Why does Physio help if the pain is psychosomatic?

Hi All,

I just wanted to share ideas with others on the subject of physical treatments.

I have a theory that in my case, my TMS symptoms seem to strike in parts of my body that have been worked the most. For instance, when I worked restoring cars it was predominantly lower back and neck pain. It got so unbearable I quit working in the trade I had enjoyed for 10 years. When I got a new job that involved less bending and awkward lifting, my back pain subsided, however, my new job involves lots of stairs and use of arms and shoulders. So the next symptoms to manifest were foot pain, ankle pain and shoulder pain. This was soon to be joined by the return of my lower back pain. I was really starting to believe that I would never be able to do a physical job again.

Then I found HBP. Within a few weeks I was relatively pain free and was doing really well up until 2 weeks ago,

I had a nasty case of symptom imperative, a sharp nerve spasm between the shoulder blades and none of the techniques I use on my known symptoms were working. So reluctantly I booked a physio for the first time since discovering TMS.

I really didn't expect it to help but it did, however the pain just seemed to move to the right shoulder that wasn't worked on, which brings me to my theory....

TMS picks areas that have tight muscles, this shouldn't produce significant pain but add some oxygen starvation and voila, there's your excruciating pain!

Although I believe in TMS 100% I'm not quite satisfied with Sarnos explanation for how physical treatments manage to work...I.e massage increases blood flow and placebo affect. This doesn't quite add up to me, I struggle to believe massage can cause increased blood flow to be sustained for weeks and I also had no expectations that my last treatment would work, but it did.

So it would be good to understand how exactly physio and the like can temporarily improve a psychosomatic pain!

T.I.A

Scott

 

So far I have been helped by Physical Therapy the most.

 

Placebo

 

Hi Boston, that's what I wanted to think, but the phisio helped even though I had no faith in it! I know the pain is TMS but it still seemed to help!

 

I think with physio therapy we are adding weight to the belief there we have a structural issue. At most we may have some or moderate relief. I think if you can take the physio for what it is and not buy into the concept that something is wrong, the exercise may provide some with relief. It's a case of use it or lose it, mind over matter.

 

There is a group of Physios in the UK who have cottoned on to the idea that a lot of chronic pain is not because of structural reasons and they advocate reassuring patients. This is likely why good physios do a good job, they reassure the client that their body is strong not weak
https://t.co/8rbVqo9Bib

 

Yes I agree it is like admitting u have structural damage, I totally do not believe I do, but physio does keep the pain at bay, all be it temporarily, and it's the mainstream solution, it can't be just placebo.

What do you think about my idea that TMS picks on well worked/ tight spots to produce pain more efficiently?

 

A few sports Dr's use the same concept, I posted about one last week. His name eludes me at the moment.

 

Yes Irish I agree, first thing my physio always says is there's nothing major wrong. And always tells me not to book another session unless i need it!

 

Then do it whether its physio or meds if it gives u relief then do it. Selfcare is #1 priority

 

Hi Scott,

In addition to placebo there is the reflex response. Simply pressing certain areas may act as a trigger for pain relief.

In my case physio actually made my condition worse sometimes.

What's most important is that you know and believe it is TMS. Why physio works for you we may never know. You are as unique as your finger print. How you subconscious works is also unique. If it like physio, then enjoy the benefit and move on.

 

Hi Fred, thanks. I think that is Sound advice, I feel I KNOW what I'm suffering is TMS, and as we know physio is not a cure. I look at physio as a last resort to keep going now because it does, for me provide quick relief. I know my pain is not structural defect si it was a tough call to make when you have made your choice that you are treating tms. It's a shame there doesn't seem to be an answer for my question as it would help, I think, to break down the idea physio can only help a structural symptom as it clearly in my case on this occasion put a spanner in the works of the flare up. I think what I'm trying to say is it would be nice if we had a good idea about how that worked, then you could say for instance..... Physio temporarily helps because TMS pain latches onto the most stressed parts of the body, by making the muscle less tense, TMS thinks... Oh I can't use that one, the area is relaxed, he won't believe he's got damage there or be able to blame it on his work. Of course unless you deal with the root of the problem it will pick somewhere else, but at least people could get physio without losing track of the mindset that you are dealing with TMS and there is nothing structurally wrong.

 

Dr. Sarno did NOT believe PT helped, that's why he quit referring TMS patients to his PT's early on in his development of TMS theory, although he liked many of the PT's personally. If it's TMS, then the benefits from PT, or any other structural approaches is the placebo effect. This is derived from briefly being taken off the battlefield of life, lessening the rage/sooth ratio--this usually lasts until you're out of the parking lot and back onto the highway of stress producers.

The relationship between the practitioner is important too, for tracordification as SteveO coined the term--some sympathetic human contact. Real injuries will heal on their own time with or without PT. Seeing a PT will help the "healing" process whether a real injury or TMS by forcing movement to the region, preventing atrophy from lack of use and building confidence to return to physical activity. Until the emotional issues are addressed, the TMS pain will continue or find a new body structure or affective equivalent to imperatively migrate to. TMS is the volume control for the pain, it will lessen or increase as the rage/soothe ratio wanes or increases.

 

As Sarno says PT will only address the symptom not the problem. Sarno dos NOT deny that PT does give temporary symptom relief though and he says he does not really understand how that works. The point of the thread is to bounce some ideas around.

 

I have to point out one thing you said here "preventing atrophy from lack of use". This is a bit off topic but I am terrified of this very fact. While I do believe in TMS I do still have my doubts about structural issues. My story is a bit complex but basically I thought that I kept injuring my abdominal muscle over and over again and never let it healed. Then when my pain became chronic I stopped physical activity, both exercise and many normal movements. I suffered from a number of other symptoms and had a downward spiral. But thankfully discovering TMS helped me tremendously and eliminated many of those symptoms. I saw a number of physical therapists for the past couple of years and they all meant well but usually made me feel worse. It wasn't until I quit all PT and started improving on my own that I believed I can truly heal from TMS. I used to be an aggressive fitness addict before the pain and now 2 years of TMS chronic pain and the best I can manage is walking for 30-40 minutes at least 4 times a week. I've done this for four months. It's winter now however and walking is not so much an option anymore. I have improved so much by walking and I wanted to take the next step by going back into a gym again and implementing the exercises and stretches I learned in physical therapy. I started with trying core exercises and stretches first but I had the excruciating conditioned pain swoop back into my body shortly after. I am so fed up of fearing movement and the fear that I do in fact have structural damage. I am terrified that the lack of movement for nearly 2 years has caused irreversible damage and tightness and moving it will make it worse. This thought process keeps holding me back and until I can prove that I am well to do normal exercises, I don't think I can heal. What are your thoughts?

 

You certainly seem to need to find your proof hopeful. TMS knows you better than you know yourself. It will latch on to the tiniest bit of doubt.

I always doubted my back pain was structural because I always managed to do a very physical job. Even if I had a back spasm at work that would make me fall I could still get up and carry on. i had wondered why the pain didn't really affect me when I was totally focused on work. For instance when machine polishing a car for a day, I would know my back is going to ache for the evening, I wondered why my back always seemed to really ache as soon as I stop polishing and relax for a minute. If I ached as much as it did when I stopped what I was doing, I wouldn't be able to cope all day.

Maybe try doing some physical activity that will keep your attention away for your body, and try not to think about what pain damage could be possible while doing it AT ANY POINT. See if you can catch it out.

One thing I found helpful was to try and notice pain starting at the very point before you try and do something.

I have a very heavy old up and over garage door, no joke it must weigh at least 200kg, and you can only open it from the inside. I really thought it was a terrible job for my back and it would give me pain. What I noticed was when i bent down, before I even touched it, the pain crept in! BUSTED! I hadn't even strained yet but the pain started and when I clocked this the pain dissipated. What a lovely bit of evidence I thought!

 

PT sometimes offers some temporary relief, but in my case it never lasted. It certainly never cured me, but Dr. Sarno absolutely did.

I think the increased blood flow, stretching, and strengthening that can come from PT all help with temporary relief. Also, the act of being touched, cared for, and the sympathetic human contact that Tennis Tom mentioned all go along way towards making you feel better.

The important point is just what Dr. Sarno tells us. PT reinforces that the problem is structural and it should be avoided.