Is Tension Myositis Syndrome (TMS) pain real?

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Tension myositis syndrome (TMS), also known as tension myoneural syndrome, is a condition first diagnosed by Dr. John Sarno.

According to Dr. Sarno, TMS is a psychosomatic disorder where emotional stress, repressed feelings, and unconscious psychological factors manifest as chronic pain.

You may have heard skeptics dismiss TMS as all in your head, but is the pain experienced by sufferers real?

Understanding TMS: What Dr. John Sarno proposed

Dr. John Sarno, a rehabilitation physician, proposed that TMS occurs when your brain unconsciously redirects emotional stress into physical symptoms, particularly musculoskeletal pain.

The idea is that by creating pain, your mind distracts you from confronting deeply repressed emotions such as anger, fear, or guilt.

Common symptoms of TMS include back pain, neck pain, joint discomfort, and even repetitive strain injuries. Unlike traditional medical explanations for chronic pain, Dr. Sarno argued that the structural issues doctors often point to—like herniated discs—are not always the root cause of pain.

While mainstream medicine has been slow to embrace TMS, thousands of patients have found relief by addressing their emotional health rather than solely focusing on physical treatments.

The pain is real: How the brain and body are interconnected

If you’ve experienced TMS-related pain, you might wonder whether it’s real or merely a psychological illusion.

Research in neuroscience confirms that pain is always real - it’s processed in your brain and interpreted as a signal of something wrong in your body. What makes TMS unique is the mechanism behind that pain.

Chronic pain often exists without a clear physical injury. In TMS, this could result from your brain amplifying normal bodily sensations or creating pain as a protective distraction.

Studies using functional magnetic resonance imaging (fMRI) have shown that individuals with chronic pain often exhibit heightened activity in areas of the brain associated with emotion, such as the amygdala and prefrontal cortex. This suggests that emotions play a significant role in how pain is experienced.

Study 1: Emotional awareness can reduce chronic pain

A 2019 study published in Current Rheumatology Reports examined the effectiveness of emotional awareness and expression therapy (EAET) for individuals with chronic pain.

Participants learned to recognize and process difficult emotions rather than avoid them. The results were striking: those who practiced emotional awareness reported significant reductions in pain compared to those receiving conventional treatments.

This study aligns with Dr. Sarno’s TMS theory. When you confront emotional triggers and repressed feelings, your brain no longer needs to use pain as a coping mechanism. EAET could serve as a modern validation of Sarno’s mind-body approach.

Study 2: Placebo effects and the power of belief

Another intriguing aspect of TMS is the role your beliefs play in pain perception.

A 2018 study in Nature Reviews Neuroscience investigated how the placebo effect impacts chronic pain. Participants were told they were receiving a powerful pain reliever, but in reality, they were given a saline injection. Remarkably, many participants reported substantial pain relief.

This demonstrates the power of the mind in altering your perception of physical symptoms. If you believe that your pain has an emotional or psychological root, you might open yourself to faster recovery by addressing those factors.

Dr. Sarno often emphasized that understanding the psychological nature of TMS is the first step toward healing.

Study 3: The neuroscience of pain and repressed emotions

A 2018 study in Pain Research and Management explored the connection between repressed emotions and chronic pain.

Using neuroimaging, researchers observed that participants who suppressed emotions showed increased activity in pain-processing regions of the brain. The study concluded that unresolved emotional distress could exacerbate or even initiate chronic pain conditions.

This supports the idea that addressing repressed emotions can lead to measurable changes in how your brain processes pain. For TMS sufferers, this means that psychological interventions may help resolve physical symptoms that traditional medical treatments cannot.

How to identify TMS symptoms and explore treatment options

If you suspect you’re dealing with TMS, it’s essential to rule out serious medical conditions first. Once other causes are eliminated, you can consider exploring treatments rooted in DR. Sarno’s principles:

• Education: Understanding TMS and its psychological origins is a key step. Reading books like Dr. Sarno’s “Healing Back Pain” or seeking out TMS resources can help you shift your perspective on pain.
• Journaling: Writing about your thoughts and emotions can help you uncover repressed feelings. Consider journaling about experiences that might be causing stress or unresolved anger.
• Therapy: Therapies like EAET or cognitive behavioral therapy (CBT) can guide you in processing emotions and challenging negative thought patterns.
• Mindfulness and relaxation: Practices like meditation, deep breathing, and yoga can reduce stress and help you reconnect with your body in a non-judgmental way.

Why TMS treatment remains controversial

Despite growing evidence linking emotional health to physical symptoms, TMS remains a controversial diagnosis. Critics argue that not all chronic pain stems from psychological causes and caution against dismissing structural or biomechanical issues too quickly.

However, proponents of Dr. Sarno’s approach emphasize that the mind-body connection doesn’t negate the reality of pain—it simply offers a broader perspective on its origins. Even if TMS is not the sole explanation for chronic pain, addressing your emotional health can be a valuable part of recovery.

Conclusion

Tension myositis syndrome (TMS) pain is as real as any other form of pain.

What sets it apart is the role your mind plays in its creation and perpetuation. By exploring the connection between your emotions and physical symptoms, you may discover pathways to relief that traditional treatments overlook.

Studies in emotional awareness, the placebo effect, and repressed emotions validate aspects of Dr. Sarno’s theory and show how intertwined your mind and body truly are. Addressing the psychological factors behind TMS pain doesn’t mean you’re imagining it—it means you’re confronting its root causes to achieve lasting healing.

If you’re experiencing chronic pain, consider broadening your perspective. Pain is complex, and a holistic approach that includes emotional awareness could offer you the relief you’ve been searching for.

References

Lumley M.A., Schubiner H. (2019) Emotional awareness and expression therapy for chronic pain: Rationale, principles and techniques, evidence, and critical review. Current Rheumatology Reports

Wager, T. D., Atlas, L. Y., et al. (2015) The neuroscience of placebo effects: Connecting context, learning and health. Nature Reviews Neuroscience

Becker S., Navratilova E., Nees F., Van Damme S. (2018) Emotional and motivational pain processing: Current state of knowledge and perspectives in translational research. Pain Research and Management

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