Any clues?

My friend X is suffering from persistent/chronic pain in her knee.
She has decided to undergo surgery because he is convinced that her pain comes from her worn out /aged knee.
She is also full convinced that surgery will stop her pain.
I know very well my friend X, her troubles, her life, her worries, her frustrations, .... even her hidden/repressed rage (unknown to her!).
IMHO my friend X is suffering from TMS pain.

What should I do ?
1-Nothing, just waiting if the placebo function of the surgery works in that case.
2-Tell my friend X about the real cause of her pain, being ready to receive her agressive reaction

Suggestions welcomed.
M

 

If you guys have never discussed it before, it's hard to open that dialogue. Keeping in mind why we have TMS in the first place, I have never heard of someone being told about it by another without a strong reaction "But my pain is REAL"..."THis NOT in my head"

I of course went evangelizing after my recovery, and I probably angered a lot of friends... which is not surprising since I was angry at the first guy who told me about it (LOL)

I have even told people about it who AT FIRST grasped it and got better, but later decided some other conversion symptom was 'real'...e.g. my friends back pain got better, but than he came down with 'real' TMJ. (Horrible marriage)

The pain is there to distract us from some unbearable anguish....oftentimes it seems more compassionate to just say nothing....

pray about it... that is a VERY tough choice.

 

I have had many discussions with people who listen politely to my TMS story, then say, “great for you, but my pain is real”. Maybe it is. People can have structural issues that will be corrected by surgery.
That said, I would let my friend do what she needs to do. If the surgery does not help, or a new terrible symptom arises, that would be the time to bring up TMS. She can then decide if it’s something she wants to pursue.

 

Based on your description, I would go with choice #1 for now.

 

I was very evangelical about TMS when I first recovered too. I even went on forums for fibromyalgia and migraines to spread the word. I received very angry responses. I've tried recommending it to friends with only one short term success. So I have given up. Now after someone complains about something that is clearly TMS, I just tell them that if they are interested in how I overcame my similar chronic pain, I'd be happy to talk to them about it. I think people discover TMS when they are ready.

 

The trouble with #1 is that she may have the surgery and suffer afterwards if the surgery turns out to be a botched job. If you're in the position of Ellen and you've recovered from TMS, then Ellen's suggestion of offering to tell your friend how you recovered is, imho, the best idea -- even if your friend does say that that was great for you but she's different and her problem's structural...At least you'll have mentioned it to her and can have no feelings of regret (or whatever) if you don't mention about TMS and the surgery's botched and, after any placebo effect's worn off, she does actually suffer with structural problems from the surgery. I say the latter because (long before I knew about TMS) a friend of mine had some vertebrae surgically fused to help his back and, with the kind of restricted movement that causes, it was far from a good choice.

 

In 2002, the prestigious New England Journal of Medicine published an article titled A Controlled Trial of Arthroscopic Surgery for Osteoarthritis of the Knee. Patients in the study were divided into three groups. Group one had one kind of surgery (lavage). Group two had another kind of surgery (lavage plus debridement). Group three was cleverly tricked into thinking they had surgery when in fact they did not (placebo surgery). The three groups were then followed for two years to track how they did. Here is the conclusion: "At no point did either of the intervention [actual surgery] groups report less pain or better function than the placebo [fake surgery] group.” Maybe that is a reason, mbo, to be optimistic about your option 1 above, though it is too bad your friend can’t have fake surgery instead of actual surgery.

I had arthroscopic lavage plus debridement of my right knee for a torn meniscus eleven years before that study was published. Unfortunately, the surgery did not help my chronic knee pain at all. I did not even get a temporary placebo boost. I later had two additional, more complicated surgeries to deal with increasing arthritic deterioration in my right knee. They did not help the pain at all either. Mine is not a tale of woe, however. I no longer have any knee pain despite the undeniable structural damage in my knee joint. How I got there is too complicated to relate here, but I can capsulize it by changing the third word in the the title of Sarno’s first book, Mind Over Back Pain, to make it Mind Over Knee Pain. To succeed, I had to do the same thing I did years earlier when I overcame more than two decades of low back pain. I had to reject--not just at a superficial cognitive level but in my core being--that the cause of my knee pain was structural. As pain scientist Lorimer Moseley likes to say, it is as simple and as difficult as that.

 

Hear, hear!

 

It could be a muscle spasm or cramp.