Wrist pain and TMS

If you'd like to hear more about the treatments described in the previous post, there are a number of good sites out there devoted to John Sarno's theories about Tension Myositis Syndrome. Here are just a few of my favorites:

tms wiki
tmsrecovery.com
tarpityoga
Rachel's RSI homage
Dr. Sarno's website

In the meantime, keep in mind that a large part of the treatment he recommends lies in truly believing that you are fundamentally o.k. - and that there is nothing "structurally" or physically wrong with you. If you feel pain, try not to focus on it. Think instead of the emotional anger or frustration that may be contributing to it, and try to own that frustration. It may be a stretch for some, but a lot of people with carpal tunnel syndrome or other RSI's have experienced partial or complete relief by doing this. Rachel's RSI homage has some great testimonials.

There's also a fair amount of independent evidence that the brain can in fact be trained to increase or decrease the amount of pain you experience. This study by Sean Mackey, a Stanford University pain expert, used MRI brain scans to show that focusing on pain increased it, whereas focusing the attention elsewhere could decrease or even eliminate the sensation of pain.

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Carpal Tunnel Syndrome and Dr. John Sarno's Mindbody Medicine

Whether you have Carpal Tunnel Syndrome, tendonitis or repetitive strain injury, there are a million people out there who will give you advice about how to deal with your pain. But before you continue to treat your wrist pain, I highly recommend you check out Dr. John Sarno's book The Divided Mind: The Epidemic of Mindbody Disorders. Dr. Sarno argues that many of the conditions often associated with fibromyalgia, carpal tunnel syndrome or back pain are actually caused by various forms of emotional repression. I know it may sound Freudian at first, but there's a lot of evidence to back up his claims. Here's his theory.

Scientists and doctors are starting to come around to the fact that the mind and body are not separate entities but part of the same system. And when you think about it, this mind/body connection makes a lot of sense. If your brain can process cues from your body - registering pain, fatigue, and temperature changes - why can't your body be affected by your mind? For example, you've probably noticed that your muscles tense up when you're feeling nervous. When you're embarrassed, you might blush. Both of these situations are widely accepted examples of purely emotional reactions being displayed as physical (bodily) phenomena.

Dr. Sarno spent years treating patients with chronic back pain. After a while he began to notice common personality types among his patients. Many of them were perfectionists and chronic do-gooders. They tried hard to please others, and when they failed they often blamed themselves harshly. To make a long story short, Sarno hypothesized that many of these people were repressing feelings of anger and frustration that were harmful to their good self-image. When he made them aware of these feelings, many of his patients experienced immediate relief from their painful symptoms.

This does not mean that their symptoms were imaginary. In all of his writings, Sarno adamantly makes a distinction between real physical pain which is caused by emotions, and "psychosomatic" pain that is merely imagined, or "all in your head." Studies of most of the patients he diagnosed with this condition, which he called "Tension Myositis Syndrome" or TMS, showed one common physical characteristic: decreased blood flow to the areas where they experienced pain. His theory is that this decrease was the mind's attempt to distract the patient from emotions that they did not want to recognize. He also noticed that the decrease occurred in areas of the body where the patient might reasonably expect to feel pain, generally in an area there had been a lot of buzz about in the media. For a long time it was back pain. Then, when Carpal Tunnel Syndrome became a widespread source of attention, more and more people started showing up with pain in their wrists. Coincidence?

Again, this does not mean that these people's pain was "all in their heads." It was very, very real, and was caused by decreased blood flow to their wrists. Other independent studies have shown that decreased blood flow can cause both pain and temporary structural damage to muscle fibers. This study on "Overuse Syndrome," which was cited in the Google blog's entry on carpal tunnel syndrome, is one such example. In keeping with this, Sarno noticed that most of his patients found relief from treatments that increased circulation, such as heat and massage, and none had lasting structural damage once the source of their problem was addressed.

Now I'm not a sucker for self-help books, but I really think there may be some truth to this. What finally sold me was that a group of high achieving Harvard students managed to heal their carpal tunnel syndrome just by following the suggestions in his book. They started a website to document this amazing event, called Harvard RSI Action. It's very worth a read.

I'll be posting more on this later, but for now I highly suggest you keep an open mind to these theories, especially if you've experienced other symptoms associated with TMS, such as back pain, leg pain or stomach problems. Here's an interview with Sarno, just to give you a quick idea of where he's coming from.

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