How I Cured My Chronic Pain

My chronic pain made me suicidal. I had it for over four years.

The pain was in my left ischial tuberosity where the hamstring attaches to the pelvis, otherwise known as your ‘sit bone’. And it mostly only hurt when I sat.

Unfortunately, until you’re in pain every time you sit down, you don’t realize how much of your life revolves around sitting. Traveling became impossible because I couldn’t last in a car or airplane. Work was difficult. Eating out with friends had to go. Even just relaxing in front of the tv at night was an excruciating exercise.

If you want to learn about why my TMS started, you can read the full story here. In this article, I want to address the specifics of how I found my way out of the entrenched neural net that is TMS and thought my way out of chronic pain after it destroying my life for four years.

Here’s what it comes down to:

You have to convince yourself that the pain is all in your mind.

And you have to BELIEVE it.

This is a much harder task than you’d imagine. We as people, of course, believe that pain is an indicator that something is physically wrong. And it is most of the time! But sometimes, our brain gets ‘stuck’ on pain mode and it can’t find it’s way out. That’s how TMS crept up on me. Some hamstring tendonitis pain sensation decided to stick around long after the tendonitis itself had healed.

So how do you go about convincing yourself that your pain is in your head? For me there were two people that I had to convince: my logical brain, and my emotional brain. Both of them had very different journeys to accepting the TMS diagnosis.

Convincing the Logical Brain

Your logical brain is all about evidence and data. In order to convince it that there is nothing wrong with you, first you need to make sure you have extensive testing done by your doctors. I had MRIs, nerve conduction studies, experimental cortisone injections, physical therapy evaluations, and several doctor’s evaluations. Some of them led to diagnosis and treatments that didn’t work. After years of this, my doctors were out of ideas and were telling me that there was nothing structurally wrong with me that could be causing this pain.

After ruling out physical causes, my logical brain was convinced this was TMS by creating an Evidence Sheet. My evidence sheet was a long list of reasons that I was certain that my pain was TMS, and thus in my head. Here is what mine looked like:

  • I have the exact personality type TMS patients have.
  • I have a history of abuse in my childhood that predisposes myself to TMS.
  • I have a long history of aches and pains around stressful periods of my life, particularly in my back and neck.
  • No medical professional can find anything structurally wrong with me.
  • Physical activity does not immediately worsen my pain.
  • I pass every physical examination with flying colors.
  • My pain completely resolves when I sleep and is gone in the mornings. Structural pain would not disappear overnight.
  • The initial onset of my pain was during a stressful period in my life (infertility treatments) and got worse the deeper into treatment I got.
  • I am able to change the quality and quantity of my pain in meditation sessions.
  • Sometimes my pain jumps over to my right side or to slightly different areas in my butt.
  • I have had a few hours, days and moments without pain.
  • The pain has resolved completely in the past for months at a time before it came back with a stressful event.
  • The pain is at its worst when I panic about it and obsess over it.
  • Drinking large amounts of alcohol numbs the pain entirely. Alcohol is a CNS depressant which makes the brain stop feeling pain.

I reviewed this evidence sheet on a daily basis to remind my logical brain of why my pain was likely TMS.

Convincing the Emotional Brain

Like many TMS patients, I’m a hyper-logical person, and I’m not very in touch with my emotional brain. So getting in contact with my emotional brain to convince it was a much harder exercise.

Making it even more difficult to convince the emotional brain is the fact that the emotional brain under the influence of pain is driven by a single powerful force: fear.

My pain was terrifying. I was terrified that I would feel it forever. That I would lead a life essentially disabled, unable to see the people I loved or do the things I loved. I was terrified that in my 30s I’d be carrying around a donut pillow to sit on the rest of my life, or not be able to work anymore. I was scared it would get worse. I was scared I wouldn’t be able to survive it.

Convincing the emotional brain, for me, meant conquering that fear. How do you conquer a fear? It’s not like I could go bungee jumping or something to show I wasn’t afraid of this thing anymore.

The first step was to stop feeding the fear. I was doing a lot of things that gave power to my fear and to my pain. For example:

  • I spent hours every day researching my pain and trying to figure out what it could be. I googled infinitely trying to find success stories or surgeries or doctors or treatments I hadn’t tried. Now to be fair, this googling led me to John Sarno and TMS, but once I knew logically it was TMS, I needed to stop researching my symptoms.
  • I was limited my physical activity pretty significantly because of the fear that I would make my ‘injury’ worse. I started engaging in physical activity again, doing short walks and light exercise.
  • I was using a number of ‘modifiers’. Modifiers are physical items that aid you in doing basic tasks. I had various pillows and lumbar rolls that I used in the car and on chairs. I had donut pillows of various densities and sizes that I sat on. I had a tennis ball I would place under my hamstring when I sat down which would take the pressure off my ischial tube. I stopped using all of these cold turkey, because using them reinforced the idea that I was ‘damaged’ in some way, when I was not.
  • I had a routine of stretching, foam rolling, icing, heating pads and using stim to try to ease pain. I stopped doing all of these things.

Stopping all of these things was scary, and it didn’t make the pain go away immediately, but it didn’t make it worse either so I took that as a good sign.

Now that I wasn’t feeding the fear with reminders that I might be damaged, I also had to retrain my brain that the pain wasn’t something to worry about or be afraid of. And ultimately, that it wasn’t real. So I talked to it. A lot. Every time it was bugging me, I’d quickly say something like “Oh, that isn’t real, I don’t need to worry about it.” Or, “You’re not a real thing, go away!” Or, “I’m not hurt, that’s just my brain.”

After several weeks of this, I was noticing some reduction in my symptoms and an increase in my pain tolerance. I had pain-free days from time to time. It seemed I was on the right trajectory, but it kept coming back.

The Authority Figure

I had worked my way through Dr. Schecter’s TMS workbook and it was one of the things that helped initially convince me that I had TMS. But neither his workbook nor my personal interventions were sufficient to end my pain. So I decided to make an appointment with Dr. Schecter to see what he had to say about my case.

He was very thorough in my appointment. He examined all of my medical history, my history of abuse, my scans, my tests, asked tons of questions, and examined my area of pain extensively. He clearly went in with an open mind. But when it came to his diagnosis, he told me that I could be fairly certain that what I was experiencing was TMS. He thought that perhaps, given my personality type, hearing it from an authority figure might make a difference for me.

He drew me a graph of his expected trajectory for me feeling better, indicating that I might see immediate improvements but there were bound to be regression periods as well where my pain would come back. But that as I carved new neural pathways, it would eventually vanish.

It took me two hours to drive home from his office and I was in excruciating pain the entire way. But I had new hope.

The next day, I woke up and the pain was gone. That was typical for my mornings. But then, it didn’t start up as the clock ticked by the hours. I went the entire day without pain. And the next day. And the next.

Hearing from Dr. Schecter that my pain truly was TMS ended my four year history of chronic pain. I had laid the groundwork and convinced my logical and emotional brain 99% of the way, and hearing from an authority in the field got me the other 1%.

Regressions

I have had three types of TMS regressions since my chronic pain lifted one year ago.

  1. Occasional Sit Bone Pain (normal TMS Pain)
    I do still have my TMS pain come back from time to time. It regresses quickly now and is never with me for more than 24 hours. The things that trigger it are: other physical ailments like bad sickness, tight hamstring muscle (usually from over-exercise) and being too hard on myself mentally. The pain doesn’t scare me anymore and I know it will be gone soon.
  2. Back Pain
    After a stressful incident, I hurt my back doing yoga and ended up with excruciating back spasms. I’d experienced this before but not for a decade. I do have a herniated disc and spent years blaming my intermittent back pain on this, but I actually don’t think it’s the disc that causes pain, I think it’s tight muscles and spasms. While I lay on the floor, my back in a 9/10 pain spasm, the thought crossed my mind: what if I treat this like TMS? I kept my cool, told myself there was nothing structurally wrong with me, pulled myself off the floor and went on some slow long walks. A decade ago, this same type of incident had me chugging muscle relaxants, pain killers and lying in bed for months of recovery. This time, with a TMS-type approach, I was completely pain free in 36 hours.
  3. Foot and Leg Tingling
    The one lingering question mark in my TMS recovery was peripheral neuropathy. I’d tested positive for peripheral neuropathy in my nerve conduction studies and there was still some concern that there might be something wrong with me that caused that. About six weeks after my sit bone pain subsided, my toes started tingling. Then my feet and ankles. Then my legs. My toes started going numb entirely. Then my fingers. I was scared something was going on, so I went back to Dr. Schecter. He sent me in for another nerve conduction study. The results were negative. The first study was wrong. He told me this was an unusual form of TMS rising again. And he was right. It was born out of the fear that something might still be wrong with me that hadn’t been quite resolved. The tingling and numbness has 95% gone away and what remains I don’t worry about.

Recovering from TMS and chronic pain is a process, and it takes time, but it is possible. My only hope is that my guide on how I did it helps somebody else figure it out. I know that I owe Dr. Sarno and Dr. Schecter my life. I hope that sharing my story can help you recover yours.

 

 

MBSR Day 5: Noticing Pain

Given my history with TMS, I have a complicated relationship with pain.

I used to viciously fight it, avoid it and try to ‘fix’ it with everything I could throw at it. My back would go into spasm, and I would go to the doctor, get pills, get an MRI, get into physical therapy for six months, struggle with my posture, give up the computer for weeks at a time, miss work, do countless exercises and stretches every day, stop picking up heavy things, and stop exercising. My back would ache for weeks, sometimes months at a time with this regime.

Last month I was doing yoga and I threw out my back again. It hurt just as much as it used to when I threw it out. The next day, I went to a theme park. Fuck it really hurt that day. Every time I transitioned from sitting to standing, including disembarking from rides, it would go into heavy spasm to the point where I almost threw up and couldn’t walk. But I just continued with my normal routine and popped a couple of Advil.

The following day I was 80% better. And 72 hours later I was completely healed.

What a difference from where I used to be with back pain with weeks of fear and life modifications and interventions. With no interventions, and simply telling myself it was temporary and would be better in a little bit, I healed a million times faster. A large part of pain is truly in the mind.

But…what about when pain is NOT in the mind? What about when there really is something wrong? I have such a history of pain being in my mind that these days, sometimes I go overboard and don’t give credence to when there really is something wrong.

And that happened in my body scan meditation today. I was doing my body scan practice, and got to the part where I focus on my fingers when I felt an overwhelming sensation of pressure coming from the back of my head. It was all-consuming. Sometimes these things happen to me during meditation, so I tried to just breathe into it and wait for it to pass. But it didn’t. It got worse and worse. It was impossible to focus on my arms. So I shifted my focus into the back of my head hoping if I acknowledged it, it would let go and pass. It didn’t. It got worse and worse.

Finally, as it was unbearable, I realized I needed to quiet the sensation. So I reached up to the back of my head where I was feeling it, and realized that my ponytail holder was pushing into that spot where I was lying on it. I removed the ponytail holder and since my awareness was still so focused on that area, I immediately felt the hot rush of blood flood that area of my skull and spread out from there. Immediately the discomfort and pressure subsided.

I was stunned. The pressure of my ponytail elastic was blocking some key blood pathway in my skull. And my body was trying to tell me in my body scan meditation that something was actually wrong and that I needed to take action. But I ignored it because…well…I have a tendency to feel intense body sensations when nothing is actually wrong.

There were differences, though, between this and my typical ‘ghost’ sensations of tension, pressure or pain. I think it’s important to note them:

  • It was stronger than my typical physical ‘ghost’ feelings.
  • It did not subside after time passed.
  • It did not change with close, meditative observation.
  • It increased in intensity and got worse.

Versus a typical phantom bubble of pain or tension, which:

  • Bubbles up and then passes with breathing and time.
  • Often collapses or changes quality with close, meditative observation.

The next time something happens in meditative practice that does not go away and continues to escalate, I am going to assume my body is asking me to take action and gently address it.

Gokhale Method: The Right Observation, the Wrong Hypothesis (at least for me)

One of the early solutions to my pain that I sought out was the Gokhale Method. I had read several accounts of people who had back pain online who were permanently ‘cured’ by following her teachings, so I bought her book, consumed it, lived it, bought all of the posture-modifying cushions, and watched every YouTube video she ever made. I even briefly considered flying down to Palo Alto to get hands-on training from the master herself.

Esther Gokhale struggled with back pain from a herniated disk, much like I did. She even went so far as to get surgery without results. So she ended up traveling the world and learning that many people that grow up in more primitive cultures don’t experience back pain, despite having lives filled with arduous labor involving carrying heavy things, bending over repeatedly, and spending long hours seated on the ground.

She spent time with these cultures, photographed them, and formed a hypothesis: primitive cultures didn’t have back pain because they had fundamentally different movement patterns than we Westerners. And these movement patterns are imprinted on children at birth. They are learned behaviors, and as such, they can be taught, practiced, absorbed and mastered. According to her theory, the way that we learn to sit and stand and move and bend is all wrong, and thus we have spines that have slightly different curvature – which gives us back pain.

Her book emphasizes how ‘graceful’ and ‘natural’ and ‘at ease’ all of these third world peoples are. And I was determined to emulate them. I would become an elegant, soft-walking wood elf that moved like a dream.

I spent six weeks fervently and religious practicing the way that Gokhale wanted me to sit and stand and walk and bend. And it made me worse. I spent all day trying to hold these unnatural postures that felt like absolute torture. Her book and videos assured me that it would eventually come to feel natural but…

It came to a head one day when I was out walking with my husband. “Is something wrong” he asked, “It looks like you’re limping or staggering around.”

“No, I’m glidewalking,” I informed him. Clearly he wasn’t grasping how beautifully and gracefully I was moving under Esther’s tutelage.

“You look like a drunken sailor angrily stomping on insects,” he responded.

It was then I realized that this wasn’t working for me. I felt constantly tense and unnatural. My muscles were stiffening up – not elongating. And my back pain was getting worse. I stopped practicing the Gokhale Method and put the book away. I chalked it up to my own failure of not being coordinated enough to achieve some of these movements. My broken movement patterns were hopelessly ingrained.

Meditation and mindfulness have been a part of my life for a year now.

And I am becoming that woodland elf.

It’s hard to believe, really. When I walk, sometimes I am gliding. My feet are soft pillows of air. My neck has all of this space to move and breathe. My legs, instead of being the stomping, plodding things they were, feel supple and lithe. I am standing up straight. I am naturally sitting straighter.

And it’s all because of one thing: I am more relaxed and more connected with my body.

I think this is what Esther got wrong. The movement patterns of a relaxed, mindful individual are fundamentally different than the movement patterns of a chronically tense, hyper-vigilant, traumatized person. It just so happens that people who live in primitive cultures are more relaxed and mindful than we are. There are lots of happiness studies that back this up. There’s less judgment, a more profound sense of community, more interconnectedness, less pressures and stressors, and so the people in these cultures are just more relaxed. And what do you know, a relaxed body actually moves differently. It aligns differently. The muscles yank on the spinal column differently from a relaxed state than from a tense.

This is something that I figured out almost immediately when I started meditating. On day eight I had my first experience with spontaneous posture correction. Where about 15 minutes into my meditation session, my breathing darkens and deepens, I feel a wave of relaxation pass over me, and suddenly I sit up straight. My shoulders open up, my neck is long, my chest is reaching for the sky, and I literally feel three inches taller.

This has happened for me now almost every single time I have meditated. At some point, my body just lets go, and suddenly I get a small glimpse of what it means to be relaxed.

Every day as TMS forces me to process my repressed emotions, let go of my fear of pain, and embrace a relaxed, mindful state, I find my body more and more able to adopt this relaxed posture naturally. It started about eight days in. It’s almost an instantaneous result.

I hope that some day this becomes my natural state, and the tense state is the temporary one that I can recover from.

In the meantime, I would advise people to not force posture. Good posture isn’t something that should be integrated into you by strictly monitoring and constantly correcting yourself. Your self-critic does enough of that already. Instead, be mindful of your body and how it feels. Meditate. Accept what your body is doing with its alignment today. Good posture will begin to fall out as the natural byproduct of acceptance and self-love.