Understanding how pain occurs

I would really like to understand how the pain is caused with TMS. I am going through Alan's new program, and in one video he tells the patient how her brain is basically interpreting a neutral sensation as dangerous and painful. I read Healing Back Pain and there was talk about the mild oxygen deprivation affecting the muscles, tendons & ligaments.

I've had back, hip and forearm/wrist/hand trouble. In PT I was told that my muscles were incredibly tight & impinging my nerves. EMG confirmed mild nerve impingement and MRI also found a herniated disc in my neck. I do believe this is TMS, but I also believe my muscles are very tight, I can feel the knots, confirmed by massage therapy, etc.

I'm trying to understand if the TMS is actually affecting my muscles and causing them to tighten, or are these perceptions of pain simply coming from fear and danger signals in my brain? Is the muscle theory separate from the neural pathway theory? The science of this is murky to me right now.

If there are other posts or books I should read, please point me in the right direction. Thank you!

 

My interpretation is there's many theories and it's probably best to go with the one that you believe in most. Could it be oxygen deprivation? Yes, but it could absolutely not be. I think the fear, anxiety, and every other negative emotion causes extreme tension in the body. Spasms can also come from this as well and when you mix spasms and tension together nothing good happens. I'm still trying to find a theory that works for me, there are multiple ones.

 

For me it is muscle spasm and pain, no question whatever.

 

Kinda looks like Dr. Ira Rashbaum who took over for Dr. Sarno at NYU still stick to the O2 deprivation theory...doesn't matter as long as people heal.

 

Me too... Low back spasm and daily moderate pain, no matter what I do! I should add, I have other odd symptoms too... Some which I know are nerve, tension, stress related and others, still on the fence about... Such as, stomach upset, headaches, racing heart, trouble sleeping, and pain in joints and muscles.. 90% of which occurs only on my right side... BruceMc mentions his was predominantly on his left side, which kind of supports the TMS theory... Why one side and not the other? Especially when I suspect I have arthritic (OA) changes (I'm 51) on BOTH sides...

 

I overcame nearly a quarter century of low back pain by accepting the oxygen deprivation explanation for why I should not fear the pain. That was back in 1991 right after Dr. Sarno published Healing Back Pain. I bought the book, read it, and applied it in my life. After that, however, I experienced nearly another quarter century of Sarno's symptom imperative in various parts of my body, usually not realizing there was nothing structurally wrong. I overcame all my symptom imperative pain by using the neuroscience explanation.

Forest mentioned Lorimer Moseley above. His Explain Pain (2d ed. 2015), co-authored with David Butler, is ridiculously overpriced, but for any TMS sufferer with a spare $85, I highly recommend it. Butler and Moseley's basic thesis is that that your brain creates pain to protect you when it concludes there is more credible evidence you are in danger than credible evidence you are safe. They use what they call a biopsychosocial model. The danger might be purely biological, as when you cut your finger or touch a hot pan on the stove. But independently of any biological contributor, the brain creates pain when psychological contributors lead it to find more credible evidence you are in danger than credible evidence you are safe. Using their framework, my own view is that the brain can and does create pain when it gets evidence of a build-up of lactic acid in a muscle that is burning oxygen faster than it is being supplied (what Sarno called mild oxygen deprivation). This is a biological contributor. But the brain also can and does create pain completely apart from any lactic acid build-up, due entirely to psychological contributors.

I fully agree with Forest when he says "what is important is overcoming your fear." Butler and Moseley's main treatment idea is that if you understand the neuroscience of how and why the brain erroneously creates pain when in fact you are not actually in any physical danger, that will enable you to overcome your fear. To me, that is a more powerful and effective way to overcome fear than trying things like outcome independence or soothing affirmations.

Although I have moved beyond Sarno to neuroscience in some respects, I think his descriptions in Healing Back Pain and The Divided Mind of how he treated his own TMS equivalent of heartburn (gastroesophageal reflux) are brilliant. That approach works for me. I think Butler and Moseley's treatment of psychological contributors to pain would be improved if they incorporated Sarno's ideas about the role of repressed emotions, principally repressed anger, as sources of danger that induce the brain to create pain.

 

Also recall that neural pathways can produce real (reversible) changes in the body! So it's possible that both explanations are correct...neural pathways initiate oxygen deprivation in some instances of TMS, causing muscle spasm or nerve tingling sensations. It all ties together.

 

Thank you to everyone for the thoughtful replies. I know that my desire to have the "perfect" understanding is just part of my personality traits that have led me to TMS. I just have to piece together what makes the most sense to me and then stick with it!