When Pain Won’t Go Away, It May Be Tension Myositis Syndrome

Dr. Mark Wiley | Jan 09, 2013 | Comments 7

Do you experience chronic or intermittent low back pain, along with a series of different types of ailments? Have you tried to manage that pain and reduce those symptoms with various medications and treatment modalities to no avail? They all may have a single root cause in common; and unless that root is corrected or addressed, the adverse health symptoms will continue. If you have tried everything and are looking for more, then Tension Myositis Syndrome (TMS) may be the culprit.

TMS Defined

Tension Myositis Syndrome (TMS) is a relatively unknown and somewhat recent health diagnostic category. It was first theorized in the 1970s by John Sarno, M.D., as being a psychosomatic or mind-body disorder: a musculoskeletal neurological disorder created by the mind and emotions that changes one’s physiology and causes pain and other symptoms.

Essentially, it is believed that stress and repressed emotions like anger and anxiety are the root cause of chronic back pain and a host of other disorders (discussed below). The theory of TMS, though not widely accepted in mainstream medicine yet, contends that repressed emotional triggers affect the nervous system which, in turn, slows blood flow to muscles, nerves and connective tissue. It basically causes a reaction or process that starves the body of oxygen, causing pain. This pain then becomes the location of focus and concern, alleviating the need (superficially) for dealing with the stress, anxiety and other emotional issues at hand. TMS case studies show that as the emotional components are dealt with successfully, the physical ailments that were heretofore intractable disappear almost instantly.

TMS Symptoms

While pain in general (low back pain in particular) seems to be the most common symptom of TMS, it is not the only one. Generalized stiffness and numbness and tingling in the body or limbs are also associated with the syndrome. Flare-ups from painful to severe come and go at different times, showing the correlation of symptoms to (perhaps) the emotional upset state of the individual at any given time.

Many who experience the problems of chronic pain, tension headache, fibromyalgia, irritable bowel syndrome (IBS), constipation, arm pain, temporal mandibular joint dysfunction (TMJD) and tinnitus (ringing in the ears) have had difficulty finding relief or cure form mainstream approaches. They may have the basis or root of their symptoms in TMS.

TMS Equivalence

As a mind-body practitioner myself and as someone who has suffered debilitating headaches and musculoskeletal pain for most of my life, I have always thought the psychosomatic (mind-body) connection plays a central role in our daily state of health. What I find intriguing about TMS is its theory of equivalence; it offers a connection not generally made in the mainstream or alternative health communities. Here are four short passages from Sarno from his book Healing Back Pain that are interesting, informative and thought-provoking:

• “TMS is equivalent to peptic ulcer, spastic colitis, constipation, tension headache, migraine headache cardiac palpitations, eczema, allergic rhinitis (hay fever), prostatitis (often), ringing in the ears (often), and dizziness (often).”

• “I believe these disorders are interchangeable and equivalent of each other because many of them are found to occur historically in patients with TMS, sometimes at the same time, but often in tandem.”

• “Equivalence is also suggested by the fact that patients often report resolution of one of these disorders when the TMS pain goes away. This happens most commonly with hay fever. I teach patients that all the conditions on the list serve the same purpose psychologically.”

• “Experience with TMS and these related conditions suggests that there may be a common denominator, anxiety perhaps, that can bring on any of these disorders. In that case, some other emotion, anger for example, may be the primary one that may in turn induce anxiety, which then brings on the symptom.”

TMS Treatment

Patients bring their medical history when consulting with a TMS physician. This information generally includes written physician reports, lab results and diagnostic imaging studies. After receiving a diagnosis of TMS, treatment begins.

The first step in treating TMS requires patient education. Physicians generally provide audio and written materials or recommend lectures. Education teaches the patient various aspects of the condition and reassures them that physical symptoms do not occur because of typical disease processes, physical injury or re-injury.

Another treatment modality physicians may use for treating TMS involves keeping a daily journal and writing about circumstances that might have created repressed emotional stress. David Schechter, M.D., recommends that when patients begin writing, they should consider whether they relate to certain key areas that often contribute to repressed feelings:

• Abuse, abandonment or neglect during childhood.
• Conscientiousness or perfectionism related to acceptance.
• Current life stressors.
• Aging or mortality.
• Situations wherein patients feel but repress negative emotions.

After identifying a list of possible contributing factors, TMS physicians require that patients formulate an essay for each of the problem areas. Longer essays provide patients with the opportunity of exploring the issue in greater detail. Schechter developed a 30-day program called The MindBody Workbook, which assists patients with documenting events that trigger negative emotions. The journal helps patients correlate the emotion with the physical symptoms of TMS. Over time, patients learn to use emotional expression rather than repression.

Part of TMS treatment also requires that patients live as if symptom-free. If physicians find no physical reason for chronic pain, Schechter advises that patients stop using conventional treatment methods for pain control. He believes these methods serve only to mentally reinforce a physical condition that does not exist. Patients must also resume normal physical activities when there is no physical evidence for pain.