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sdiddy
46 Posts |
 Posted - 06/03/2013 : 16:19:56
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I have been working on TMS therapy for my shoulder (see my other posts for background) for almost 2 months now and have seen a lot of pain reduction during the active hours of the day. However, at night, the pain increases a lot and keeps me up and wakes me up.
Just curious as to why this is happening? It hurts most probably first thing in the morning, but then shortly after seems to dissipate quickly.
I am trying to figure out if this is TMS, or if I really do have a tear, inflammation, etc that is exasperated at nighttime for some reason. |
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tmsjptc
USA
124 Posts |
Posted - 06/03/2013 : 17:29:30
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| sdiddy, I've had different symptoms but the same aspect of hurting most in morning. Seems to me that if it was a tear or inflammation, you would get relief and healing after resting. But, if it is based on unconscious emotions then it could easily increase at night. The way I used this information was to further bolster my understanding and belief that it was TMS. |
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njoy
Canada
188 Posts |
Posted - 06/03/2013 : 19:34:52
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I agree that tms comes out to play at night when my mind and body are tired and not occupied with other things. I also wake up in the morning with aches and pains which dissipate fast (usually) and don't bother me (usually) in the day.
*****
"It's worth considering that tms is not a treatment but rather an unfolding of the self, and a way of living as an emotionally aware and engaged soul." Plum |
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Ace1
USA
1040 Posts |
Posted - 06/03/2013 : 20:25:56
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| A lot of times TMS tends to effect people when they are not so busy with work. They feel they should be doing something else more productive at that time or anticipating the next days work. |
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pan
United Kingdom
173 Posts |
Posted - 06/04/2013 : 05:31:44
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Any nurse will tell you that the demand for painkillers always elevates at night as patients become far more aware of their pain as the day ends and nighttime begins. The reasoning for this is purely that in the busy environment of a hospital in daytime patients are distracted and their brains are processing far far more visual and sensory stimuli...it doesn't take much to see how this fact correlates with why TMS patients also notice their pain more at night.
Wake me up with your amphetamine blast
Take me by the collar and throw me out into the world
Rock me gently & send me dreaming of something tender
I was brought here to pay homage to the beat surrender
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NextAdventure
USA
57 Posts |
Posted - 06/04/2013 : 06:28:54
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Lets get to the true physiology of this. Mornings can be bad because the body is stiff from lack of movement and circulation. The lymph system that removes byproducts works on muscle movement and during sleep they are less effective. Since we remain sympathetic dominant during sleep with TMS we can awake with pain.
As the day progresses chemicals like adrenalin that the body produces to keep us awake are also pain modulators. When we are stuck in sympathetic dominance (TMS) we are running high levels of these chemicals and hormones. Unfortunately we are also running high levels of muscle tension so the pain can exceed the pain gate control of these chemicals.
Around 3:00 pm these chemicals start to decline as the body prepares for evening somnolence. The combination of fatigue from chronic tension and the reduction of these alerting chemicals can make some people feel the pain worse.
Some people with autonomic dysfunction have diurnal aberrations so their timing of these cycles can be altered. |
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tmsjptc
USA
124 Posts |
Posted - 06/04/2013 : 09:19:33
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| NA, other than a little yawn and stretch, I never had this kind of pain in the morning before the chronic TMS started. Also, while going through the healing phase, I've had symptom substitutions. One of these was foot and heel pain that I had NEVER had before and it was most prevalent in the morning when I got up but continued all day to a lesser degree. Also, sometimes I would go to bed without pain but wake up with a tension headache. What kind of movement and circulation wasn't happening at night that you think would cause these things to sometimes happen? |
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Dave
USA
1864 Posts |
Posted - 06/04/2013 : 10:13:22
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quote:
Originally posted by sdiddy
I have been working on TMS therapy for my shoulder (see my other posts for background) for almost 2 months now and have seen a lot of pain reduction during the active hours of the day. However, at night, the pain increases a lot and keeps me up and wakes me up.
Just curious as to why this is happening?
Suggest that you re-read the portion of Dr. Sarno's book that discusses conditioning. It is one of the most important concepts of TMS. |
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balto
839 Posts |
Posted - 06/04/2013 : 16:20:24
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While you're awake your mind is occupied with many other things and you focus less on the pain symptoms. At night and early morning your mind is free so you focus more on the symptoms. The pain level is the same all day, you just think is it worst when you're focus on it. But the symptoms will get worst if you "expecting" it. You somehow condition your body to expect the pain to get worst at night and early morning.
for some people the symptoms get worst when they bent down to tie their shoes or when they brush their teeth or walk to the mailbox... Sometime in the past they experience a symptoms attack at a particular time or while doing something, after that their mind just associate that "time" or while doing that "thing" with an increase in symptoms. Their mind "think" that "time" and "thing" as a sign of danger and produce the corresponding symptoms. (fight or flight respond)
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No, I don't know everything. I'm just here to share my experience. |
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sdiddy
46 Posts |
Posted - 06/05/2013 : 11:27:34
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Balto, thanks for your thoughts....
I guess that is the confusing part for me. I TOTALLY understand that at night and in the morning it would hurt because i have a habit of thinking deep thoughts at night, life planning, career, family, stress, etc....I know its not healthy but I havent learned how to let go and pass out like my wife does. It has kept me up many nights of my life. SO that part makes sense.
The part that DOESNT make sense is what you mentioned, which is other times when I EXPECT pain or am sitting and even thinking and worrying about my shoulder and pain (during the day), and it doesnt hurt. For example...I will be sitting on the couch motionless, watching tv, and start stressing about my shoulder, wondering when it will get better and when I can play sports again, and normally this type of high level stress would have caused throbbing or shooting pains or something, but nowadays it doesnt do anything. Its actually concerning to me that my shoulder only hurts during very specific movements, or like at night when I spend quite a bit of time sleeping on my arm, because this seems to indicate that the pain isnt stress induced but rather a physical issue. It used to hurt all the time, but after letting it rest and doing TMS therapy, it now only hurts during specific movements or at night.
I am not sure what to think....Do I test it and start to play sports again? I am scared to do that and cause it more damage (if it IS in fact physical and not mental). I am just getting so fed up of babying it and not being able to do what I want, and its affecting my overall mood, stress, and health. |
Edited by - sdiddy on 06/05/2013 11:28:53 |
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Dave
USA
1864 Posts |
Posted - 06/05/2013 : 12:18:58
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quote:
Originally posted by sdiddy
Its actually concerning to me that my shoulder only hurts during very specific movements, or like at night when I spend quite a bit of time sleeping on my arm, because this seems to indicate that the pain isnt stress induced but rather a physical issue.
Again, please read, re-read, and re-read Dr. Sarno's explanation of conditioning.
It's not about your thoughts or expectations. TMS is more clever than you think. The fact that you believe "the pain isn't stress induced but rather a physical issue" is the precise goal of the symptom.
It seems you are overthinking things. Ignore the symptoms as best you can. Accept them as benign. Explore the potential psychological triggers. Resume normal activity. Trust that the symptoms will fade as long as your are diligent in your efforts to diffuse the power they have to preoccupy your thoughts. |
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bryan3000
USA
513 Posts |
Posted - 06/05/2013 : 12:28:58
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My symptoms have always been 10x worse in the morning/late morning and considerably better at night. For many of use, this is pretty easily attributed to daily cortisol and gaga/serotonin patterns.
I agree with Balto and others here, though... if your symptoms are at night, when your body should generally be more relaxed... it seems a good chance that conditioning or general thought patterns/anxiety are the culprit. |
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balto
839 Posts |
Posted - 06/05/2013 : 12:35:13
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sdiddy, I think your pain level increase during specific movements or at night is due to conditioning. Your body use implicit memory to increase the pain level at night or during specific movements. Let me try to explain it as best I can.
When you accidently touch a boiling pot of water, what do you do? Your hand would automaticly pulled back right away. You don't hold on to the boiling pot and think in your mind that: "hey, this pot is hot, if I don't pull my hand back it will burn and I will be in pain..." . That's your implicit memory at work. Old experience help instruct your body to perform a task without any awareness from you at all. It is a kind of conditioning.
Sometime in the past you experience a tms pain attack at night. Your body just remember the time (at night), the place (in the bedroom), the environment (the bed, the sheet...),... when that happened. Your mind "wrongly" associate "the time, the place, the environment..." as a sign of danger to you and it produce the necessary changes in your chemistry and physiology to produce the increase in pain level.
Some people have pain increase a suffer a panic attack each time they go thru a tunnel or over high bridge. Just about anything can be a "conditioning object", we just have to acknowledge that and eliminate our fear of it or try to loose any concern about it, the conditioning effect will lessen and be gone in time.
Pavlo's dogs stopped salivating at the sound of the bell after they don't get any food for a while.
About the fear of starting doing more sport, why don't you just start out slow. Just do light activities at first and increase the intensity as you feel more comfortable using your body again. When confidence come and fear is gone you will be cure. Goodluck.
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No, I don't know everything. I'm just here to share my experience. |
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sdiddy
46 Posts |
Posted - 06/05/2013 : 14:46:17
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I suppose you are right and this is very helpful info. I didnt realize that conditioning might really be a factor here. What then is the reason that if I stretch both my arms back, then the right one (the "injured" one) hurts? It seems that the goal of TMS is to initiate pain as a means of detracting or distracting me from dealing with my real stress and fears, but if the pain only generally hurts during a rare specific movement, then it doesnt seem similar to my other TMS issues in the past. Curious your thoughts on this?
Another TMS issue I have had (and still have off and on) is a throbbing chest and left arm pain....it stems from stress and my long-time fear of having a heart attack, despite my general good health. I have had above avg cholesterol for some years though, mostly genetic, (I dont eat fried food, red meat, sweets, etc) and have a generally active and healty lifestyle and below avg BMI, but having high cholesterol has really scared me. But when I get those pains, its a very "in your face" throbbing or shooting pain at ANY time of the day or night. I can usually take deep breaths and say "this is just TMS" and the pain goes away.
What I am experiencing with my shoulder is completely different, so I am trying my best to overcome it, but still have this nagging fear that if I try and do some light weight training or play golf or basketball again, I might re-tear my rotator (assuming that this was a physical injury), and then set me back another year or so. I dont know if I can handle that, but on the flipside, I dont know that I can live not knowing either.
Perhaps I should take your advice and take baby steps and see what happens? I am really trying to think back to how I cured my lower back TMS years ago, and I am pretty sure I just threw caution to the wind and went for, playing sports, etc and not caring about the pain. I cured myself VERY quickly of that 6 year long pain. But this shoulder thing is taking much longer. I think the primary difference was that with my back, after reading "healing back pain" I KNEW for certain that this was TMS. The book detailed everything I had been through exactly, but I havent seen nearly as much info or evidence on shoulder TMS, and I dont know what to think. Plus the multiple doctors I saw in the past about my shoulder all claiming a small tear and wanting to do exploratory surgery didnt help my confidence.
It feels good knowing you guys are here to offer your help and advice...dunno what I would do without this community. Thanks
quote:
Originally posted by balto
sdiddy, I think your pain level increase during specific movements or at night is due to conditioning. Your body use implicit memory to increase the pain level at night or during specific movements. Let me try to explain it as best I can.
When you accidently touch a boiling pot of water, what do you do? Your hand would automaticly pulled back right away. You don't hold on to the boiling pot and think in your mind that: "hey, this pot is hot, if I don't pull my hand back it will burn and I will be in pain..." . That's your implicit memory at work. Old experience help instruct your body to perform a task without any awareness from you at all. It is a kind of conditioning.
Sometime in the past you experience a tms pain attack at night. Your body just remember the time (at night), the place (in the bedroom), the environment (the bed, the sheet...),... when that happened. Your mind "wrongly" associate "the time, the place, the environment..." as a sign of danger to you and it produce the necessary changes in your chemistry and physiology to produce the increase in pain level.
Some people have pain increase a suffer a panic attack each time they go thru a tunnel or over high bridge. Just about anything can be a "conditioning object", we just have to acknowledge that and eliminate our fear of it or try to loose any concern about it, the conditioning effect will lessen and be gone in time.
Pavlo's dogs stopped salivating at the sound of the bell after they don't get any food for a while.
About the fear of starting doing more sport, why don't you just start out slow. Just do light activities at first and increase the intensity as you feel more comfortable using your body again. When confidence come and fear is gone you will be cure. Goodluck.
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No, I don't know everything. I'm just here to share my experience.
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Darko
Australia
387 Posts |
Posted - 06/05/2013 : 16:50:28
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Sdiddy,
I always get the pain at night.....If I have a stressful fight with my other half this can also give me pain at night. It doesn't sound like you have a physical issue......as they get better, and generally are painful all the time.
I almost sent myself crazy trying to figure out the conditioning theory.....might be true but wasn't for me in this application. It's really simple, if I'm "seeing" too many threats in my day to day life, or in the future I start to generate deep tension. You'll notice when your mind is occupied you'll start to tense a part of your body, like back area or shoulders.
The tension is deep in the unconscious because one keeps thinking negatively or fearing everything OR it could be an anger thing for you.....or all of the above!
I have to get my day to day thinking and focus under control. Ultimately I need to feel secure....and this gets me calm. It's mainly a money thing for me.
When the lights are out, then the tension sets in because consciously I know its all BS......
take a look at what is going on in your life and how you're thinking about it all....and change your perspective. Then it could take a little while for your system to calm down.
Good luck
D |
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balto
839 Posts |
Posted - 06/05/2013 : 19:39:16
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sdiddy, your mind is filled with nothing but fear thoughts. You constantly scanned your body for symptoms, your analyze your pain and trying to figure out what is wrong.... How do a worrier like yourself expect to get well? :)
There could be many reasons for your pain and why you feel the pain is worst at certain time or during specific movements. Like Darko said above, tension from everyday life's difficulties can have very negative effect on your tms symptoms. Or It could be conditioning like I've said earlier... Whatever it is, it happened because of FEAR.
According to Sarno's theory, that Fear is what keep your attention and distracted you from some strong negative emotion deep in your subconscious mind.
That Fear is what Claire Weekes call the second fear and is what keep you in a fear - symptoms - fear loop.
That Fear is what Dale Carnegie said we must laugh at to get rid of it.
That Fear is what the Buddha called the second poison dart. We doubted our self, we doubted our ability to be well.
That fear is what Steve O tried to defeat by doing and keep doing physical activities.
tms/anxiety can not stay exist without you fearing it. When all fear thoughts end, the body automaticly reset itself and calm itself down, and pain symptoms just melt away.
So try to find way to eliminate your fear, all of it, and you will be well again.
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No, I don't know everything. I'm just here to share my experience. |
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Dave
USA
1864 Posts |
Posted - 06/06/2013 : 10:28:49
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quote:
Originally posted by sdiddy
...if I stretch both my arms back...the "injured" one...hurts during a rare specific movement...throbbing chest and left arm pain...its a very "in your face" throbbing or shooting pain...I might re-tear my rotator...
Do you see a pattern here?
I believe you are "running up into your thoughts" and allowing obsession about the physical symptoms to continue. You are looking for some evidence or proof that the pain is TMS. None will be forthcoming. The more you focus on the physical aspects of the pain, the more the pain will continue, because it is working.
You are stuck and not allowing yourself to accept the benign nature of the symptoms. It is almost as if you are looking for reasons to prove that this particular pain is not TMS. The doubt has evolved into obsessing about the pain and that in and of itself is a distraction. It is a vicious cycle.
You have to try your best to stop thinking in the physical realm, accept the pain as benign, and resume physical activity. As long as you allow the fear to dominate your thoughts, the pain will continue, because its purpose is being fulfilled. |
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sdiddy
46 Posts |
Posted - 06/07/2013 : 11:03:33
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I hear what you guys are saying...I really do...but I guess my response would be....what if you are wrong??
If you are, and I resume basketball, and it was a tear, bursitis, inflammation, whatever, then it WILL get worse and potentially set back my healing another 6 months or so? This is my honest and open fear.
The pain doesnt bother me...its the fear of what the pain might be an indication of. I did shoot some baskets for the first time in a long time this week, and I will admit my shoulder is sore and hurts a bit more since then....I played gingerly and carefully, so who knows.
So then I ask myself....what to do? SInce neither you, nor me, nor even a doctor can say with 100% certainty as to what is wrong with my shoulder....After hearing your advice I am left with 2 choices I suppose:
1. To try and heal with TMS therapy I must truly 100% commit to TMS and not just sit around and hope the pain goes away, but actually use my shoulder, play basketball, golf, etc and not give the pain a second thought.
2. I can assume its a small tear or inflammation, leave my shoulder alone, not play sports, then when it heals and the pain is gone, start up physical therapy again to strengthen it and prevent any future injuries.
What do you think? Is my reasoning sound? I dont know what to do. |
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balto
839 Posts |
Posted - 06/07/2013 : 11:39:19
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S, the human body is an amazing machine. Any physical wound will heal in less than 2,3 months time. If after resting your shoulder 2,3 months and you still have pain then it is very very likely is tms. Also, if the pain level goes up and down, then it is also could very well be tms. Pain level from real injury don't go up and down. And do you notice your pain level go up and down in sync with your stress level? If it is then it also tell you it is tms.
Do you also have other "telltale" sign of tms, like insomnia, anxious, depress, stomach trouble....
The normal advice here is go have your shoulder check by an MD to rule out any thing serious. Take it easy for a couple months if you're not sure. Then if it doesn't improve then go the tms way 100%.
Another thing you can try is do whatever you can to stop worrying about your health and stop fearing your symptoms. You don't have to go back to all your normal physical activities, just work on eliminate your fear and health worry. If you're able to do that then you will be cure for sure.
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No, I don't know everything. I'm just here to share my experience. |
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sdiddy
46 Posts |
Posted - 06/07/2013 : 17:31:46
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Balto, I was playing sports and lifting weights without much pain in january and february, but then (perhaps I pushed too hard), the pain starting to creep in around march. I stopped playing sports and lifting as the pain worsened.
Since then I have let it completely rest, not doing anything strenuous with it. The pain DID dissipate quite a bit, and about 8 weeks ago I started "TMS therapy", which seemed to decrease the pain too. Now, I dont feel much pain except at night, morning, and during specific movements. But like I said, I am not using it much.
This week I got tired of sitting around and only running on a treadmill and went and shot a basketball a couple times. The shoulder felt stiff and sore, but not terribly bad after.
I think partially the doctors make things worse by saying things like "some tears and bursitis wont heal by themselves and require surgery because the tendon keeps rubbing against the bone" etc etc. Maybe its true...I dont know....but things like that are what allows me to have the nagging fear that something is physically wrong. I am sure you know what I mean.
To answer your other question, although I am not depressed or have severe insomnia or anything, I AM under a bit of stress and anxiety about having a baby with my wife. We are getting old and there is a fair amount of pressure (self imposed) to "do the right thing" and start trying, even though we dont feel 100% ready. The truth is, we will never will. That is the problem with type A people like us who ALWAYS want to do the right thing and make everything perfect...if I cant control the outcome of every circumstance, its scary for me. So YES I will admit its a nagging fear in the back of my mind...but truly I am not sitting around stressing like a maniac...I am trying to approach it pragmatically and with a healthy perspective, but still...its the scariest thing I have ever had to do or decide.
Not sure if this matters, but I also have not had a sip of alcohol in 60+ days (cleansing the system prior to trying to conceive). I would think this would actually help "heal" my shoulder faster too.
Anyways, thank you |
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Dave
USA
1864 Posts |
Posted - 06/08/2013 : 08:16:33
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quote:
So then I ask myself....what to do?
1. To try and heal with TMS therapy I must truly 100% commit to TMS and not just sit around and hope the pain goes away, but actually use my shoulder, play basketball, golf, etc and not give the pain a second thought.
2. I can assume its a small tear or inflammation, leave my shoulder alone, not play sports, then when it heals and the pain is gone, start up physical therapy again to strengthen it and prevent any future injuries.
That's it in a nutshell. You have two paths from which to choose. There is no in between.
If you are not at a point where you can truly accept that the pain is not due to a structural issue, and you cannot banish the fear that you may injure yourself, then your mind is simply not at a place where you can treat the pain as TMS. As long as you allow this doubt to occupy your thoughts, baby yourself and/or seek physical treatments, there is no chance of successfully treating the symptoms as psychogenic.
To recover from TMS you must be truly ready to take path #1. Even if you do not believe 100%, you must act as if you believe 100% and commit fully to treatment. If not, then you have no choice but to take path #2. Perhaps one day you will be ready to take the other path and commit fully to the TMS diagnosis. It seems you are not there yet. |
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Why does it hurt more at night?
