I’m a physician. Family Medicine. Sports Medicine. Integrative Pain Management.
I see a lot of patients with pain. For acute pain, the recent injury, for example, treatments
include ice, topical creams, oral medications, physical therapy, and injections.
Persistent Pain (Chronic)
But what about people with persistent pain? Pain in their back, pain the neck, pelvic pain, jaw pain, arm pain, gut pain? First, we exclude any serious causes with appropriate imaging (x-ray, MRI) and sometimes blood tests. Many of these individuals with persistent or chronic pain have seen many practitioners before they come to my office. They just haven’t gotten better, and usually get a bunch of different diagnoses and feel very confused and frustrated.
TMS
Often, I diagnose these individuals with TMS, tension myoneural syndrome. This means that their pain, while quite real, is more about the mind/brain and emotions than it is anything structural or mechanical. They may have tight muscles or a weak core, but that is not why they have pain and that is not the way to the cure.
Diagnosis
I ask them “what’s going on in your life”? I find out often that quite a bit is going on. Issues with a significant other, a boss, anger, grief, fear, financial pressures, etc. I ask them about their childhood. Sometimes divorce, rarely abuse, often issues and pressures leftover from that difficult time in one’s life. I ask about personality: patients with TMS are often hard on themselves, people-pleasers, and highly responsible.
Treatment
The treatment for TMS follows the cause. It is more about education, psychology and changing what we believe and what we think than anything else. So, I recommend journaling, writing about feelings, expressing feelings, sometimes psychotherapy. I advise self-talk and affirmations to change neural pathways that have been established that reinforce a pain cycle.
Self-Talk
Self-talk for pain? Yes, I advise patients to break the fear/worry cycle with education (reading books, listening to podcasts, videos). But I also advise changing the internal dialogue of fear and worry with affirmations. I teach people to change the chatter in their head from fear to success, from worry to healing.
Affirmations for Pain
So, what can you say to yourself, if you start believing that the problem you have is benign and more about your stress than your body? (this assumes a good medical checkup first, of course)
- I am healthy and strong, I am healing.
- I have harmless pain and I’m learning to deal with my stress
- I can heal, I can be more active, activity is good for me
And so on… (see ThinkUp app)
David Schechter, M.D.
Board-Certified Physician in Culver City, CA
Medical Staff, Cedars-Sinai Medical Center
Formerly, Clinical Assoc Professor USC School of Medicine
Author, The MindBody Workbook and Think Away Your Pain
Www.MindbodyMedicine.com
