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pspa123
672 Posts |
 Posted - 01/09/2013 : 12:25:32
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| So for quite some time in addition to neck pain I KNOW is psychogenic but which is still a work in progress, I have had leg pain (one leg only) that seems to have TMS-like qualities in that it can move from the knee to the back of the knee to the hamstring, and doesn't seem associated with any acute injury. While it can be pretty intense, I don't fear it -- at least consciously -- and I have not let it stop me from my regular workout routine of the treadmill and indoor bike. The thing of it is though, it seems to be getting worse over time and much of the time it's now quite painful to walk or even just stand. Just going to the grocery store can be an ordeal. At that pain level I am finding it hard to just accept it or ignore it or float through it or some of the other techniques I have read about. The leg also just doesn't "feel" as though it's moving right, compared to my other leg. I would be greatly appreciative of any suggestions (other than rest LOL, I refuse at least at this point not to work out). |
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Peregrinus
250 Posts |
Posted - 01/09/2013 : 13:43:45
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Peter:
I’ve been having a similar experience. I usually notice a pain in my knee as I start on a bike ride: sometimes the left and sometimes the right. I push hard on the peddle slightly hyper-extending the knee and the pain often disappears immediately. I’ve been saying to myself that its just another TMS demon that came about after a friend had knee surgery about 6 months ago. He was in the hospital for one month!
Been reading your interesting posts and hope to see more.
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shawnsmith
Czech Republic
2048 Posts |
Posted - 01/09/2013 : 16:28:58
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Chapter 18 of Marc Sopher's book: "TO BE OR NOT TO BE … PAIN-FREE: THE MINDBODY SYNDROME"
HIPS, KNEES AND LEGS
I’d like to start by stating that total hip joint replacement can be a
miraculous surgery. However, just as CT scans and MRI studies of
the spine show degenerative changes in most of us as we age (usually
incidental and not the cause of symptoms), so, too, will hip x-rays
often reveal degenerative changes that are not the cause of symptoms.
This case proves this point.
Jack was a former athlete, now in his 40’s, with left hip pain. His
orthopedist told him that he would benefit from a new hip joint as his
x-ray showed “significant” degenerative changes. After this visit his
left hip pain increased and he mentioned it to me at the time of his
annual physical exam. When he told me that his right hip felt fine, I
asked him to humor me by having both
of his hips x-rayed. On x-ray, both hips had the same “degenerative” changes, yet his right hip did
not hurt! I advised him to put off surgery, resume activity (he had significantly decreased his exercise after being told of his arthritic
condition) and not pay too much attention to his hips. Following
these instructions, his discomfort subsided and he successfully
resumed exercise and athletics.
I’ve had quite a few patients like Jack. Enough to recommend x-
rays of both hips in all of my patients with complaints of chronic hip
pain. Invariably both appear similar on x-ray, though only one will
hurt. This is often sufficient to convince someone that they have
TMS – that their very real physical pain has a psychological cause.
What is particularly interesting are the explanations offered by
various practitioners when x-rays are normal. People are given
elaborate explanations about biomechanics and told they have
problems with various muscles (like the psoas), tendons (ITB, or
iliotibial band) or bursae (bursitis). Sometimes they are told they
have a knee problem that is resulting in hip pain. While this is
possible, I believe it is far less common than generally claimed. Leg-
length discrepancy is another condition that has been blamed for hip,
knee or foot pain (and even back pain). I find this extremely amusing.
Assuming that the patient’s legs are the same as the set he was born with, that he has used these very same legs for all types of activities
before without any problem, then why should this asymmetry be
responsible for symptoms NOW? How does this make sense? That
person’s musculoskeletal system has never known differently – it is
perfectly adapted to its structure.
TMS affecting the knees is also fairly easy to recognize. A
significant physical process responsible for knee pain is invariably
indicated by the history and examination. A sudden blow to the knee,
a forceful twisting or acute hyperextension can cause damage to bone,
cartilage or ligament. However, most of the chronic and episodic
knee pain lacks this type of history and exam fails to reveal important
intra-articular pathology. Eager to give a physical rationale for these
chronic, intermittent symptoms, physicians will offer chondromalacia
patella, patellofemoral syndrome, iliotibial band syndrome (ITB
again), arthritis, bursitis, tendonitis or possibly a small cartilage injury
not evident on exam. What all of these have in common is the
presence of a chronic, non-healing process. Although we are
incredible creations with a remarkable ability to heal, for some
reason, we are told that there is an ongoing physical problem. So, a litany of physical remedies are prescribed: anti-inflammatory
medication, steroid injections, braces and supports, glucosamine
chondroitin (no better than placebo in my experience), physical
therapy, special exercises to strengthen the quadriceps and possibly
arthroscopy (surgery).
In my experience these physical remedies either fail or provide
only temporary relief, supporting the notion of a placebo response.
Not infrequently if pain subsides, pain will surface in a new area – the brain does not give up its strategy!
Lately I’ve noted an increasing frequency of lower leg pain, either
in the calf or shin. Calf pain is described as sharp or stabbing and
may be precipitated by certain weight-bearing activities, but not by
others. The common diagnosis is muscle strain, pull or tear, though
I’ve seen it explained as compartment syndrome (this is an unusual
condition where exercise induces such an increase in blood flow and
muscle swelling that the pressure within the muscle compartment
becomes too great, resulting in pain). Usually the person has done
adequate stretching and warm-up before the activity and the activity
itself is not unusually strenuous or unreasonable for the given level of fitness. I know this one from personal experience because this is what my brain hit me with after I eliminated my back pain and sciatica.
Want to hear ridiculous? I could walk without much difficulty – if I
tried to jog, I’d get intense pain after 50 yards! I could bicycle 50
miles or do one hour on the Nordic Track, but I couldn’t run 100
yards! After many vociferous discussions with my brain, I was able
to get rid of this pain and have run five marathons in the past three
years.
Pain in the anterior lower leg, or shin, can be described as dull,
aching or sometimes sharp. Diagnoses may include muscle strain,
shin splints or stress fracture.
X-rays or bone scans may be used to support these diagnoses.
Despite this, I have found that TMS is the most common culprit.
Again, I will acknowledge that we can get injured, particularly if we
do a new activity to excess or improperly. However, the typical
individual with shin pain will have appropriate footwear and gear,
they will be doing appropriate stretching and warm-up, and they will
be doing an activity that they have been doing regularly, with facility and expertise. So, why do they get pain now? Once I point this out, most will accept TMS and be able to get rid of their pain and resume exercise. This is an exemplary case:
Steven is a teenager and a budding running phenom. In the course
of his training he began to experience left shin pain. He had not
suddenly increased his mileage or suffered any trauma. Methodical in
all things, his footwear, nutrition and hydration are all appropriate.
Podiatrist and orthopedist recommend rest as treatment for presumed
stress fracture. When he returns to running the pain returns. A bone
scan is ordered and interpreted as showing a stress fracture and more
rest is advised. At this point he came to see me. He admitted to being
a perfectionist and putting much pressure on himself. Not
surprisingly he’s a straight A student and participates in a host of
extracurricular activities in addition to running. After I explained
why I think his leg pain is psychological and running should not cause
him pain, he went home and read The Mindbody Prescription. The
next afternoon he phoned, obviously very excited. He had just
returned from a long run and felt fine! He went on to have an
outstanding season, continually lowering his times and improving his performance. His only frustration was an inability to convince his
teammates to think psychological and better deal with their “injuries.”
Barbara came in for evaluation of chronic hip pain. She also
noted intermittent heel, knee and low back pain. Symptoms appeared
to have begun around the time of her mother’s illness and death
several years prior. She worked full time in addition to her
responsibilities at home to her husband and teenagers.
She admitted to self-esteem issues and was candid about growing
up in an environment with multiple alcoholic family members. Her
pain vanished and has not returned since she learned that it was
psychologically caused.
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Edited by - shawnsmith on 01/09/2013 16:31:19 |
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pspa123
672 Posts |
Posted - 01/09/2013 : 16:39:43
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| Shawn thank you for that chapter. Some of what he is saying certainly applies to my situation, in particular about not doing anything unusually strenuous or unreasonable. And I have had experiences similar to his being able to walk but not run -- there are days I feel just fine in the midst of a relatively hard ride but two hours later I can't walk without lots of pain. I suppose one could also posit a physical explanation -- endorphins, muscles tightening after being warm, etc. --in any case a very provocative piece for which I thank you. |
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carrick
Ireland
19 Posts |
Posted - 01/10/2013 : 04:11:16
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Hi there,
I'm by no means an expert and am still in the process of healing, but please believe that your pain is TMS. I have had severe knee pain for the best part of a year, not severe any more but still consuming my thoughts, I'm working as hard as I can to change my thougt process. Please read SteveO's book, it has really helped me. My knees started to both me when I noticed clicking and grinding with certain movements, stairs and just an uncomfortable feeling, I suppose I was not in a good place at the time mentally either.
Anyway as Shawn mentioned below (thanks so much for your post Shawn), the physio told me that I had chondromalacia patella and that I would need to see him once a week, do lots of exercises, supports for my shoes etc and if all of that failed he would send me for an MRI. I remember the day I said, will this get better and go away and he replied no once you have it you have it! For me, that was the worst thing I could have heard. It got worse and to cut a long story short, I got an MRI which was normal but surgeon still told me that I needed arthroscopy. I really didnt want an op but things went downhill, I could hardly walk at this stage, severe pain in left knee, stairs were an absolute no, no. I ended up on crutches, very down in myself and then I discovered TMS. For the past few months I have tried to believe it TMS, at times I doubt but that's typical of the way my mind works. As mentioned I am still healing but am so, so much better, I can walk, do yoga, pilates (I couldnt bend me knee when it was bad so had to give up all the things I love).
I still focus way too much on my knee and how it is, but since discovering TMS and SteveO's book, I am making great progress and looking at life in a differnet way. I hope to wirte again when I am fully healed, but I just have to be patient and wait for the time to come!!! I know this is not a success story, but a hopeful one at the same time that I wanted to share....Good luck! |
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tennis tom
USA
4749 Posts |
Posted - 01/10/2013 : 07:20:51
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quote:
Originally posted by carrick
Hi there,
...I'm by no means an expert and am still in the process of healing, but please believe that your pain is TMS.
...I still focus way too much on my knee and how it is, but since discovering TMS and SteveO's book, I am making great progress and looking at life in a differnet way. I hope to wirte again when I am fully healed, but I just have to be patient and wait for the time to come!!! I know this is not a success story, but a hopeful one at the same time that I wanted to share....Good luck!
Hi Carrick,
Au contraire, yours is a success story, you've turned the TMS corner and taken control of your mindbody health. You are not letting the NOCEBOS of so called "experts" control your life. You are becoming your own expert on YOU.
You are leading a "dynamic" life of doing and not invalidizing. As SteveO says, "HEALING IS GRADUAL, VERY GRADUAL". Have a half 'n half, you deserve it.
Cheers,
tt
==================================================
DR. SARNO'S 12 DAILY REMINDERS:
www.youtube.com/watch?v=r0dKBFwGR0g
TAKE THE HOLMES-RAHE STRESS TEST
http://en.wikipedia.org/wiki/Holmes_and_Rahe_stress_scale
Some of my favorite excerpts from _THE DIVIDED MIND_ :
http://www.tmshelp.com/forum/topic.asp?TOPIC_ID=2605
==================================================
"It is no measure of health to be well adjusted to a profoundly sick society." Jiddu Krishnamurti
"Pain is inevitable; suffering is optional." Author Unknown
"Happy People Are Happy Putters." Frank Nobilo, Golf Analyst
"Be careful about reading health books. You may die of a misprint." Mark Twain and Balto
"The hot-dog is the noblest of dogs; it feeds the hand that bites it." Dr. Laurence Johnston Peter
======================================================
"If it ends with "itis" or "algia" or "syndrome" and doctors can't figure out what causes it, then it might be TMS." Dave the Mod
=================================================
TMS PRACTITIONERS:
John Sarno, MD
400 E 34th St, New York, NY 10016
(212) 263-6035
Here's the TMS practitioners list from the TMS Help Forum:
http://www.tmshelp.com/links.htm
Here's a list of TMS practitioners from the TMS Wiki:
http://tmswiki.org/ppd/Find_a_TMS_Doctor_or_Therapist
Here's a map of TMS practitioners from the old Tarpit Yoga site, (click on the map by state for listings).:
http://www.tarpityoga.com/2007_08_01_archive.html |
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carrick
Ireland
19 Posts |
Posted - 01/10/2013 : 07:59:05
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| Thanks TT, and thanks again for your help and support when I first posted on this forum, I hope you're keeping well. Here's a funny one, I was walking across the canteen in work yesterday, I feel I walk funny, as I am always protecting my knee (I know I need to stop that!), so I am usually conscious of how I'm walking etc, anyway as I walked I felt a sudden sharp pain in my knee, my reaction was panic, oh no I can handle the way things are at the moment, but I can't go back to constant sharp pain, so fear had set in...I let it get to me, but read few chapters last night, had a serious talk with myself and picked myself up...Anyway today, I was anxious about lunch time and what do you know as I walked in the exact same spot the pain hit me again...It has set me back a little, but in a way it confirms to me that this has to be TMS and the pain today was a conditioned response from yesterday! Who knows why it came yesterday but have to expect set backs and then get on with it as best we can...Speak soon TT and hope the weather is a bit better in your part of the world, lashing rain and cold in Ireland! Lou |
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tennis tom
USA
4749 Posts |
Posted - 01/11/2013 : 09:02:28
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quote:
Originally posted by carrick
...my reaction was panic, oh no I can handle the way things are at the moment, but I can't go back to constant sharp pain, so fear had set in...
...but read few chapters last night, had a serious talk with myself and picked myself up...
... as I walked in the exact same spot the pain hit me again..
...in a way it confirms to me that this has to be TMS and the pain today was a conditioned response from yesterday!
Thanks for the kind words Lou, driving up from the desert of Kali, to NorCAl was very windy and a few drops of rain, but sunny so far today.
Good post! Yes CONDITIONING, Pavlov's dogs and all that. Driving 600 miles yesterday, I had urinary urgency coming upon all my usual watering holes, even with topping up my tank with Flomax. Now I make a game of it, how many times CAN I go on a trip--my record was five times in 100 miles!--I'm calling Guinness, it should be a good tie in for their business. Fear is the TMS gremlin's best ally against us, facing it will give you power to control your destiny.
Cheers,
tt |
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shawnsmith
Czech Republic
2048 Posts |
Posted - 01/11/2013 : 09:12:35
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| Frequent urination = TMS. Been there, done that. Thank God that manifestation of my symptoms is in my past. |
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pspa123
672 Posts |
Posted - 01/13/2013 : 11:13:51
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| Shawn and Carrick, thanks. I am trying my best to apply a TMS mindset to this and just to let it be, but as it keeps worsening when I work out it is getting hard to keep that approach up. The treadmill has been a refuge for me over the years, now it's more a torture chamber. |
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shawnsmith
Czech Republic
2048 Posts |
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pspa123
672 Posts |
Posted - 01/13/2013 : 11:56:49
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| Shawn thanks I've been applying some of those principles to it, not straining against it, not fighting the pain, just being with it, etc. i have tried SteveO's technique of trying to focus on a different part of the body. And I understand Marc Sopher's logic too, although it seems a bit reductionist. But for all that it's starting to feel like a biomechanical problem/injury. |
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shawnsmith
Czech Republic
2048 Posts |
Posted - 01/13/2013 : 14:20:56
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| I am assuming you had a full medical exam on the knee and leg. What were you told about it? In other words, what label did they place on your condition? No one on this message board can say you do or do not have TMS; you will have to come to that conclusion on your own. Most of us, except for a few, are not doctors or any kind medical professionals. We base our comments on what we have read on our own or daily experience within our own bodies. Recovery from TMS takes time and the more you want it to be quickly over with the longer it will take to recover. Personally, I have had TMS for about 8 years, not always in the same part of the body, and I always try to remain hopeful even if at times I have days of discouragement. Some people recover in a matter of weeks and some people take quite a bit longer. There is no magic number regarding how long recovery takes as it is dependent on many factors. |
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pspa123
672 Posts |
Posted - 01/13/2013 : 15:29:52
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| Shawn, no, no medical exam on this knee. I want to avoid the nocebo of the physical diagnosis, or to date that has been my thinking. |
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shawnsmith
Czech Republic
2048 Posts |
Posted - 01/13/2013 : 15:59:17
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quote:
Originally posted by pspa123
Shawn, no, no medical exam on this knee. I want to avoid the nocebo of the physical diagnosis, or to date that has been my thinking.
Although I understand the impact of nocebos on a person who is already suffering, I feel even Dr. Sarno would recommend a physical exam on any new symptom with a view to ruling out anything serious. But that is your call. I had a very severe case of frozen shoulder a couple of years ago which was pure agony. I went to see the doctor about it just in case. I even did physio until I found out that he did not know what he was doing and it cleared up on its own. And guess what? As soon as that shoulder cleared up the other shoulder started. How weird is that? That's classic TMS. |
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pspa123
672 Posts |
Posted - 01/13/2013 : 16:35:15
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| Shawn thanks. If I am to believe Dr. Sopher and other orthodox TMS thinkers, it must be TMS because I have no acute injury and there is no such thing as chronic biomechanical/overuse injuries causing pain. When I take just the slightest misstep and feel my knee twist and get sharp stabbing pain though, or when I can't straighten my leg out, I wonder? On the other hand, the prospect of getting a physical workup and being misdiagnosed with some innocuous thing as the source of the pain is equally unappealing. I don't know what to do. |
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shawnsmith
Czech Republic
2048 Posts |
Posted - 01/13/2013 : 16:49:16
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| Trust me pspa123, I sympathize with your dilemma. |
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Leg/knee pain advice welcome
