About Tension Myositis Syndrome (TMS)
MindBodyMedicine.com is designed to educate the public and health professionals about the importance of the mind-body connection in health and illness.
Research continues to point to the vital role of emotions, the mind, and the brain in the cause and cure of a variety of illnesses. From ancient perspectives in different cultures to recent research on the physiology of the brain and nervous system, more insight is being gained on this mysterious, yet self-evident mind-body connection.
What is "mind-body"?
Have you ever been embarrassed and in a second or two blushed bright red?--this is an example of the power of mind (e.g. a thought) to cause REAL, physical changes in your body. The change in this case is increased blood flow to your face. You feel flushing and experience a blush. Ever been nervous before an exam or a competition? Remember how your stomach felt in knots? Again, a mind-body connection.
Research and empirical data suggests that chronic and acute back pain, jaw pain (TMJ), arm pain (RSI), pelvic pain, many tension and migraine headaches, skin rashes including eczema, irritable bowel syndrome (IBS) some pelvic and prostate pain can be caused or worsened by emotions such as anxiety, anger, fear, and grief.
Some people are more prone to these disorders than others. Back Pain may be more likely, for instance, in people who are self-critical, perfectionistic, and highly responsible for others. I call this the "Type T personality".
People with chronic pain are often suffering from a mind-body disorder known as TMS, or Tension Myositis Syndrome, Tension Myoneural Syndrome, or the Mindbody Syndrome, PPD (a diagnosis that is relatively unknown or understood in both the medical and alternative communities.
TMS is a name that describes how symptoms are perpetuated in various areas of the body by "stuck" neural pathways. In addition to pain, other symptoms and conditions can be successfully treated in many cases.
Do I have TMS? (TMS questionnaire can help)
TMS often manifests as a soft tissue condition of the muscles, ligaments, and nerves of the back and neck. The pain in TMS is caused or worsened by tension and in most cases, can be eliminated by a mental, cognitive, conscious process that involves focusing on the emotional, rather than the physical or structural.
Tension Myoneural Syndrome describes the very common problem of chronic pain, e.g. back and neck pain, and redefines it as physical pain with roots in emotional tension and neural pathways from certain brain regions. This syndrome was first theorized by Dr. John Sarno at NYU's Rusk Institute. In the late 1970's and early 1980's he described in detail a theory, involving the connections between emotions, the brain, the limbic system, and the autonomic nervous system that generates this process. The end product is painful tissue that causes local pain (trigger points, areas of spasm) and sometimes distant pain (sciatica,etc.). The cure is educational and psychological and highly effective in most patients.
This diagnosis is probably not that well known or accepted in the medical field because of the emphasis on pathology and a "cartesian" split between mind and body that pervades medical thought. Typically the medical profession is split: If it's mental, it must be psychiatric; if it's physical, surgery or medication must be the answer. There is rarely a meeting of the minds, where physicians can heal via treatment of mind and body. But successful TMS treatment must involve both an appreciation and understanding of the physical pain AND the vital connection to the mind and emotions.
In the last fifteen years, we have learned a lot more about the brain through functional MRI imaging (fMRI) and important research on the localization of acute versus chronic pain. Chronic pain is found more in the emotional regions of the brain (prefrontal cortex, amygdala) and acute pain (e.g. ankle sprain) more somatosensory cortex. This is important because it provides a neuroscientific explanation for why in treating chronic pain we must focus on the brain and emotions.
updated August 2020.
We've learned a lot since Dr. Sarno's original conceptualization of TMS. My focus these days is on the evidence from neuroscience research that is confirming and explaining TMS in newer, better ways. For example, as pain goes from acute (recent, few months) to chronic (more than 6-12 months), it changes in character.
Studies have shown the pain becomes more linked to the emotional centers in the brain. The neural pathways become more entrenched at this point and it's harder to eliminate them... especially if you use the same approaches as you might use with an acute injury.
If instead the focus is changing thoughts, changing beliefs about the pain, processing emotions more effectively, the results are often remarkable. We use journalling, reading, studying materials rather than physical treatements to change the brain... the solution to the pain.