Hello everyone

Hi everyone. I’ve decided to become a bit more active in the TMS community. I went through the program in 2014 after a work related back injury and had some success. After the pain mostly went away I sadly gave up on all the skills I learned through the program and went back to my old self. I was never fully able to break the fear of back pain however. I was still partially stuck between physical and psychological. I’ve had some recent flare ups of back pain and anxiety and this time I want to be committed to not only becoming pain free but to also become fear free. As long as I am afraid I will never fully be cured of TMS.

Some background: I work as a paramedic and hurt myself in December 2013 lifting a patient. Was off work for 3 months. In that time I had an MRI that showed Schmorl’s Nodes which I was told are nothing to worry about by the doctor. X-Rays were also normal. I found Healing Back Pain during this time and read it and really agreed with the idea that my pain is due to emotions. I have always been an anxious person, worrier and perfectionist.

So my recent flare up of back pain started about a month ago. It is pretty mild and I only feel it when I bend forward. I am still working full time as a medic and lifting heavy at the gym. I don’t want to give these things up. I started to feel myself spiraling into that fear pain cycle again which is why I am going to go through the program again and this time I will not give up as soon as I feel relief. I want to break the fear for good this time. I am on day 4 right now and I am hopeful for the future. I have seen a doctor for my recent flare up and have an MRI scheduled just to rule out anything like cancer or infection, but until then I will be assuming this is just another TMS flare up.

Things I have tried that have done nothing are massage, chiro, naproxen and tylenol. I am seeing a psychotherapist periodically to work through some things, and have had some recent stress in my life that may have been the precursor to this flare up. I have decided to stop all physical treatment at this point. Thankfully I am still working and maintaining all my activities so I think I will have an easier time at this than my 2014 episode when I pretty much retreated into my apartment for 3 months. I am really appreciative of this community and I am hoping to post a success story here some day. My benchmark for success will be eliminating not only the pain but also the fear.

If anyone has any thoughts or suggestions I would greatly appreciate it.

 

Some interesting observations I made in relation to my first injury in December 2013 relate to a timeline of stressful events that preceded the injury.

In August 2013 I split from my long term girlfriend who lived with me. In September I had persistent cough and occasional shortness of breath. In my mind I thought lung cancer (yes I know crazy leap there). Got chest X-ray and was normal. In October 2013 I noticed a brief twinge of low back pain that lasted a few hours during a stressful call. Then on Halloween 2013 I felt like I got glass in my eye on a stressful motor collision call. When I got assessed at hospital there was no glass in my eye at all. Then around Christmas I got exposed to carbon monoxide on a call. Then 2 days after that I hurt my back.

It seems like my mind was trying a shotgun approach of TMS symptoms to find something that would stick and distract me. Back pain did the trick.

My most recent flare up started around the time I accepted a full time position at my job. I was part time for 8 years so going to full time has been stressful for me due to the increased hours. Since I never broke the fear cycle from my past injury, more work = more fear. Maybe the added fear started my flare up. Maybe my brain is trying to get me to go back down to part time so that it feels more secure. I’m not sure.

 

Hi John, thanks for sharing this part of your TMS story, and it's good to hear from you. Participating on this forum is helpful (and I'm addressing myself here as much as you as I too want to share more than I do). Like you, fear - and especially fear of TMS pain - is an ongoing issue for me. I am sure that working full time as you do will be helpful - I know from experience that when I am physically and mentally occupied and working with others my symptoms are a lot less noticeable.

Wishing you well and looking forward to reading more of your progress when you want to post again.

 

Thanks west. I think in my situation it’s the fear that is worse than the pain. For whatever reason I am terribly afraid of being off work and disabled. My first injury had me off for 3 months, and honestly I think it was mostly due to fear of making things worse because the pain wasn’t all that bad back then either. I probably should have gone back to work in a week instead of 3 months. So when I feel pain now, it is what the pain represents in my mind that is worse than the actual pain. Pain represents injury in my mind and injury represents disability. I need to find a way to break that pathway. Pain does not always equate to harm and is not a reliable indicator of tissue health.

Why do you think you still struggle with the fear? What does it represent to you?

 

Hello John,

This is a key insight. There is something 'shotgun' and random about the ways tms insinuates itself, and it can be somewhat bewildering as to 'what sticks'. Usually there is something symbolic about this, or as in your case, something that apparently threatens a change or a move. That you possess such clarity about this already is an excellent sign. As is your understanding of the role of fear.

...you have posted on this as I am writing

I note that you have followed the SEP first time round, have you had chance to explore Alan Gordon's new program yet? It contains fresh insights and is based more on neuro-psychology that the classic Sarno approach which translates as more tools in your tms-beating kit.

I have a hunch you'll face this flare down quick-smart and for good. Once you lick the fear, tms tends to shuffle off and leave you alone. Fear serves the purpose of keeping us preoccupied and therefore distracted. Tis a great moment when we realise there is nothing to fear.

 

Oh that's a big one and I don't have a definitive answer. Re fear of the pain it's something about the illusion of losing control, being overtaken by pain to the point where I lose my sense of who I am. Fear in general - linked to perfectionism and catastrophising. If I make one mistake it's the end of the world and I'm a worthless human being. So I get paralysed into acute anxiety and non-action.

I do understand your feelings around disability - many years ago I had long periods when I was unable to work for back issues.

I second @plum's suggestion re the Alan Gordon programme. This has helped me to defuse so much of the negative chatter that goes on in the mind. I need to be reminded that the answer is simply to realise there is nothing structurally wrong however much my brain and body try to convince me otherwise, to get on with life, to soothe oneself as best one can, and find joy and pleasure in just being alive. Easier on some days than on others I know. I'm struggling at the moment as I'm temporarily confined to the house while I recover from foot surgery last month and my TMS symptoms have ramped up. I guessing this is no coincidence.

 

So much of this centres on whether we feed the Wolf of Love or the Wolf of Hate/Fear (I've been listening to Rick Hanson again. Sometimes it does well to remind myself of his sage offerings).

Fear can blindside so terribly that it can be really tough to get back on an even keel never mind anything else. On days like that this forum is an absolute godsend.

How is the foot healing going?

 

Oh Plum it's so slow!! I'm reassured by the practice nurse this is not unusual for a foot injury as the blood circulation in the lower extremities (i.e. feet and lower legs) is less effective than in other parts of the body, plus I am 69 and you don't heal as quickly at my age apparently as you do at, say, age 19. However on the plus side the wound has healed sufficiently that I was able to start having showers/baths again 10 days ago which is lovely. For the past few weeks with the heatwave I've been wearing a deeply unflattering t-shirt and shorts and sitting on the patio reading, interspersed with watching the Tour de France. However the latter finished yesterday so I'm planning to start clearing out cupboards and drawers and suchlike.

It's been an interesting learning experience to say the least, but I'm increasingly thankful that in my case I will eventually heal - I'm guessing by the end of August give or take. That's a gift. And I agree with you that on bad days, like the last 48 hours for me, this forum is wonderful.

 

Bless you. Healing may be slow but at least it's sure. Funnily enough, once The World Cup ended I started another round of de-cluttering and space-clearing. It always makes me feel better. (I'm re-reading Marie Kondo).

I hope this next month treats you kindly and passes quickly for you.

Plum x

 

Hey Plum, I am not surprised back pain stuck for me. Back pain and paramedics go hand in hand. Literally anyone who has been working as a medic for more than 5 years will tell you about their back troubles. People say it's because of all the lifting we do. I'm not so sure I buy that explanation anymore. It makes you wonder if repression is an essential part of the job, and why so many medics end up with chronic pains. I wouldn't be surprised if it really is TMS. There's plenty of other professions that probably lift heavier and more often than us, and I doubt they have epidemics of back pain like we do. I am just speculating here of course.

Interestingly, I just finished working 60 hours over the past 5 days, and now I get 7 days off. I already feel my pain ease off a bit knowing that I have 7 days off to relax. It is still there, but it doesn't feel as threatening and intense as it did during my last 5 shifts. My brain probably associates being off shift with safety and being on shift with risk, so it ramps up the pain when I have to go in to work. Maybe my unconscious is trying to get me to call in sick so that it can feel safe. But I believe you have to face your fears head on. If you retreat, the fear will gain ground on you. It's weird that when I am actually on a call with a patient, I don't really think about or feel my back discomfort because my entire focus is on someone else and not on myself.

I did read through Alan's program over the last 2 weeks before I decided to start the structured program again. I really like the idea behind neural pathways as it provides a mechanism for what is actually happening. It seems more grounded in science, and it really opens TMS up to multiple directions of attack. I know some people here are completely against using medications. I would agree with that for NSAIDs and opiates because I don't think they really do much to break the pain/fear cycle. I am not so sure with regards to tricyclic antidepressants. There's lots of studies showing their effectiveness at treating chronic pain by working to desensitize the nerves. Neural pathways are essentially overly sensitized nerves from my understanding, so if you can desensitize them long enough to remember what it feels like to be pain free, maybe new pathways can form in their place. Of course you don't want to neglect working on the emotional issues as well at the same time. This way you can attack the problem from two directions. I have been considering trying Elavil to test out this strategy. I would want to see if after a period of time, maybe 6 months to a year, whether you could discontinue the drug without a return of symptoms once the new pathways take over from the old ones. Has anyone here tried this at all? I find it really telling that one of the front-line medications used for treating chronic pain are anti-depressants, which work on the mind. It really supports the TMS theory in my opinion.


Westb, it seems like you and I have very similar personalities. I too am a perfectionistic and catastrophizing person.I think the illusion of losing control is exactly where my fear of disability stems from. It is irrational though. If I were to be disabled, I have disability coverage through my employer, and also I have a loving and supporting wife by my side who wouldn't leave me to flounder. I am wondering since you are 69 years old, are you retired? Did you find your fear of losing control decreased after retirement or remained the same?

 

John,

In my (albeit limited) experience of paramedics, I have noticed just how much emotional lifting you wonderful souls do, if the numerous occasions we've had paramedics out to my Mother-in-law are any indicator. And I mean that sincerely. Having been a carer (caregiver) to my hubby for over a decade, I have become quite good at seeing such deft and immensely compassionate psychological acts of kindness. So yes, the physical lifting probably isn't helped by the psychological driving force that must accompany your work. I'm confident that a measure of repression occurs in all the caring professions. There is only so much human suffering anyone can take before being overwhelmed.

The patterns of pain, shifts and time off are telling. Delays in onset of pain is a classic indicator of tms. It really is entirely typical to feel nothing when using the body in ways that 'should' cause pain only to feel it come on later. I notice this a lot in myself in my caring capacity. I completely agree with facing fears, sometimes full-on yet at other times a graduated and gentle approach works best. Whichever we choose, it is the facing down of fear that counts. It is amazing to watch fears and pain fade like the kinaesthetic illusions they are.

I also agree completely with your view on meds. My tms manifests as trigeminal neuralgia and the strongest painkiller I take is paracetamol. After struggling for a number of years without meds of any description (which is why I pragmatically endorse their use as part of an overall healing plan), my doctor put me on Amitriptyline. They have helped me a lot. I'm not a 100% healed yet but after the best part of 2 decades and an insane amount of stress (my hubby was diagnosed with young-onset Parkinson's when I was in my 30's), I am much better than I dreamed possible and am maintaining a steady course. The link to the mind is irrefutable.

I'm glad you've joined the forum. You have a stable energy that feels good. And thank you for the great work you do, work of such importance and strength in those most frightening of human moments.

 

Plum how did you find the side effects of Amitriptyline (Elavil)? This is one of the medications I have been thinking about trying. Did it help your pain significantly and how long did it take to work? I was thinking of trying the lowest 10 mg dose to test it out.

And thank you for the kind words

 

No, not really, because immediately after my 60th birthday I injured my back and was confined to the house for 2 years with what was called spinal instability while I tried the orthodox treatments (very painful and didn't work). So I was forced to retire then. When I finally pulled out of the back injury my current severe IBS symptoms kicked in. I then found this forum and now understand that these are TMS-driven. I was conscientious and a worrier to a fault at work, was well thought of but I paid a very high price for that. When I no longer had work issues to worry and obsess about then the IBS started, seemingly to plug the gap. And that's what I'm dealing with now. I am so looking forward to finally getting on with my life and actually enjoying my retirement!

Re medications. Most days I don't take anything. Occasionally when the bloating and colon spasms are severe I take Buscopan. Maybe once or twice a year I take soluble aspirin or ibuprofen (paracetamol no longer agrees with me). I was on opioids for 2 years with my back pain issues and I never want to go near them again.

 

I think it's worth a shot. I started on 30mg and only increased to 40mg. The main side effect for me is the beautiful sleep (I take them in the evening), and sleep has proven to be a healing lynchpin for me. This ties in with the protocol of a doctor who posts here sometimes. His name is David Hanscom and I write how his work benefited me in 'My Story'. His take on chronic pain is worth exploring because he embraces oversensitisation of the nervous system.

The only other side effect I have is some weight gain but I am also peri-menopause so hard to tell how much to attribute to each. Aside from that...nothing.

The sleeping side effect came on within days, and the pain began to come off the top gradually. It wasn't dramatic. The doctor explained that I could go up to 150mg before trying something else if the Amitriptyline didn't work but these other things were anti-seizure meds and I said 'hell, no'. Possibly a slighter higher dose would have served to knock the pain out completely but I like to feel present and aware in my own life and I suspect higher doses would have induced a zombie state. At this level I am clear as a bell.

The meds just helped by acting as a circuit-breaker which has greatly enabled my discovery of healing practices that work.

 

Thank you Plum. And I'm a fan of Marie Kondo too. x