Need some help (chronic tension)

Hi everyone!

It feels great to have found a forum where other individuals also have chronic pain (or have hopefully gotten rid of it). Let's start my pain journey from the beginning. I was around 11 years old when I started to notice tightness in my neck, shoulder, and upper back (mostly on the right side). It eventually became quite irritating and started affecting my life. I became more sensitive to light and sound and couldn't run without getting headaches (which were there most of the time, even when not running). I finally decided to consult a physiotherapist. She diagnosed me with a lot of trigger points in the area of pain/tightness (neck, shoulder, upper back – you name it). She thought the reason for my discomfort could be my excessive screen time, with PlayStation and the phone being the biggest culprits. As I desperately wanted to get rid of the symptoms, I cut off all of those things. As you may understand, it was challenging, especially explaining to friends that I couldn't play games with them because of this. I felt ashamed of my limits, but the feeling of tightness and headaches was worse. Over the coming years, I found some unconventional ways to use my phone without discomfort, or maybe you could say "without consciously experiencing discomfort." I became obsessed with ergonomics and maintaining "good posture" overall.

My head plays a significant role in the discomfort I am feeling. As soon as I think, "Hmm, maybe this movement is bad for my tightness," it worsens, and eventually, I become afraid of things you shouldn't fear. For instance, it could be lifting heavy objects without "good" posture or even odd things like wearing a hoodie. The tightness shifts from day to day, and at times, I experience more tension on my left side, while at other times, it's on my right (though I consistently have tension on both sides).

Unfortunately, I also started experiencing other problems. When I was around 13 or 14, I began to feel pain in my right arm. It felt stiff, and even as I write about it now, I'm experiencing some stiffness (and occasional flashes of discomfort). I started using an "elbow protector," which was supposed to improve blood flow. I also significantly reduced using my right arm, believing it was overused, which was almost comical to see me typing on a keyboard in school with one arm. Even this "injury" was embarrassing for me, and I started making excuses to avoid using my right arm. Of course, I thought I had carpal tunnel syndrome. I gradually improved over time (perhaps over a year or two) by following a 10-minute daily routine on YouTube with a massage gun designed for people with carpal tunnel syndrome.

So, the last few years have been somewhat better. I've started using my phone in more normal positions, but only when necessary (e.g., when I have to make a phone call or when I'm too uncomfortable to come up with an excuse not to use my phone). I still get tight and painful after using the phone in positions that aren't "good posture," even if it's only for a minute or less. I've always used the phone, but only in positions I deemed as "good posture" or ones that don't cause discomfort. These positions are mostly when I'm sitting with my elbows on my knees or on a table. I've never found a way to use the phone while standing without experiencing discomfort/tightness afterward.

About a month ago, I decided enough was enough and began investing time in solving this problem once and for all. I researched all my symptoms, and the diagnosis that made the most sense to me is Myofascial Pain (Trigger Point Pain) and Levator Scapulae Pain on my right side (which I wasn't even sure existed before I started trying to diagnose myself, but I felt pain there when I tested my Levator Scapulae). I started using a massage ball to target my trigger points and incorporated daily stretches. I became very frustrated and disappointed when I couldn't seem to find the perfect trigger point or didn't experience relief from massaging and stretching.

In recent weeks, I've started learning about the mind-body syndrome, and much of it resonated with me. The usual personality type for mind-body syndrome was a perfect fit for me – someone with severe anxiety, especially socially, a people pleaser, highly self-critical, a perfectionist – basically, all of that. I scheduled an appointment with a new physiotherapist and hoped he would be knowledgeable about this syndrome, as it was mentioned in his profile that he was "fascinated by chronic pain and how the nervous system can influence the pain we feel." To my disappointment, the meeting focused entirely on my symptoms being primarily caused by lack of movement/tightness in the upper back, and he gave me exercises to work on. Unfortunately, I was too uncomfortable to confront my ideas about the mind-body syndrome. He suggested that I shouldn't be afraid of using the phone in a normal, looking-down position as long as I took micro-breaks. This made me wonder if he was considering the mind-body connection without explicitly mentioning it.

Now, I'm in a state of confusion. I have another appointment with him next week, and I don't know if I should trust that all my symptoms will improve by doing these upper back exercises. I wonder if any of you have a story similar to mine. I would also appreciate some help in diagnosing my discomfort – do you think it could be related to mind-body issues? Could this tension be resolved with a combination of physiotherapy and mind-body work, or is that as confusing and counterproductive as it seems to me?

I would appreciate all your thoughts and help. Excuse me for my lengthy text; it feels like a huge relief to have written this, as it has been my secret for the last 8 years.

All the best!

 

Your PT is quite informed.
He’s asking you to dump the fear, and get back to doing movement with your body so you can see there is nothing to be afraid of.
Taking breaks from your phone is good advice. Phone usage can be a way to disengage with our emotional world through mindless scrolling or the feeling we need to be jumping on things at work immediately. A break helps you contact with the real world going on around you.
The back exercises can help you fear using these muscles less, it’s up to you to decide if that is working for you. Some folks find the need to focus less on the pain areas and simply get to moving more as Sarno suggested to slowly get back to regular activities.

Muscle tension is the T and the M in tms. You need to engage in the TMS work and at tmswiki.org (scroll down the page) there are two free programs that introduce you to the work. Work through one of your choice slowly, and lean into it. This is heart and soul work not just thought work.
You’ll learn techniques that hopefully enlighten you to the emotional work, patterns, triggers, self-soothing and ultimately confronting your fears.
For Anxiety, Claire Weekes books are old fashioned, but none are better.

good luck!

 

Thank you for your reply. It made me realize that the PT could be informed and someone who deserves more trust than a judgment from me after just one session. I will engage in the TMS work as suggested. I have also ordered Alan Gordon's book "The Way Out," which I have heard should be really good. I like the podcasts he has been engaged in, so hopefully, it will introduce me to the work that needs to be done. Have you read that book, and if so, do you recommend putting your trust in it? All the best

 

@Mountainclimber1
Alan’s book is excellent, and the Pain Recovery Program offered here for free is the precursor to the book. They go very well together.
Talk to your pt and ask if he’s read the book. If you find your pain continues while engaging with your pt over time, you might try experimenting. Ask to do exercises for overall fitness and wellbeing and not just targeted to your pain site.
You could also suggest you’d like to take a break from any physical therapy for a few months to assess whether you can do this on your own.
I’d just go slow. Wait to make any decisions as you proceed. Part of your goal is to address your highly activated nervous system. Being slow and gentle to yourself helps.

 

It's good to hear that the book is a worthwhile investment and that it complements the program offered here. Thank you for your advice regarding my work with my physical therapist; as you mentioned, patience and assessing it over time are probably the key factors. I appreciate the time you have taken to assist me; I truly appreciate it!