Alan G. TMS or structural abnormality?

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Question

About a year ago, I injured my lower back doing heavy deadlifts and took some time off after excruciating pain for a couple weeks.

Then 4 months ago, I started heavy lifting squats and leg presses again and the pain returned. This this time I went to see a PD and got an MRI, which showed a 6mm bulging disc at L5-S1. The doctor said it wasn't too serious and PT alone should heal it but a week AFTER my MRI results, sciatica symptoms started showing up in my left leg.

Today I just finished Dr Sarnos book Healing Back and have some questions hoping someone can answer.

How do I know if my 6mm bulging is structurally abnormal or not? My doctor tells me it's not serious but I don't understand why I still have symptoms after 4 months of PT.

Based on the fact that sciatica symptoms showed up AFTER my MRI, could this be TMS related? I was pretty stressed out when I found out and upset I didn't get an MRI sooner.

I am no longer in "pain" and do not need any meds, but do have uncomfortable sensations in my lower back and left leg. How do I know if these uncomfortable sensations are caused by TMS or not? Would I even be in this miserable state if I never injured myself in the first place?

To me, if I understand it correctly, because I injured my disc, it is causing a structural abnormality. However, whether I feel any pain or not is not solely dependent on that bulging disc or structural abnormality. The pains/symptoms are caused by my repressed emotions. HOWEVER, if I never injured myself, it's highly unlikely my repressed emotions would cause pain symptoms in my lower back or legs but it could cause symptoms in other areas of abnormality. Is this correct?

 

Answer

If there wasn't a specific traumatic injury during this most recent round of weight lifting, I'd guess that the 6 mm bulge was there even before this recent onset of pain. The pain can persist in the absence of structural cause because neural pathways in your brain can learn and remember pain. So even once an injury heals, pain can persist.

To answer your last question, the mind does not need a structural abnormality to cause TMS pain. In fact, often these structural abnormalities are just incidental findings and the result of general wear and tear. I have several 5 mm disc herniations but have no pain associated with them.

Given the fact that your doc, a non-TMS doc doesn't think the disc bulge is significant, that's pretty compelling evidence. Not all disc bulges are equal, there's a lot of factors to take into account: the amount of space in the spinal canal, etc. A man I worked with had a 13 mm disc bulge and became completely pain-free.

I'd work toward reducing your fear around that "6 mm" term. I'm sure every time you even think about it, it freaks you out. Furthermore, work toward reducing your preoccupation around the symptoms. I'd guess you think about them all the time. Since the purpose of the pain is to serve as a vessel of preoccupation, thinking about them all the time serves to reinforce them.

I'd go over part 1 of this program:
http://www.tmswiki.org/ppd/TMS_Recovery_Program#Part_I

I think it applies most directly to your case.

Alan

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