Back Pain: Tension Myositis Syndrome (TMS)

This is part 1of a series about pain and pain management.

My intention in writing these articles is to provide information about the wide spectrum of approaches in the field of alternative medicine. I am basically a very skeptical person especially when it comes to unconventional methods that are claimed to be the “cure for everything”. Therefore I can somewhat reassure you that what I present here is selected carefully and has proven successful with my experience in daily work with my clients.

Pain, and primarily back pain, is the leading cause of visiting a doctor. Chronic pain can make people’s lives miserable. Pain medications do not address the cause, and unfortunately surgeries are not always helpful either. People may become hopeless and depressed. Therefore looking at alternatives in cases of chronic pain is very important.

In my first article about pain, I want to introduce you to Dr. John Sarno and his concept about TMS.

In medicine there is an interesting phenomenon. Some peoples X-Ray’s or MRIs show severe damage of the spine (degeneration, bulging or slipped discs etc.) but they don’t have any pain. On the other hand, people whose spinal examinations show an almost perfect spine are suffering from excruciating pain. How can that be?

Professor and M.D., John E. Sarno, is a medical orthopedic physician of the New York Rehabilitation Center, and teacher at the New York School of Medicine. He has dedicated his life as a medical doctor to this phenomenon he calls TMS. He has pursued the real cause of all the pain in our back, shoulders, neck, arms, hips and legs, wrists (carpal tunnel syndrome), fibromyalgia, migraine headaches etc.

Why is the pain sometimes there, sometimes not? Why is the pain moving from one side to the other or into different parts? Why does the x-ray show a bulging disc at one side, but the pain is on the other side? Sarnos most notable achievement is the development of a different diagnosis which he calls Tension Myositis Syndrome (TMS). (Myo means muscle). It is considered to be a condition in which emotional stress causes physical pain in the human body. The chronic pain disorders of the back have their origin in a benign (though painful) physiologic aberration of soft tissue (not the spine).

The powerful emotions of fear, anger, anxiety, and other negative stresses, when repressed (consciously or subconsciously) can cause muscles to tense in the areas of the body near the spine. This has led to misdiagnoses of structural abnormalities of the spine, pinched nerves, disc disorders, or other physical causes without consideration of the important role that TMS plays. According to Dr. Sarno this is the result of medicine’s failure to recognize the nature of the disease.

Dr. Sarno asserts that once the patient confronts the repressed emotions that lead to the muscle tension, the pain will lessen and eventually disappear. Regular treatments such as salves, heat treatments and other physical therapies and sometimes even surgeries provide temporary relief and address symptoms but do not get to the root cause of the problem.

The emotional aspect of illness is not new. Hippocrates advised his asthmatic patients 2,500 years ago to beware of anger. The whole field of psychosomatic medicine is based on the mind body connection.

An important observation made by Dr. Sarno of his back pain patients is that over 80 percent have histories of migraine headache, heartburn, stomach ulcer, colitis, irritable bowel syndrome, hay fever, asthma, eczema, and other disorders strongly suspected of being linked to repressed emotional tension. It seemed logical to him that these painful muscle conditions might also be induced by tension. He put that hypothesis to the test and treated hundreds of patients with a nearly 90 percent success rate by just teaching them how to deal with TMS.

He states that the physiology of TMS begins in the brain. Repressed negative emotions, stress and tension cause the autonomic nervous system, which controls blood circulation, to increase or decrease the flow of blood to certain muscles, nerves, tendons and ligaments. When blood flow is decreased, this means that there is less oxygen available and pain receptors of the nervous system respond to the lowered level of oxygen in the tissue This deprivation results in symptoms of pain, numbness, tingling, and sometimes weakness (therefore blood flow increasing treatments like massages, heat, exercises etc. are temporarily often helpful).

Before the pain can be diagnosed as TMS, it is essential that the person is examined by a physician in order to rule out the potential of serious illness as the source of pain.

To quote Dr. Sarno, “The treatment program rests on two pillars: (1) The acquisition of knowledge, of insight into the nature of the disorder and (2) The ability to act on that knowledge and thereby change the brain’s behavior.”

He says “Information and knowledge is the treatment”. When patients become aware of pain, they are encouraged to focus consciously and deliberately on any likely psychological cause that may have triggered the pain. This may be a family emergency, financial problem, a recurrent source of irritation, an annoying sound, a traffic incident, a memory of an affront – in short, anything that could be responsible for tension at that moment.

Many of his clients feel a relief from chronic pain just by reading his books (The Mind Body Prescription or Healing Back Pain) or by watching his videos. A small percentage of suffers need professional support in their process. Many times solving a personal problem or situation is not possible, but to start the healing process it is important to let go of the fear and simply to know that the pain is due to mild oxygen deprivation, which is harmless and not because of a herniated or degenerated disc. Important is to change your brain’s programming.

Examples of personality traits that easily contribute to TMS:

Expecting a great deal of yourself, driving yourself to be perfect in achievement to succeed, criticizing yourself, or being very conscientious or sensitive to criticism in general may cause you to be angry inside. Similarly if you have a constant feeling of being under pressure or having too much responsibility in your job, relationships or marriage, if you have a strong need to please people, to want them to like you or if you tend to be very helpful to people, if you are a caretaker type or tend to worry about others, all these also might contribute to build up internal stress and anger.

Dr. Sarnos theory believes that TMS is mostly caused by suppressed anger or rage. The brain “fears” that this may become conscious and therefore produces pain to distract you from these intense emotions. To start the healing process, Dr. Sarno suggests that you make a list of all these feelings and bring them into your awareness, see it as a daily task.

The pain may not subside immediately. It could take several days, weeks or months. The conscious mind is quick to zero in on the probable cause. The subconscious, on the other hand, is slow, deliberate, and not eager to accept new ideas and change. However, making it a habit to search for the cause of tension will pay off over time in decreased pain. Remember: “Every change in the physiological state is accompanied by an appropriate change in the mental emotional state conscious or unconscious and conversely, every change in the mental emotional state, conscious or unconscious, is accompanied by an appropriate change in the physiological state”.

For more information about the Health Coach please contact me:

Barbara Rotthaler, German licensed Naturopath and Health Practitioner
01 (376) 766 1987

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