Derek S. Help with TMS diagnosis

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Question

I am 99% sure that my back pain is TMS. Since reading the books on TMS a couple of years ago, I have had much better results than with anything tried by my PCP, chiropractor or back clinic w/ PT's. After my latest flare up, I contacted a listed TMS Physician, thinking his diagnosis would help eliminate any structural diagnosis uncertainty. They recommended that I first go see a PCP, get an X ray and/MRI and then follow their given protocol. If I was not helped by their protocol, they could then assume it is TMS, and I was then to call back and possibly schedule a TMS appt. They called this approach diagnosis by exclusion. This answer confused me and I am wondering if you had any thoughts/advice on this approach. I am currently doing the 30 day structured program since this happened. Things are improving!!

 

Answer

Hi Emile,

Thank you for submitting this important question.

It brings up a very salient issue regarding the importance of a TMS diagnosis in recovery.

A diagnosis by exclusion is the method that some TMS physicians will use to determine the causality of your symptoms. There are some physicians who will actually perform a TMS diagnosis by applying pressure to certain areas of your body assessing for tenderness, though not all TMS physicians will utilize this approach.

It is always a good idea to see your PCP to get X-rays and imaging tests to rule out any significant structural issues. This should always be done to ensure that you are not under-treating something serious or dangerous. If they can't find anything significant in the standard diagnostic tests, then you schedule an appointment with a TMS physician and you have your diagnosis by exclusion.

In your case, it appears that utilizing the principles of TMS recovery have already given you significant symptom reduction. I would continue to operate from this mindset. Since you've already been through treatment by your PCP, PT, and back clinic, I would imagine that major structural issues have already been ruled out. If this is the case, going through all of the diagnostic tests again seems like overkill. Even with a diagnosis by exclusion, there may still be some lingering doubt. Ultimately, the belief must be your own.

As you stated, you're 99% there.

Keep working on the remaining 1% and you will get there.

-Derek

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I believed about 90 percent that my back pain was from TMS but withheld about 10 percent that it was structural.
It took a while but I finally believed 100 percent in TMS and did some more journaling and forgiving those whom I blamed
for childhood anger, and I healed. But it does take total TMS belief, as Steve Ozanich and others have said.