Although it is not likely, it is possible that your pain and/or other symptoms could be caused by a serious condition such as a tumor, a fracture, cancer, or infection that may require immediate medical and/or surgical treatment. For this reason it is absolutely essential for you to undergo a thorough examination from a licensed physician (if you have not already done so) before embarking upon the self treatment protocol described on this site.

Red flags

Neck and back pain red flags (these signs do not necessarily mean something horrible is wrong, but it’s important to make sure):

  • Weight loss without dieting.
  • Unexplained fevers or chills.
  • Light tapping on the spine is painful.
  • Incontinence and/or true numbness around the groin and buttocks in a “saddle” pattern.
  • Any accident with forces that may have been sufficient to fracture your spine.
  • A fierce headache, and/or an inability to bend the head forward, and/or fever, and/or altered mental state.
  • Severe headache that comes on suddenly and/or “the worst headache you’ve ever had”.
  • Pain that grows steadily worse and is mostly unaffected by position and activity, is worse with weight bearing and at night, and comes with other signs of being unwell.
  • Poor hand coordination; weakness, “heavy” feelings, and atrophy; diffuse numbness; shooting pains in the limbs (especially when bending the head forward); an awkward gait.
  • Symptoms that spread equally into both legs, especially numbness and/or tingling and/or weakness, and especially if it is aggravated by lifting. The same symptoms limited to one side are also a concern, but less so.
  • Difficulty urinating, incontinence, numbness around the groin, foot drop (a toe that drags), and significant weakness in the legs are all potentially serious signs of a neurological problem.
  • Back pain that throbs in sync with pulse.
  • Unexplained episodes of dizziness and/or nausea and vomiting may indicate a problem with stability of the upper cervical spine.
  • Steroid use, other drug abuse, and HIV are all risk factors for a serious cause of neck pain.
  • If you are feeling quite unwell in any other way, that could be an indication that neck pain isn’t the only thing going on.
  • The main signs that neck pain might caused by autoimmune disease specifically include: a family history of autoimmune disease, gradual but progressive increase in symptoms before the age of 40, marked morning stiffness, pain in other joints as well as the low back, rashes, difficult digestion, irritated eyes, and discharge from the urethra.

Injuries can and do cause pain

It is also important to understand that acute injuries cause pain. It is when pain does not resolve within a reasonable period of time that it starts to become appropriate to seek a psychological as opposed to physical explanation. A good example is the pain that I experienced after a major car accident. There were three people in the car that day and we all had significant pain afterward. The other two people experienced resolution of their pain within a few weeks (normal). I, on the other hand, got worse in the months following the accident and went on to develop chronic pain that lasted nearly a decade (not normal).

Exam findings that should cause you to proceed with confidence

If your exam shows only:

  • Disc abnormalities (narrowing disc space, bulging of the disc, herniation of the disc)
  • Abnormalities of other spinal structures (spondylosis, bone spurs, pinched nerves, enlargement of ligaments in the spinal canal, stenosis, spondylolisthesis, scoliosis)
  • Arthritis
  • Bone spurs
  • Strained back or neck muscles
  • Piriformis syndrome
  • TMJ
  • Tendonitis
  • Frozen shoulder
  • Abnormalities of tendons or rotator cuff muscles
  • Plantar fasciitis
  • Morton’s neuroma
  • Carpal tunnel syndrome
  • Fibromyalgia
  • Chronic fatigue syndrome
  • One or more TMS equivalents
  • And/or your physician supports a “conservative” (i.e. non-surgical) approach to your problem…

…then you can consider yourself healthy enough to proceed with a TMS self-treatment protocol.

Take your doctor’s treatment recommendations with a grain of salt

Know, however, that your physician may be dismissive of the notion that your pain could have a psychological cause. He or she may give you prescriptions for pain or other medications and may recommend injections, physical therapy, or other treatments. My recommendation is that you take this information with a grain of salt and politely decline any recommended treatment.

At the early stages of your recovery, discussing TMS with doctors, family members, or friends is a high-risk activity. This is because they are likely to either roll their eyes (at best) or react with contempt (at worst) if you try to explain what you’ve learned from Dr. Sarno. This can result in doubt and discouragement that will get you off track before you have an opportunity to get started. For this reason, it is best to either avoid these discussions altogether or limit discussion to people who you know will be supportive of your efforts (for example members of the discussion group at TMS Wiki) until much later in your healing process.

This information is being provided to you for educational and informational purposes and as a self-help tool for your own use. It does not constitute medical or mental health advice or treatment. Do not delay in seeking medical care or discontinue treatment recommended by a physician or other health care provider because of what you have read on this site. Readers suffering from pain or any other symptom should undergo appropriate medical examination to exclude serious injuries or illnesses that may require immediate or aggressive treatment before initiating the self-treatment approaches described on this site. This information is to be used at your own risk based on your own judgment. Please refer to my full disclaimer here.