pain is TMS, or has a HUGE TMS component. Including what I am suffering now, and suffering, I am. It's a medical condition, and it has (or had) a physical cause, but I think my TMS personality is protracting my pain. I need help.

In late October of 2020, I developed an "anal fissure" which is basically a "cut in the butt". It started a few months after a serious throat infection earlier this year, requiring me to be on SUPER strong antibiotics for over a month, leading to constipation, which eventually, opened an anal fissure. At first I thought it was just a hemorrhoid, and I was treating it with all kinds of creams and crazy fiber supplements, ice, heat, etc. I was making it worse and worse. I didn't go to the doctor, until about 6 1/2 weeks later, after I began to bleed from the rectum and have serious pain, and I became quite alarmed.

I went to see my GP, who is very good, and to my surprise, he could not find a hemorrhoid. Seeing the agony I was in, he immediately referred me to a Colorectal Surgeon/Proctologist. The Proctologist saw a fissure immediately, and told me they can take weeks to months to heal, but most (95%) do not require surgery. The good news is it isn't cancer. The bad news is it led me into the worst pain of my life, months and months of spasms of the rectum, specifically the muscles of the inner anal sphincter (autonomic nervous system/pelvic floor). HORRIFIC.

I reached out to Nicole Sachs and to my amazement she has had both professional and personal experience with these issues, and said it is "Good Old TMS". And I should treat is as such. She was empathic but firmly warned me to treat it aggressively as TMS, and not fall into the trap of thinking medically. Unfortunately, because I have a medical student background, that has been damn near impossible.

Here is where I am now...

According to my last visit to my colorectal doc, the fissure is basically HEALED! He said it is so small as to be barely be visible. He also said my rectal sphincter is OUT of spasm and the pain I am currently experiencing (a horrible amount of pain which has now spread to my prostate, penis, lower back and sacrum, buttocks, tailbone, piriformis, IT bands, sciatic nerve and entire butt) is "PELVIC FLOOR DYSFUNCTION". Colorectal doc said there isn't much more he can do. He does not think the fissure is causing the pain anymore, as it's almost gone!

Surgery isn't necessary as it's basically almost healed and "botox therapy" (the other treatment for fissures) won't help as the sphincter that was in spasm is no longer in spasm. It has "spread" to the muscles of the low back and pelvis. He sent me to a Physical Therapist, specifically a pelvic floor specialist. This is a repeat of what happened in my 20's! Only FAR more painful.

So, to the Physical Therapist I went, last week. She confirmed pelvic floor dysfunction, but to my amazement, she said that pelvic floor dysfunction is from TENSION, specifically, severely tightened and spastic muscles, inside the entire base of the pelvis, that affect the entire reproductive and eliminative areas due to NERVOUS TENSION, ANXIETY and STRESS. It's "freeze" as in "Fight, Fight, Freeze". She suggested I read "A Headache In The Pelvis" and I did. It's a TMS book that doesn't know it's a TMS book. The entire thing is Sarno central, under a medicalized guise. She did some pelvic floor release through targeted massage and also did a rectal trigger point release, which was mildly painful but helped. She also gave me some homework of stretching and breathing, and recommended the curable app. Luckily, she's a fan of Dr. Sarno and knows about TMS. She thinks this is my brain on fire. She wants to see me 5 or six more times. She believes I will fully heal, if I do the work. Which is both mental (stress relief) and physical (massage, stretching, yoga, breathing).

So, now what? She helped me, but if I keep seeing her, am I "medicalizing" this?

Has anyone cured pelvic floor pain/rectal pain/bladder pain, etc using TMS methods?

I know the answer is yes.

PS- This year has been a "Steven Ozanich" year for me, in terms of catastrophic stress. I've been dealing with this while simultaneously caring for an ailing spouse, dealing with unemployment, a global pandemic, horrific anxiety attacks, agoraphobia, working from home, lack of physical activity, and a very severe fear of leaving my house. Also, a change of job, enrolling in online school, a caretaker relationship, barely making ends meet, argumentative family issues, the works. Most stressful year of my life, by FAR, and I have buried two parents and almost been homeless. This is far worse, and feels even more traumatizing than that did. I'm in hell.

Ok, so....what are the chances this PAIN IN MY A$$ is 100% TMS and HOW do I relax, release, trust it's TMS and let it go? How? Any ideas?

This is absolute misery.

Help appreciated, truly.

Thanks for reading my novel.

 

So very sorry to hear of your suffering, Donavan.

Yes, your symptoms are 100% TMS. The way to address them is the same way you addressed the other TMS symptoms you have overcome. You are experiencing the symptom imperative. It is all the same. I know from experience how easy it is when new symptoms occur to fall into the medical rabbit hole. But you are aware that is where you are. You have demonstrated from your previous successes that you know the way out. You just need to commit to it. You can do this.

 

Yep, I agree with @Ellen . I can totally relate to the agoraphobia and online school can be frustrating when everything takes longer to get done. You have so much more on your plate than me, a young full time student, so kudos to you for getting through the year. Plus we forget how lucky we are just to be alive and safe in these times.

Just be real about your feelings. The capitalized words mean you really needed to vent. Don't let it build up. Those sharp twinges and spasms will come and go like cramps and it totally makes sense that it can move around anywhere in the body. There's plenty of pelvic issue etc. stories on here, so you're not alone! It hurts, sometimes a lot, but it's not permanent. Make time for you. Get enough sleep. Every time you feel tense- exhale exhale exhale slooowly (Ujayi Breath is really good for this). Keep turning on that relaxation response. Make time for socializing (on Zoom). It's ok to go out to a quiet place fully masked. It's ok to cry. Don't be afraid of working out, just ease back into it. Fresh air is good I'm not great at this one but unplug more, especially from the news.

Tldr; The PT's advice is totally reasonable. Don't forget to focus on self care and prioritizing your own needs. Every time something goes off track, get back on track.

 

Thank you for your support… Do you have any recommendations as to what I might do specifically for this? What I did before was affirmations and journaling, as well as telling myself that nothing was physically wrong with myself. That’s the only hitch I’m having, as this started with a real medical issue (fissure) that has gotten better and better despite the symptoms getting worse and moving (TMS). But my medical doctor told me that the fissure has almost fully healed, he can barely see it, it’s mostly scar tissue now, and wouldn’t be causing these new pains. PT agreed, and said that these kind of things can start off a nervous system disruption cycle that causes pain and muscular spasm after the medical issue is healed or almost healed…like a nervous system PTSD/trigger. AKA: TMS. It’s like I know mentally that it’s TMS but I’m having a hard time with the “medical” event as instigator. But Nicole Sachs herself told me she thinks fissure pain is 100% TMS.


What might be a good first thing to do for me? Also I’m noticing that the physical therapy is making me worse, maybe I should just look at it as exercise and walking, stretching… If I look at it as physical therapy for a “pelvic floor disorder” it gets worse. I also have a lot of exercise phobias and I am way too sedentary. But when I exercise it gets worse at first… Thoughts?

 

Keep the area moisturized, sensations sometimes might be more obvious if you're going to the bathroom or something. It doesn't have anything to do with physical activity though so you're good to go. Ease into it, do something you enjoy, pay attention to something else, and it's ok to admit it hurts. It's all TMS and it's coming up because other things seem burdensome at the moment. Spasms hurt but are not structural disorders, they're entirely stress related. So for something like this, getting into a normal routine is better than a body part specific routine. PT is for rehabbing a broken leg or physical injury. If it's pain management only, find something that's fun and relaxing.

 

It's very common for TMS to start from a medical/structural cause. It's harder to overcome because we hold on harder to the belief that the problem is medical and not psychological. So I suggest working on solidifying your belief that what you are experiencing is TMS and the cause is psychological. I would keep reading or listening to material on TMS. Write down your reasons and logic for knowing it is TMS. You've already consulted trusted sources, like Nicole Sachs, who told you it is TMS. Maybe see Schecter again if you can--anything to build your belief.

Many of us here on the Forum are lifetime, varsity-level TMSers. I, too, have struggled with it all my life and remain amazed at the creativity of my subconscious in coming up with new and unique forms of TMS. But I eventually overcome it, and I know you can too.

 

Years ago I had a hysterectomy. I had the pain in butt thing ( horrid) that sent me to the ER. They said it wasn't from the surgery..it was muscle spasms. I took a flexeril and it went away, so they were correct. Thinking back I was under a great deal of stress, so I'd say TMS was the problem. I'm not a doctor but that's my guess.

 

How are you doing now, OP?
I just wanted to chime in because I went through something very, very similar. I think it might be interesting for you to read my story.
I have created an account specifically for this purpose because I've been where you are.

Sorry this is such an enormous post; skip to the part where I start putting stuff in bold font if you don't wanna read it all. That's when I do the combat-stare and get real serious.

In 2011 (I was about 30) I also developed an anal wound (probably a hemorrhoid or some kind of small fissure) of some kind: I woke up with a grueling rectal pain that worried me to shreds. I got some cream, and was told to just sit (..) it out.
I did not deal with this medical situation well at all: I became completely obsessed by it. It started to eat me instantly. Almost without any distraction I was thinking about, worrying about, or googling about my malady. Weeks later the pain had still not subsided, although the fissure was already confirmed completely healed by doctors.

A month later I was still ball and shackle with my pain, my discomfort and pain sitting and lying down, the rectal pain, rectal fullness, tailbone pain, pain in the perineum, under the ballsack, lower back, etc. Pain was my jailer. It kept me jailed while it taught me extensively about pelvic anatomy. It was a terrible school.
My days consisted mostly of trying to describe what I was feeling (is it pain, is it tension, is it hypertonicity?), where exactly the pain was hanging out at that moment, and how bad it was on a scale to 10 (usually really close to 10).

This ignited a series of visits to an army of medical professionals, I'm not gonna name them all but trust me, you name it I've done it. And, you know it's coming... they all declared me 100% healthy. There was nothing wrong with me.
(One doctor actually had the wits to diagnose me with pelvic tension but that didn't help much, more about that at the end of my post.)

It felt like my life had made a drastic turn for the worse. I was now a diseased man, imprisoned by a mysterious malady. The pain was only absent right after I woke up. From there it would build. Unfortunately, since we do it so often, pooping really propelled things into orbit and was a fast way to drive the pain up to overwhelming levels and it would hang out with me all day, except when I was moving around. I oddly usually only felt this pain when I was sitting or laying down, but I've come to find it manifests differently for everyone. But in the end it's all the same thing.
Booze or downers took care of it really well too, and believe me that I've done my fair share of it to mitigate the panic and desperation that was bestowed upon me by this terrible syndrome. Next day it'd be worse, though.

Fast forward, I hope I'm not hijacking your thread TOO much with my personal misadventures but I have a point to make so bear with me, 2 years: I met my now wife while travelling and I had a pain free month for the first time. But only until the moment that I realized that I had been painfree for a month: the pain woke up and came back immediately.

Fast foward another 2 years, with the pain slightly waxing and waning during those years, but being there 80% of the time, through one of my extensive googling bonanza's, I discovered TMS and this .. kind of.. made things click for me. It wasn't a big a-ha moment but I had already intuitively felt that the only way to alleviate symptoms was to ignore them completely, to live with them, to let go, but this was EXTREMELY hard and my mind was constantly fighting back and trying to tell me there was something 'else' going on.

The urge to intellectualize and medicalize my pain was unbelievably strong. My obsession with this pain was some sort of twisted addiction.

So, I was still ball & shackle a lot of the time, but after investigating TMS back in 2015 things changed.

I am now 10 years past my initial medical 'event' (like you had), and the past years my symptoms were pretty much gone for 95%, bare a few short flareups here and there that luckily never really managed to imprison or obsess me. (What did happen is that I developed other replacement pain (abdominal, dental, knee, all that good stuff)).

I've just had a bad flare-up in the ol' pelvic/rectal area that mimics the pain I felt in 2011 after my fissure. This flare-up, the past few days, made me remember all of the extensive reading I had already done on TMS in 2015, and FORGOT about.
That's right, I think learning about the mindbody connection that created my pelvic pain made me succesfully forget about it all together, even including my self-diagnosis of TMS. I'm not sure that was Sarno's point all along, probably not, but I honestly didn't know I already owned books about it. I now have Sarno's book twice. (And I'm not a typically forgetful person or having a benzo habit or something.)

This flare-up was triggered by a stressful period (sure seems you've had your share this year, I'm so sorry about it) and.. accidentally opening my 10 year old diaries on a google drive where I logged and rated my pelvic pain in a meticulously formatted excel-document. Boom, pain back.

To me, this is all the proof I need that this pain is conditioning, that this pain is TMS.

It is ridiculous that I'm feeling the EXACT pain of this hemorrhoid or fissure from july 2011, all the way in august 2021. It has actually genuinely made me laugh how absurd it is.

Today I've been brushing up a lot on Ozanich's book and other TMS related texts and the pain that has been plaguing me for 2 weeks now has already gone from an 8 to a 2 or 3, in just 1 day. Who knows it'll be a 9 again later tonight, but I know enough.

The past 2 weeks I've fallen victim to all my old mistakes of 'medicalization'. Overzealous stretching, thinking about getting back in touch for treatment by pelvic PT's, electric massagers, heatpads, coldpads, general mental obsessing, feeling like I could not enjoy life until this pain was gone.

I was already daydreaming about anal probes providing bio-feedback readouts on fancy equipment. Maybe I could sign up for some pelvic camp somewhere, and think and talk about it and have it investigated for 4 days straight (those exist!). I was physically and mentally bracing again, everytime I got ready to sit on a chair or couch: my mind-body succesfully rekindled my fear of sitting, exactly as it has done for 10 years.
For my mind, giving in to pelvic pain is like learning how to ride a bike: it has learned how to do it and will get back to it effortlessly, no matter how long the pauses in between.

It seems you have a clean bill of health from your doctor so finally here's my take, do with it what you want:

In my opinion, and I get no pleasure out of saying there's 10 years of experience to base that opinion on, every thought or action spent on this pelvic pain garbage is one too much. This harshness is not directed at the sufferer of course, but at this terrible syndrome itself. It's BS, forget about it. There's nothing wrong with you.
Please, don't be me, don't obsess over rectal pain on and off for 10 years. That's a hell of a lot of time I've spent thinking my life was over or at least in shambles, that I could have spent on something fun.

The only periods that I didn't have any pain was when I arrived at rock bottom and miserably accepted that my life from now on was to suck and I was going to have painful spasms sitting and lying down forever. Looking back, taking that defeat always led into symptom-free phases. Because it is TMS.

I'm absolutely not an expert on TMS so I can not speak to the do's and don'ts of combining TMS with PT and stretching from a theoretical perspective, but intuivitely I'm feeling a very strong No.

PT's mean well (even the ones that stick needles up your ass, I've had them do it, I've been known to really brag about those sessions during get-togethers) but the problem is that they will keep reinforcing your thoughts about your symptoms, thus keeping the tension alive. Even if it temporarily helps.
I guess stretching might be fine but don't do it to fix the pain. Do it because it feels nice to have stretched limbs. And because it might help you to move around more smoothly.

"A headache in the pelvis" is a well thought out and elaborate book, I've read it twice, but it won't take your mind off of your pelvis unless you become ninja-like at the paradoxical relaxation and meditation part. The sheer amount of information kind of frightened me to be honest and definitely did not make me feel un-sicker.
Also something about them selling their 'home treatment program' including a kindle tablet (?) for $3250 doesn't sit right with me and to me fits right in with the claims made in Ozanich' book about medical professionals having a horse in this race: mon$y, and feeding you the conviction that you need them to get rid of your chronic pain.

The only healthy place for anyone to go vent or learn about this condition going through this, imo, is in TMS based literature or a TMS forum. Skip the support groups and ignore the good doctors that hide out on a website called Reddit all day.
For me, all of this stuff keeps the vicious circle alive.

These are just my thoughts and I hope they resonate with you. I sure as hell wished someone would have told me this back in 2011 when I developed my symptoms. I could have started to break the horse that is this syndrome way earlier.

I'm no longer fearful of the pain and everytime I feel & dismiss it, I see it as a victory over it and a step towards healing and breaking it.

If we are sure there's nothing else that is causing this, just trust that it's TMS. What do you have to lose? You're in pain anyway. Go for it 100% and you will heal.
All the best.

 

Burning hole or pelvic spasms?

 

Hi I have from chronic pelvic pain. This is 100% TMS. If you want any tips I am happy to chat with you. it took a lot of emotional work and somatics to get thru it.
Laura

 

Contact me please

 

Did it go away i am in the same spot same case