Chest Pain and TMS

Hello,

I'm 22 years old and have been dealing with chronic pain since November 2023. The pain started suddenly while I was at work scanning papers. I experienced a heavy, dull ache below my xiphoid that was unlike any pain I had felt before. Initially, I thought it might be related to a sickness I had been experiencing, but the pain persisted and became debilitating. It made standing, walking, driving, and even touching my lower ribs extremely painful. Additionally, I experienced significant discomfort in my thoracic region that sometimes caused nausea.

Despite undergoing various tests and treatments, including blood tests, endoscopies, steroids, and proton pump inhibitors, the results were inconclusive. I was diagnosed with musculoskeletal pain and referred to physical therapy. After two months, my back pain improved, but the rib pain persisted. During one therapy session, the therapist deviated from my usual treatment plan to try a different approach. This involved an exercise where I was positioned with my chest against a mat, while the therapist applied pressure to my back and had me lean back to stretch my thoracic spine. This exercise was uncomfortable and painful, and after it, my symptoms worsened significantly.

A CT scan showed no structural damage, and a subsequent course of prednisone did not fully alleviate the pain. I continued physical therapy for three more months with partial relief but ultimately decided to stop therapy. Now, in August 2024, I'm still experiencing pain. With no clear diagnosis, I've been researching conditions like costochondritis and xiphodynia, which are thought to involve inflammation that may not be visible on imaging. I found some information online that was concerning, particularly about costochondritis. There was a physiotherapist from New Zealand named Steve August who suggested that costochondritis could persist because the joints in the back tighten with cartilage. However, costochondritis is typically characterized by sharp pain aggravated by movement, while my pain is more in the lower ribs and xiphoid area, and I don't have tenderness in these regions.

I recently came across TMS (Tension Myoneural Syndrome) and am unsure if it could apply to my situation. My symptoms don't involve pain in the back, neck, and limbs like most others. I'm open to any possibilities but am struggling with uncertainty. I frequently cancel plans and find it challenging to manage work due to persistent pain. During flare-ups, the pain is present even when resting.

I'm looking for clarification on whether TMS could potentially be responsible for my symptoms or if there might be another explanation. Any insights or advice would be greatly appreciated.

Thank you.

 

Hi Hope,

TMS can cause pain --and many different varieties of pain, in any part or parts of the body.

I think you're on a typical journey of seeing how you fit the TMS diagnosis. Supporting pieces are "many tests and diagnoses and they can't find the real reason," a variety of treatments which don't resolve the symptoms, or may temporarily. This is the path: finding out everything you can which can confirm or refute that this is a mindbody issue. It can be tricky, but the more you learn about it, the more you'll either see or not see yourself in the stories of others. The location and type of symptom is less important than how you might fit a pattern of stress events correlating with onset, personality type, childhood mindbody ailments history, etc, etc. The Structured Education Program on the Wiki here is very helpful. Reading success stories is helpful, even if you don't find the exact symptoms, and you probably won't. I got all hung up on finding foot pain cases when what I read about was mostly back pain. Don't let these differences stop you.

Beginning to use the techniques and expecting to see results (with patience) is another major exploration intertwined with your education. If you get some results, this is a great confirmation you're on the right path. And, as Howard Schubiner has said, ask yourself (based on your physician diagnoses) or your physician "am I safe to pursue this path for the next six months without putting my health at risk." If the answer is yes, then you have nothing to lose and much to gain. And simply getting doubts and obstacles of all kinds brushed aside opens your way immediately to the beneficial effects.

Good luck in your journey and keep asking questions, and dig into the material deeply.

Andy

 

Thank you, Andy and Jan, for your insights. I realize you hear stories like mine daily and often offer the same advice, but your guidance has provided me with a stepping stone toward hope and reclaiming my life which I haven't had in almost a year now. I deeply appreciate it.

Here's to healing!
-Hope

 

Oh my....I'm so sorry that at age 22 you've been through all that with the doctors and unhelpful treatments.

What you experienced was normal pains that every single person has from time to time.
The fact that you know what a xiphoid is means you have been symptom searching way too much online or going to too many doctors.

The thing they don't tell you in life is that we all have aches and pains. And they don't mean a thing. We grow up with this expectation that we are going to feel 100% perfect at all times, energetic and pain free, at your service! The reality is that we do things and we get pains and inflammation, and then they go away.......unless we worry about them, question them, wonder if something is wrong and let our TMS brains keep us in pain to distract us from other issues.

And all those doctors and medical tests and physical therapy and drugs were adding more and more and more fuel to the fire.

You are right now in the throws of some heavy duty health anxiety, my friend. Rib pain in the area that you mention is one of THE most common pains in the world. Everyone has had it at some point. And eventually it goes away.

In the old days, we had doctors that weren't afraid of litigation and they would say, "It's just a pain. Don't worry about it. Nothing is wrong."
Today doctors are afraid of litigation and they make money for their practice by using all the new fangled tools to "rule things out."
You are stuck on the "rule things out hamster wheel."

Step right off it.

Pain in that ribs area is so common and 99 times out of 100 is meaningless inflammation that gets worse if you keep touching and checking it.
The 1 out of 100 times that it's not it would be something already been identified.

Good luck!

 

You’re 100% right. When these aches and pains came on I thought nothing of it until I saw the Dr. for them. They essentially said there was nothing identifiable wrong then prescribed me with Cymbalta to help with both anxiety and the pains. I’ve been hesitant to take the medication without knowing if it would work or not because nothing was found through testing so I decided against it. I’m continuing my education in occupational therapy, so my undergraduate classes focused on health has given me too much of an awareness of the body… That on top of endless searching for people with my specific pains and thinking my pain is unique or different somehow. Since I had gotten so lost in searching and thinking there is something wrong with my rib joints, it is going to take time to overcome the fear of my body being “broken”, but with time I hope this mess was TMS from the start.

 

I've been through the same thing many, many times.
I'm a lot older than you and I can tell you I've had that rib pain like that many times. The first time of course I got scared.
That's the one good thing about being old. You've had everything before and lived through it!