BigBlueWolf

PSA: On Chronic Pain and What I Learned Dealing With It

About a month ago I wrote a post detailing my repetitive stress injury in both hands and advice to others. While it was written with some good advice in mind, it turned out that the source of my pain was not RSI or carpal tunnel syndrome. Once I learned what it was and how to overcome it, I made tremendous progress at recovery.

What I’ve learned in a few short weeks is that when it comes to chronic pain and associated conditions, most people in the medical profession try to approach it from a “let’s fix a machine that’s not working correctly” perspective, implying that there’s a mechanical problem to be solved. The problem is that they are not very good at solving it, as the epidemic of chronic pain world-wide demonstrates. Worse yet, a lot of the standard treatments for chronic pain – physical therapy, drugs, surgery, etc. – are far from effective and quite often don’t work or only do so temporarily.

When I got my diagnosis I was initially calm, thinking I’d caught it early enough that I could easily beat it. But as my condition got worse, a real panic began to set in. Not being able to do work or leisure activities with my hands had me worried about my career foremost. And so I worked with my doctor to find the best possible therapeutic approach.

Around mid-February I was looking online for stories about people beating RSI, and I came across people who claimed to do so by following the advice of Dr. John Sarno.

Sarno was a medical doctor (d. 2017) who eventually devoted his career to treating chronic pain. He influenced many others who have followed in his path. However his work is still considered outside the mainstream. This is because he proposed that if a patient’s case had no direct evidence of a structural problem then there’s a good chance they were suffering from a condition he named Tension Myositis Syndrome (TMS), a disorder where the brain unconsciously reinforces pain signals through stress, anxiety, fear and repressed emotions. This can result in a vicious cycle that can make life a living hell for its victims because the conventional therapies don’t provide relief. The pain could happen for no obvious cause or persist after an initial injury had long since healed.

If that sounds a little far-fetched, consider the well-known condition that amputees experience called phantom pain syndrome. Here the brain continues to fire a pain response for a limb that no longer exists. How is that even possible? TMS is a related condition except there’s no tissue damage. The brain has learned a pain response via over-sensitized nerves and an unconscious psychological process keeps the pain going long after it should have stopped.

The great thing about TMS is that it’s easily treatable. The main part of that treatment is:

  • Acknowledging that the pain isn’t a structural problem.
  • Reading and writing exercises that are designed to break the negative feedback loop and convince the sub-conscious brain to stop sending pain signals.
  • For persistent cases (no resolution after three months), working with a therapist in a group or one-on-one basis.

And yeah, it works.

I am quite a skeptic and rational person. But every medical professional had a different take on what was happening, and when a therapy didn’t work they were always ready to tell me how response is so different from person-to-person. And if tests (like my nerve conduction study that came back clear) didn’t support their diagnosis, they often seemed to be making up reasons for why I was experiencing my pain. So I was already half-convinced most of the experts I was talking to were only guessing. (Me: Wait a minute, you’re telling my I developed tendinitis simultaneously in every finger on both hands even though I use my left hand far less? Doctor: nods and says yes.)

Sarno and other doctors who practice the treatment of TMS are well aware of this problem. They point to it along with poor outcomes documented in medical journals as proof that a lot of treatments for chronic pain are not evidence-based.

I started doing my reading and writing exercises for TMS a little over three weeks ago. Within the first couple of days, my pain went through changes in type, sensitivity, and location – sometimes moving completely out of my hands and instead into my shoulders and back. In TMS this is a called “symptom imperative” where the brain attempts to compensate for the disruption by relocating the pain somewhere else.

Within another couple of days, I played a game on my PS4 for several hours with minimal discomfort.

This week has been mostly pain free. I’ve had symptoms flare up occasionally, as progress isn’t necessarily linear. But if you’d have told me in January I’d be back to all my normal activities in such a short time, I wouldn’t have thought it possible. I’ll continue my reading and writing. I expect within some number or weeks or months I will be writing a success story like many others.

If any of this intrigues you – whether dealing with your own stubborn chronic pain condition or simple curiosity – do yourself a favor and take some time to read about TMS and how people have defeated it to get their lives back. Chances are you might know someone who could benefit from looking into it, as long as they aren’t convinced that they all they need is the right exercises, pills, or low-success surgery option.

TMS is not a quack or new-age thing, it’s simply looking at the issue of pain from a perspective of the whole person and the psychological contribution to their health. Even better, it doesn’t really cost anything to treat unless you’re in a minority of people who would need to work with a therapist to get the most benefit. The majority of success stories don’t reach that point.

Here are some great resources I found online:

Here’s some favorite stories I read specifically about TMS and recovery from hand pain:

Be well. Take breaks from your gaming when necessary. And never underestimate just how huge a role stress can play in your life!

JaffaCaffa

I’m so glad you’re improving! That’s incredible to hear. :) I’ll definitely look into the links you shared. Chronic pain is hell, wouldn’t wish it on anybody. I really hope things continue to look up and that you don’t have too many setbacks. I think it’s great that you acknowledged how improvement isn’t linear, that’s so true. I think it can be easy to feel down about steps back that you take, especially particularly rough patches, but focusing on the improvement and hard work is definitely a positive outlook. :)

stef

Very well written and I’m happy you are improving! I admittedly don’t take care of myself well, and that includes my stress level and how much I game and don’t take breaks. I will share what you wrote with others in hopes that it helps some people out, and even maybe me in the future. I hope you continue to feel better and thank you again for writing this up!

Zeruel

Issues like that are things that I’m really afraid of having to deal with myself. I’ve been fortunate enough as to not have that as of yet.
You’re a bold man, seriously. Personally I might’ve just ignored the issue and just been afraid for whatever reason. Good to hear that you’re improving. You’ve got more balls and more willpower than I do! :)

BigBlueWolf

Thanks, bud. One of the most important things that TMS therapy emphasizes is how much fear perpetuates the pain cycle. Once I overcame the fear that I would hurt myself, progress really began to take off. :)

PeteOzzy

I’m really, really so very glad to hear that Blue. I hope this is the start to a bright and beautiful recovery or at least a management of the condition in a way that reduces its effect on you to an absolute bare minimum. It’s been a brave thing to discuss it like this and hugely interesting in a personal way. Thank you for sharing!

I’m always willing to try new things and have long passed the point of thinking doctors necessarily know what they’re talking about at all times so I’ll be looking into this quite deeply myself. It has to be better than the alternatives at the moment.

BigBlueWolf

Thanks, Pete. I hope it helps. Best wishes to you!
Yesterday I had a marathon Witcher 3 session using with a controller. My hands only complained a little. They feel fine this morning. :)

tsupertsundere

This was an incredible writeup. BigBlue, I am so glad you pushed through the uncertainty and frustration to keep doing research until you found something that worked. I haven’t heard of anything like this before, but it definitely makes sense.

I hope your recovery trends ever upwards, and it’s so great both your career and your beloved hobbies are returning to your grasp. You’re overcoming a BIG thing.

pedro

Great news bigblue :)

EvilBlackSheep

I’m so glad to hear your condition’s been improving. Thanks for updating us and sharing your experience, it was really interesting to read. I hope you keep getting better, take care <3

Kap

Interesting stuff, Wolf! I’m glad to hear that you were open-minded enough to give it a try, and even happier to hear that it’s working for you! Stress negatively affects us in a multitude of ways, and psychosomatic illnesses are very real, and far too common. Keep doing what you’re doing, and here’s hoping that your hands will be completely pain-free and back to normal before you know it!

BigBlueWolf

Thanks, Kap! :D

Lengray

I’m glad things are looking brighter for you. Chronic pain can be debilitating and sometimes, even painkillers don’t work.
I can totally relate to your case because at the end of last August, I started to have pain in the back of my left knee. Constantly. I had gone for a run a couple of days before but nothing harder than usual. After a week of almost constant pain I went to see my GP and he diagnosed a tendinitis and gave me medication. It had no effect. Then I had a echography of my knee done and the radiologist couldn’t see anything wrong with my muscles or tendons. Somehow, knowing that nothing mechanical was wrong, I started to feel a little better (but the pain still kept me awake some nights). So I started to do something I hadn’t practised in a long while: meditation. I stuck to it daily (and still do) and my pain slowly went away. By mid-January, it was gone.

BigBlueWolf

Yes, I think a lot of people go through things like this but never know that it really is because they have never heard of TMS. That being said I’m totally convinced that pain from experiences like yours happen to a lot of people who do something (meditation in your case) to nudge the brain into turning off the pain signals. I had some less serious occasions in my life where a body part started hurting persistently for no good reason and it only got better when I simply didn’t let it consume my attention.