I had a very interesting experience regarding TMS (Tension Myositis Syndrome) pain this week.  As you know, I have been talking about how most chronic neck, back, shoulder, knee and hip pain has an emotional cause rather than a physical one.  As Dr. Schubiner (one of Dr. Sarno’s successors) says that when he examines a patient for the cause of pain what he looks for is a tumor, and infection or a fracture; almost everything else is TMS pain. 

One day this past week I was practicing yoga.  I decided to do some work on my shoulders.  I did some intense stretching with weights.  I felt great!  I then taught a class, had a meeting with someone and then sat down at my computer to begin to write an article for my newsletter.  I was probably working for about 2 hours.  When I was finished, I went to get up and I realized that I couldn’t lift my right arm.  I was in so much pain!  Meanwhile, I hadn’t felt a thing prior to that moment.

Great, I thought, now I really did it!  I messed up my shoulder.  It must have been all of that intense stretching with the weights.  Now what was I going to do?  How would I be able to teach my classes?  I was working on making some videos about arm balances.  How would I be able to do that?  My shoulder was really messed up.  Maybe I should have it looked at?

For the rest of the evening, I was in a lot of pain.  I used my left hand to do everything because my right arm hurt so much.  I was pretty down about it.  I complained to my husband about it.  I told him that I thought that I had really done something bad to it.  His response was to tell me to just relax.  He said I probably overdid it and that it would be fine in a day or two. 

Well, that shut me up.  I realized I was not going to get any sympathy from him.  But inside my own head I was worried about it.  I also thought: “Great, Karin, you have been going on telling people that their pain, no matter how physical it feels, does not have a physical origin.  Now, here you are, thinking about seeing an Orthopedic doctor to get your shoulder checked out and you are probably going to need shoulder surgery.  How can you possibly keep talking about TMS now?”

I was dejected and wasn’t sure what I was going to do.  The work I had been doing at my computer earlier in the day was an article for my newsletter about TMS pain.  I had spent 2 hours on it and now I couldn’t possibly publish it.  How could I tell people that their pain was TMS, but that I had really messed up my shoulder?

There was nothing more I could do that evening.  So, that night I just went to sleep thinking about how maybe all of this TMS stuff wasn’t real.  Even though I had seen Dr. Sarno in the 90’s and he had cured me of excruciating back pain back then, what was going on now???

I woke up abruptly in the middle of the night and the first thought I had was that this pain was just plain bullshit!  I had this sudden clarity of thought that the pain absolutely was TMS pain.  I thought back on my day and I realized that I had done the stretches between 7:00 and 8:30 am when I was practicing before teaching my class.  I taught my class with no hint of pain in my shoulder whatsoever.  I had a meeting afterwards where there was some disagreement with the other person.  Still no pain.  I sat down at my computer to write my newsletter, with which I have a love/hate relationship.  I like having a newsletter and I think most of my students enjoy it to some degree, but it is a burden to have to crank it out every week. (Which I have been doing for years.)  Still no pain. It wasn’t until I went to get up that I notice that my arm hurt.

I asked myself, If I hurt my shoulder during the stretches, why didn’t my shoulder start to hurt right away?  If I had strained, or tore or pulled something, I would have noticed it during the workout.  This was evidence that I did not “do” anything to my shoulder. 

Then I thought back to my meeting where I disagreed with the other person.  One of the important factors in TMS pain is the personality traits of people pleasing.  I do not like disagreeing with other people, but I had. This makes me subconsciously feel uncomfortable and is one of the emotional causes of pain.

Writing my newsletter is also a source of stress.  I often end up on Sunday evening trying to crank it out at the last minute.  Here I was trying to be good (another personality trait implicated in TMS) by writing it during the week.  This self-imposed pressure is a contributor to TMS pain.

I often wonder why the people I talk to about TMS always go to a physical cause for their pain.  Yet, here I was looking for a physical cause to pin my pain to.  I tried to blame something that happened nearly 6 hours before to the pain I was experiencing in my shoulder.   

As soon as I had these thoughts, my pain dissolved.  And that is literally what it felt like.  I had successfully cured myself of the back pain that had to do with repressed emotions about my mother, her bout with Alzheimers and her eventual passing and all of the burdens of responsibility that fell to me as her primary caregiver.  But now, my subconscious mind was looking for a new place to put the pain.  Dr. Sarno called this the symptom imperative, where you cure the pain in one area only for it to show up in another area.  Until you deal with the emotional stuff, the pain will keep popping up. 

My right shoulder has always been a slightly problematic area for me and I think my subconscious mind saw an easy target to house the pain.  And, for a short period of time, it worked.  I really thought that I had messed my shoulder up for real this time!

It was so very interesting to me that my mind immediately went to a physical cause, which it wasn’t.  It is also funny that catastrophizing is one of the behavioral traits of people prone to TMS.  I immediately thought that I had “really messed up my shoulder this time”.    I was in such a panic over what I might have done to my shoulder that I didn’t stop to think that the onset of the pain and the physical activity had nothing to do with each other.  Fortunately, this time, I was able to say to myself, “Karin, you were just catastrophizing.”  And the pain went away.

The other thing that is interesting about TMS pain is that your mind knows where your weaknesses are.  Since your subconscious mind controls every part of your body, it knows where your old injuries are, where the arthritis is, where the herniated disks are and it will put the pain in those areas because your conscious mind is most likely to accept those explanations for pain, even when they are bogus.  Dr, Sarno said that it is not possible to have pain from an old injury.  Once the body heals something it is healed.  But your conscious mind will readily accept your old  pain surfacing. 

We also tend to accept the pain because, unless you see a TMS doc, most regular doctors will tell you that these findings on x-ray or MRI are the cause of the pain.  But they are not.  They are just the bumps and bruises of an active life and part of the aging process.

I hope my story will help someone recognize that their pain could be caused by emotional reasons and not physical ones.  You have to learn to look for the inconsistencies, such as: the pain doesn’t happen exactly at the moment of physical activity.  Yes, muscles can be sore the day after a workout, but that soreness is different from the inability to lift your arm. 

Instead of asking about the physical reasons for your pain, ask what were the emotional stressors that happened around the time of onset of pain?  In my case it was a combination of a disagreement and the (self-imposed) stress of what I was working on.

It is important to recognize negative thinking and how that contributes to pain.  It was interesting how quickly I went from being fine to catastrophizing about how I was all of a sudden going to need surgery!  These mental habits are hard on the self.  I call these Mind Traps.  There are 7 of them:

1.      Negative self-talk. This can be described as the IBSC: the itty bitty shitty committee

2.      Catastrophizing. Always seeing the worst-case scenario

3.      Exaggerating the negative and discounting the positive. Not seeing the lesson or blessing in what happened

4.      Mindreading. As if you really know what someone else is thinking.

5.      Being the eternal expert. Do you want to be right, or do you want to be happy?

6.      Beware of any statement that starts with should. Stop shoulding all over yourself.

7.      Fear. I can’t because I’m afraid of/that________.    When you are blaming something/someone else it is usually because of fear

The fact that the pain went away as soon as I realized that it could not possibly have anything to do with my workout, shows that it was truly TMS pain.  Now that doesn’t mean that it can happen that fast for you, but anything is possible.  I have done a lot of work with TMS in my life, so I recognized the mental and emotional patterns.  But, not at first!  Can you attach an emotional trigger for your pain?  Or, do you always go to the physical?