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SarnoFan
USA
72 Posts |
 Posted - 06/03/2009 : 10:51:21
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Okay. I've been preaching TMS to my son and yesterday he had an MRI. Today we were told he has a RUPTURED disc in the low back. He has had increased pain over the year. He's an elite athlete in a high contact sport. He doesn't play now due to pain but needs to get back in the next few weeks or he may miss a season again (pressure!). He was just referred to a neurologist and I worry this will prolong rather than cure his problem).
At this point, we are told this is different from a Herniated Disc so I want a "Sarno" take on the RUPTURED discs.
My son is devastated even though I told him it could be a "nocebo" effect and not a tru cause of his pain. I don't want us to go down the structural diagnosis path, but the doctors of course are scaring us into thinking this is serious.
Any thoughts |
Edited by - SarnoFan on 06/03/2009 10:53:04 |
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mk6283
USA
272 Posts |
Posted - 06/03/2009 : 11:11:10
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To my knowledge, there isn't any real clinical significance to disc rupture versus disc herniation. My understanding is that almost all herniated discs have some component of disc rupture as it is the nucleus pulposus at the center of the disc that normally is extruded/herniated and that usually follows some rupture of the disc capsule. So in it of itself, I wouldn't put too much weight on the fact that he has been diagnosed with one over the other. The terminology used by all is far from universal/standardized with regards to spine pathology. I, however, am not an expert and I do not have any personal insight to offer so I defer to any others with some more experience. However, I regardless would put far more emphasis on your son's clinical presentation and exam findings. If he has no deficits on exam (weakness, reflex changes, etc.) and has no other associated neurologic complaints aside from the chronic pain (numbness, tingling, etc.), then I wouldn't abort a TMS diagnosis based on this recent setback alone if you still feel he is someone who might be prone to TMS. Besides, what have you got to lose? I know you wouldn't dare be stupid enough to send him into the OR for this, right? :)
Good luck!
Best,
MK |
Edited by - mk6283 on 06/03/2009 11:14:38 |
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Peg
USA
284 Posts |
Posted - 06/03/2009 : 17:32:47
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You mention that he has had increased pain "over the year". Wouldn't you think if he had an acute injury (ie disc herniation) that it would have healed by now? The lack of resolution, IMO points to TMS.
You mention that he has been recovering from ACL repair surgery, so he hasn't been active in sports, making it unlikely that he has prevented his supposed back injury to heal.
Medical studies show disc bulges, herniations, spinal stenosis, arthritis, etc in people with no back pain. You are right about the steroid injections and surgery, studies do not show them to be very effective treatment options.
"He's an elite athlete in a high contact sport". Is that what he truly wants to be doing? Are there other pressures he is under? Preparing for college, etc
"...but needs to go back or he may miss a season again" How does he REALLY feel about this prospect?
Finally, does he fit the profile of a tmser? Is there any way you could bring him to see a tms trained physician? It can be very reassuring, even liberating to be told that it's tms and that there is hope.
Good luck.
Peg
In questions of science, the authority of a thousand is not worth the humble reasoning of a single individual. Galileo Galilei |
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Peg
USA
284 Posts |
Posted - 06/03/2009 : 17:33:56
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One more thing.
I like your name.
I'm a fan as well.
Peg
In questions of science, the authority of a thousand is not worth the humble reasoning of a single individual. Galileo Galilei |
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Peg
USA
284 Posts |
Posted - 06/05/2009 : 04:38:54
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Your son is lucky to have you in his corner.
".... I will have him confirm TMS before my son starts believing the disc is keeping him from being able to put his socks on."
-----Well said!!
I think the 1.5 hour drive would be worth it for peace of mind and more importantly, to avoid a future of unnecessary, ineffective and potentially damaging treatments. Not to mention the dire warnings creating the nocebo effect you mentioned above.
My daughter developed back pain at about 15 out of the blue with no injury. We went to her primary MD who referred her to an orthopedist. An x-ray showed some milld scoliosis, but no other abnormality. He recommended a bone scan to look for a slipped vertebrae (? spondyloliisthesis?), which would involve injecting dye into her system.
My daughter had had no injury and had not been participating in sports at the time. Her back pain began after losing her grandmother and also, after her daily stress headaches had gone away. She was admittedly a worrier and put a lot of pressure on herself in school. High school was tough with the pressures, peer groups, etc. She had the typical tenderness of the muscles in the other areas that Dr. Sarno had identified.
I communicated by e-mail with Dr. Sopher, who was supportive but a distance to travel. I decided to bring her to see a tms trained physician and we saw Dr. Martinez who practices in a neighboring town. He was excellent with her and confirmed our suspicion of tms as well as offering continued support.
So, we handled it the way we handle tms and her pain resolved. She's 20 now and doing well. She'll occasionally have tightness in the area, but now knows what to do and has developed stress management techniques. Of course as a teenager, it was difficult to get her to journal, but she has found what works for her.
Let us know how you make out.
All the best,
Peg
In questions of science, the authority of a thousand is not worth the humble reasoning of a single individual. Galileo Galilei |
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carbar
USA
227 Posts |
Posted - 06/08/2009 : 12:42:44
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When I came down with TMS related pain as a teenager I was "an elite musician." Developing RSI in my arms put a stop to all of my playing. It felt like my life was in free fall.
After digging around in the emotional stuff surrounding this, I came to discover that I built most of my self-worth on external success.
The fear of not being able to do the activity that gave so much meaning to my life was definitely a fear that fed right into the TMS cycle and probably prolonged my pain at the time.
Of course, my parents were completely clueless when it came to TMS and I had to figure this out on my own following years of pain. Glad you can be there for your child with helpful information!
That being said:
the phrase "winding up on a path versus choosing one" comes to mind. i'm not sure how I wound up being so into music. It just kind of happened. The momentum of childhood kind of piles on and suddenly as a teenager I was playing music for hours everyday. Almost a habit versus a passion. When becoming an adult there's a lot of consider, maybe this is a question that your son can ponder while considering the emotional aspects of TMS.
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sarita
130 Posts |
Posted - 06/09/2009 : 12:41:50
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sarnofan, go for the physical treatments. tms is more of an option if all other treatments failed.
GOOD LUCK |
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pandamonium
United Kingdom
202 Posts |
Posted - 06/10/2009 : 02:41:57
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I'm not sure I agree with Sarita. Although it's very difficult when the patient is a family member and almost an adult, I feel like he needs to make the comitment one way or another.
I've run a mile from steroid injections myself, and if I was the parent I'd explore the emotional reasons behind why he is experiencing this pain.
Just my two penneth.
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A beginner's guide to psychology: If it's not your mum's fault.... it's your dad's... |
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sarita
130 Posts |
Posted - 06/10/2009 : 04:13:38
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panda is right. i really dont know what steroids are all about, if its hormones i would be careful. but physical therapy helps in some cases. has helped me in the past. this time with my back pain, it didnt help AT ALL, in fact it made me worse. i am just saying this may be a clue.
a friend of mine had a hernia and through pt the disk just went back in. thats what she said at least. 
sarno said he has the biggest sucess with those who went through everything, chiro, pt, massage, acupuncture, meds etc etc.
if the physical therapist is good, it should not be bad.
panda is absolutely right about the commitment. without it, if you have one foot in the physical treatment and one in TMS, both will be useless. i also think, once he sees physical therapy is not the answer perhaps, then he will be more able to grasp and commit to TMS. not an easy task for a 17 year old. |
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Elorac
United Kingdom
41 Posts |
Posted - 06/10/2009 : 09:07:55
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I've been following this thread and I'm a bit confused.
I thought it was a fundamental belief in TMS that herniated discs do not cause back pain.
Can they cause pain sometimes? Does it depend on the nature or size of the herniation?
Doesn't Dr. Sarno describe a disc herniation as a "normal abnormality"?
When being assessed for TMS, aren't the physical exams etc. to rule out anything such as a fracture, tumour or infection? If the only thing that shows up on MRI is a heniated disc, isn't that considered to be irrelevant in regard to the pain?
(These are genuine questions, not rhetorical.)
SarnoFan, on reading your member profile. I don't know how long ago this was written, but you say that your son had chronic low back pain for several months, and that doctors and scans could not find a cause. Does this mean that at one point in the past your son had chronic low back pain but an MRI did not show any herniation? If there was no herniation at that time, what was the cause of the pain?
If you and/or your son think that his pain may be due to TMS but are unsure, then an assessment with a TMS physician would be a good idea.
Whatever you and your son decide to do, I wish you all the best.
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Edited by - Elorac on 06/10/2009 09:38:52 |
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mk6283
USA
272 Posts |
Posted - 06/10/2009 : 11:59:17
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TMS is not a diagnosis of exclusion. There are certain elements that should be present before one assumes they are dealing with a probable case of TMS. The patient's history (both medical and psychosocial) as well as their personality type are extremely important in the assessment. I have a friend who developed persistent back pain that just didn't feel like TMS to me. He didn't have the classic TMS personality, he had no history of any other psychosomatic disorders, there weren't any major emotional issues that he was (or was not) dealing with, and his description of the pain just didn't sound like TMS. I recommended that he get scanned and lo and behold he had an occult fracture that he thinks developed when he went skiing a month earlier. I have another friend who I was certain had TMS. I sat down and spoke to him, gave him the books to read, and he got better on his own. My point is that its just as important to rule in TMS as it is to rule out anything else.
As far as herniated discs are concerened, I'll repeat what I said earlier: they are usually incidental, especially in the sole setting of chronic pain. If the rest of the history and exam are unremarkable, then it is unlikely that the disc herniation has anything to do with the pain. I cannot comment further about this case in particular because I haven't seen the patient, scans, etc. and, more importantly, I do not know the individual involved. However, its always best to listen to your doctors and if you suspect TMS may be involved, then try and see a doctor who understands and treats TMS. Good luck!
Best,
MK |
Edited by - mk6283 on 06/10/2009 12:07:19 |
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pandamonium
United Kingdom
202 Posts |
Posted - 06/10/2009 : 14:38:43
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although in some ways you could argue that it would be easier for a 17 year old to accept TMS than some of us older folk!
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A beginner's guide to psychology: If it's not your mum's fault.... it's your dad's... |
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Elorac
United Kingdom
41 Posts |
Posted - 06/14/2009 : 08:08:17
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I have never had an MRI so I have no idea if I have any bulging or herniated discs. I was told (before I knew anything about TMS) that I "probably had a bulging disc". So I can't speak personally in respect of herniated discs, and I still have the confusion I mentioned previously about whether or not we are to believe that a herniated disc CAN sometimes cause pain. Has anyone been assessed by a TMS physician and told that their pain IS caused by a herniated disc? I don't know.
However, I think there are a lot of posts on here written by people who were diagnosed with a herniated disc, and who followed the TMS route and eradicated their pain without any medical procedures. Also, people who tried medical procedures to no avail and then succeeded with the TMS approach.
Has your son read any of these posts? It might help.
A formal assessment for TMS is probably what's needed to clear the confusion.
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JoeyT
USA
25 Posts |
Posted - 06/15/2009 : 16:21:40
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quote:
Originally posted by SarnoFan
Well we are seeing a TMS doctor next week to clear our doubts.
This morning we went for a 2nd opinion with a spine specialist (orthopedic sports med) who said the same things and more: PT, strengthen core, avoid certain postures/movements, retrain how to play his sport (how does one really do that and eliminate pain?) then try injection and surgery would be last resort. This Dr. said he also suffered a herniated disc at age 19 and is still 'nursing it' in his 50's. NOT encouraging. Not suprisingly, my son's pain increased from a 5 to a 9 after the appointment.
I had the same issue when I saw my neuro back in November. First off I was a mess last summer with all kinds of crazy things happening to my body...About the first of September I got some low back and leg pain. It was not that bad at all but at that time, with everything else going on with it I panicked and convinced the doc to get a lower back MRI...Of course it showed I had bulging discs and pinched nerves..But my doctor did not seem overly concerned and even said that it could likey go away over time...Remarkable my lower back pain went away about 90%... Right before Thanksgiving I had an appointment with my neuro that was scheduled about 3 months early as a follow up to some shoulder/ upper back problems I was having.. I showed the new MRI of my lower back just to keep her informed. I had very little if any low back pain when I enter her office. After she sees my new MRI she suggests I find a new, less physically demanding job, and refer me to a back surgeon...( I never saw the surgeon.)...The funny thing is when I got home my lower back began to hurt and it never really went away..
I started some back exercise and began to were a back brace at work..Also I began to hate my job, because i felt I was doing damage to my back that would not ever go away..To me that was the real beginning of my chronic back pain.
Oh yeah the shoulder upper back problems that plague me for over a year has almost disappeared since the lower back leg problems started.. |
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Webdan65
USA
182 Posts |
Posted - 06/15/2009 : 17:15:00
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In the 12 years since I had my first twinge of back pain - I've learned a lot.
First let me say, that everyone is different. But we often experience some of the same stuff.
TMS has been the culprit every time I have had pain. Yet, despite knowing all about it and curing myself a number of times over the past decade - it comes back once in a while. And even a seasoned TMS veteran can fall prey to believing the mainstream doctors and physical therapists.
While there MAY be a possibility the herniated disk is pressing on a nerve - there are tons of proven and well documented study that shows 65% of people WITH NO pain have herniation's. That means out of 100 painfree people, 65% of them have what the modern medical community would call "bad backs". They would caution you to bend carefully, not to lift heavy objects, quit your sports, basically stop doing anything physical at all.
Just because something shows up on an MRI doesn't mean it is the absolute cause of the pain.
I'm crooked. Meaning, the base of my spine at the tailbone is about 1.5" to 2" to the right of my spine at the center of my shoulder blades. I've got a wicked tilt.
I was NOT in pain. However, I went to physical therapy to work on these muscle imbalances likely caused by poor posture and compensating for pain back when I had it. But the point is, I didn't have much pain when I started physical therapy.
Dr. Shubiner told me - being crooked doesn't cause pain. There are tons of people with scoliosis that have NO pain.
It took 6 weeks before my physical therapists completely programmed my mind to believe that I had a bad back and no wonder I hurt. When I was under the constant care of a PT, my pain escalated beyond anything I have ever experienced. 8 out of 10 all day - every day. I was the walking definition of chronic pain.
Only when I came to my senses and dove back into TMS and fired my physical therapist did I begin to work myself out of the chronic pain thought patterns I had developed. I do truly believe chronic pain and thought patterns work together.
You get what you focus on. What you focus on magnifies. Expect pain, it will be there waiting for you. etc. etc. etc.
That's why Sarno's program is to talk to your brain, think psychological - ignore the pain, resume physical activity.
Unfortunately - there IS a huge catch 22. Sarno cautions to get checked out by a doctor to make sure nothing serious is wrong. Cancers, tumors, etc. However - when a MD tells you you have a herniation - our natural instinct is to go. "Holy crap, that IS serious." And from there, the though patterns spiral out of control.
My family wonders why I have seen so few doctors over the years - despite being in and out of some pretty serious pain. They just didn't get the TMS belief system that hearing "bad stuff" from traditional MD's will slow down the process of getting rid of the pain.
I've read recently that herniated and even ruptured disks can heal. Take an MRI a year from now and see if it is the same as it was in the last scan. The body is an amazing thing. If we can survive car crashes and amazing traumas from incredible accidents and recover to a life free of pain, surely we can overcome pain that seemingly came out of nowhere with no specific trauma.
My recommendation for your 18 year old son. Have him read, and re-read the sarno books. Tell him to commit to the journaling process. Perhaps all this self imposed, or coach imposed pressure to excel in school and in sports is enough pressure to cause these pain syndromes.
I guess my take is this: What does he have to lose by diving into a TMS treatment program. It is certainly less invasive than any traditional program of drugs, injections or surgery.
Lastly, when I dove into TMS to rid myself of my chronic pain - I stopped ALL exercises geared towards my back and fixing that crookedness. All I did was return to the treadmill and began lifting weights to prove to myself that I COULD do it and that I WAS NOT broken.
The less attention I paid to the pain, the more "normal" activities I resumed - the better I felt.
Hope this helps... And email me through the site if you want to talk off line.
Dan
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pandamonium
United Kingdom
202 Posts |
Posted - 06/16/2009 : 05:40:22
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I agree with what crk said on another post: if you go to a "physical" doctor, you're going to get a "physical diagnosis", and the more docs you see the more diagnoses you can have, take your pick! The fact that 2 or 3 docs can give conflicting opinions just tells me that none of them really know what's going on!
I'd stick with TMS unless a tumour can be seen, or something as serious.
I hope your TMS doc can diagnose your son, SarnoFan, and that he starts to become pain free. He has youth on his side and he should be receptive.
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A beginner's guide to psychology: If it's not your mum's fault.... it's your dad's... |
Edited by - pandamonium on 06/16/2009 05:41:19 |
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Elorac
United Kingdom
41 Posts |
Posted - 06/18/2009 : 09:47:49
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Hi, it sounds like you're doing all the right things. I wish you all well next week, whatever the outcome.
I'm sure that Dr. Sarno mentioned a patient of his who was a young athlete with a herniated disc, I'll try to find the reference for you, but I think it might be in "Healing Back Pain" and I have lent my copy out at the moment so I can't check that one. Maybe someone else can check that book.
Also, don't forget that, even if your son is diagnosed with TMS, Dr Sarno doesn't tell you to just jump right back in with your normal activities. He says that you should gradually reintroduce your normal activities when the pain is subsiding. If you try to do it too quickly your brain might still be programmed to expect pain. |
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stanfr
USA
268 Posts |
Posted - 06/19/2009 : 07:11:22
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Hi SarnoFan,
Boy it sure does sound like your son has a classic case of TMS based on the self-imposed pressure etc he's put on himself. He's lucky to have you guiding him in the right direction. Don't go too crazy wondering whether a 'ruptured dis' or other problem could really be causing the pain, Ive been asking for a good explanation of the precise role disc herniations play in TMS for 10 years and have yet to get a satisfactory answer--the important thing is to realize the psychological component here is what's causing the pain, not the disc. The way you know this is that countless folks (like me) have overcome these MRI-indicated "pathologies" and we are pain free!
Hopefully your son will come to realize the true cause of the pain, because it will be soley up to him to accept that diagnosis, and unless he can commit to that, TMS therapy wont do any good. |
Edited by - stanfr on 06/19/2009 07:12:58 |
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SarnoFan
USA
72 Posts |
Posted - 06/23/2009 : 07:20:03
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We saw a TMS doctor and based on his exam he wasn't able to conclude that my son is undoubtedly suffering from TMS ans nothing else.
The physical exam did not have all the tender spots he was looking for, but maybe one or two. His strength and reflexes were normal.
Based on the MRI and his symptoms, there is a possibility his current pain may be caused by nerve root compression or perhaps somthing else.
Since this TMS doc is a rheumatologist 1st, he took an xray and bloodwork to rule out arthritis. This was based on the fact that my son has had trouble with stiffness in his back, hips, legs for a year, even when his pain was minimal. The 'herniated disc' is probably recent, in the acute phase, and needs to heal. The issue now is...is it TMS anyway because symptoms appeared a year ago, yet peaked the last two months?
Therefore, he told us we should go ahead with the injection today that we had previously scheduled with our other doctor, to see if he gets relief.
My son has a follow up appointment in a couple of months to see how he has progressed with his epidural injection(s) and symptoms. This would also give the disc time to heal, if it is newly herniated. The L5 nerve root is compressed, and at this time the doctor cannot rule it out as the source of pain.
That's the update for now. I will write again with the results of the injection, rehab, and the TMS docs xray and blood test results. |
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Webdan65
USA
182 Posts |
Posted - 06/23/2009 : 07:35:48
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My recommendation:
While "waiting for things to heal" - pursue the TMS treatment as well. Work on reprogramming his mind to - I'm fine. My body is strong and getting better each day kind of stuff.
TMS is no invasive and won't complicate any of the physical remedies you are pursuing. In this way - you've got the best of both worlds. |
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Peg
USA
284 Posts |
Posted - 06/23/2009 : 12:15:09
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>"The physical exam did not have all the tender spots he was looking for, but maybe one or two"
One the other hand, you mention that your son has had " stiffness in his back, hips, legs for a year, even when his pain was minimal."
Couldn't this have been due to the muscle spasm that frequently is the manifestation of TMS. Those multiple areas seem to correspond to the areas that Dr. Sarno has observed tenderness in on physical exam of his TMS patients. Besides, why would a young healthy athlete have "stiffness in his back, hips and legs, for an entire year? That doesn't make sense to me, in terms of a physical, structural issue.
Of course you need to do what you think is right, and trying the injection for pain relief may be what's needed, but I didn't see any mention of your son reading one of the TMS books, doing any journaling, or speaking with a mental health professional.
I agree with Dan, why not try both approaches. Wouldn't that give your son the greatest posibbility of success (relief/healing)? Also doing some of the emotional work looking at his stresses and worries couldn't hurt.
Good luck,
Peg
In questions of science, the authority of a thousand is not worth the humble reasoning of a single individual. Galileo Galilei |
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Help: 18 yr old son diagnosed with RUPTURED DISC
