Tension Myositis Syndrome (TMS) and How to Treat It

This is my complete guide to Tension Myositis Syndrome (TMS) which may be the reason for your chronic pain, fibromyalgia and other conditions.

Do you have recurring back pain, sciatica, or some pain in other areas of your body that can last for months?

Is pain always at the back of your mind stopping you from living your life to the fullest?

Do you also experience other symptoms such as irritable bowel syndrome (IBS), headaches, heartburns, hiatus hernia, or skin conditions?

Do you often feel anxious or depressed?

If you answered yes to some or all the questions above, you may be suffering from Tension Myositis Syndrome (TMS)—and you don’t have to live with that forever.

What is Tension Myositis Syndrome (TMS)?

Tension Myositis Syndrome (TMS), also known as Tension Myoneural Syndrome or Mindbody Syndrome, is a name given by John E. Sarno MD to describe pain, not caused by an injury or a structural problem with your spine, but that is rooted deeply in your psyche.

That’s why it’s called Mindbody Syndrome—the symptoms are physical and manifested in the body but their origins are in the mind.

Tension Myositis Syndrome is a totally harmless and 100% treatable disorder if you address the emotional and psychological causes.

You may be already questioning TMS, “Is this excruciating pain caused by my psyche? BS!”.

I hear you.

That was my initial reaction when I first read Dr Sarno’s book Healing Back Pain fifteen years ago.

But if you go deeper into these things, then everything begins to make sense.

I hope this article will be the start of an amazing healing journey for you.

Who Gets Tension Myositis Syndrome?

The short answer is anyone.

Anyone who can feel emotions can get Tension Myositis Syndrome.

However, TMS is more common among those who fall in the “years of responsibility” group, as Dr Sarno said.

That’s usually between 25 and 60 when someone strives to succeed, provide and excel in life.

TMS is common in people who:

• Aim for a successful career
• Care and provide for their families and others but often forget themselves
• Face the challenges of a life or career transition
• Try to stand on their own two feet financially and build wealth
• Experience uncertainty, stress and anxiety
• Strive to be the ideal person, parent, worker, student, etc.

Dr Sarno noticed that elderly people were not affected as much as younger people which made him think that the root of the pain couldn’t be structural.

“How come the spine of a 70-year old produces less pain than the spine of a 30-year old?”

Numerous studies show that “spinal flaws” are not the cause of pain.

Let me be clear: Not all pain is psychological—not all pain is mindbody syndrome pain.

Pain can be a result of a serious injury such as a broken bone.

If, however, there is no clear myoskeletal or neural damage, your pain could be linked to your feelings, personality or life circumstances— your pain is Tension Myositis Syndrome pain.

The Psychology of Tension Myositis Syndrome

Tension in the term TMS means repressed emotions in your unconscious brain.

We often repress emotions that go against our desired/perceived identity or that are unacceptable by society.

We repress them because they are too painful, uncomfortable, embarrassing, and frustrating to deal with.

These repressed emotions can grow so much that they end up manifesting as physical pain.

How is this possible?

Because research in neuroscience shows that emotional and physical pain use the same neural circuits.

Negative emotions are more than enough to cause pain in different areas of our body while we’re still pointing the finger at our MRI, a herniated disc, arthritis or disc degenerative disease.

This picture from one scientific study shows how social rejection and physical pain activate the same neural circuits in the brain.

The emotions that usually generate the physical pain are:

1. Low self-esteem
2. Anxiety
3. Anger

Let’s look into each one in detail.

Low Self-Esteem

This is the usual “I’m not good enough” feeling.

And what do you do if you feel you’re not good enough?

You do more.

The tendency to strive, excel and overachieve often comes from an unconscious feeling of low self-esteem.

The problem is that no matter how hard you strive, you never think you’ve achieved enough.

People with TMS are their own severest critics.

They may complain that their tension is caused by external and unavoidable stressors such as an over-demanding job or family responsibilities but that’s not the whole picture.

It’s their own conscientiousness, their perceived beliefs of their own performance and success that generate the tension.

The whole world may think they are doing an outstanding job but they still may think they’re not good enough.

Perfectionism is a self-destructive and addictive belief system that fuels this primary thought: If I look perfect, and do everything perfectly, I can avoid or minimise the painful feelings of shame, judgement, and blame. — Brené Brown

In other cases, the lower the self-esteem on the inside, the more someone wants to show strength, confidence and assertiveness on the outside.

And they may be totally oblivious to it because this is running on an unconscious level.

Most of these people (I was one of them) initially reject a TMS diagnosis.

“Low self-esteem? Repressed inferiority feelings? Me? Ha Ha Ha! That’s all BS!”

In each one of us there is another whom we do not know. — CG Jung

At other times, people with Tension Myositis Syndrome find it hard to accept who they truly are and try to become someone else.

Why?

Because again, they think they are not good enough, they don’t accept themselves—they want to be liked and respected by others.

This is a learned behaviour that has served them well in the past to a certain extent but comes at a cost: repressed emotions, tension and pain.

When you stop being codependent on someone else’s thoughts and feelings and learn to be content with who you are and whatever you feel, the tension goes away along with the pain.

Anxiety

Who wants to be labelled “an anxious person”?

Anxiety is associated with unexpected reactions and behaviours.

That’s why we want to keep anxiety separated from our consciousness and others.

No one brags about their panic attacks to their friends, right?

You want to be thought of as a calm person: a Buddhist monk capable of handling the most challenging and stressful situations.

For years I denied the existence of my anxiety. I wanted to appear strong as befitted the successful professional in investment banking I used to be.

When I came to terms with my anxiety, I became less anxious.

It’s interesting that when I recently published a guide on anxiety on this website some of my friends were shocked to read my own anxiety story.

“Angelos? An anxious person? Who knew??? I always thought you were a chilled person”.

Those who were most shocked when I openly admitted my anxiety, are the ones who probably feel most ashamed of their own anxiety.

This is how repression works.

For every action, there is an equal and opposite reaction.

Do you feel not good enough? Do more, be perfect.

Do you feel anxious? Smile and appear chilled.

That may work for a while but it adds up and this is how Tension Myositis Syndrome and pain enter your life.

Interestingly enough, anxiety and low self-esteem often go together.

You’re anxious when you:

• strive to be someone else other than your true self
• want to be liked
• try to control other people’s behaviours, expectations, opinions, thoughts about you
• can’t say no and have a hard time addressing your own needs and wants
• struggle to comply with distorted beliefs that are accepted by society but are against your true self

Anxiety leads to physical pain and continues to fuel the pain.

Before the pain started, you were anxious about a million things but now you’re also anxious about your pain.

You can’t stop checking for the pain.

Is it gone? Is it still here? What if I sit down? What if I stand up?

Anger

Things that makes us anxious tend to make us angry too.

You get angry when you realise that you can’t control someone else’s thoughts and opinions about you.

You get angry when no achievement is enough to make you happy.

You get angry when you can’t control your emotions or your pain.

Unconscious anger is very common in personal relationships and family dynamics too.

Dr Sarno hit the nail on the head in his book Healing Back Pain:

An important source of anger and resentment, of which we are usually unaware, stems from our sense of responsibility to those who are close to us, like parents, spouses, and children.

Though we love them, they may burden us in many ways and the resultant anger is internalized. How can one be angry at elderly parents or a baby?

Anger often comes from an inner conflict between what you want to do and what you should do.

How many should-do’s are imposed explicitly or implicitly by your family, society, culture, employer, partner, children, religion?

Bringing all these things to the surface may be enough to take your pain away.

Understanding the deeper reasons you feel angry may be enough to release the tension and ease your pain.

How Do You Treat Tension Myositis Syndrome?

I’ll give you a full list of actions and tips that will help you to deal with your TMS and get rid of your pain.

Before that, I’d like to draw your attention to the two most important things that will accelerate your healing journey.

Dancing Gracefully with your Emotions

The root of Tension Myositis Syndrome is not the negative emotions but the repression of negative emotions.

The problem is not the feeling but you NOT WANTING to feel certain feelings.

The tension only happens when you refuse to feel, reject, or repress “uncomfortable” feelings.

Acknowledging negative emotions and tracing them back to specific events in your life can be enough to release the trapped energy and give you pain relief. You don’t have to turn your life upside down and make drastic changes to get rid of your chronic pain.

Just working with your emotions and understanding where the pain comes from can be enough for permanent healing.

You don’t have to act on what you feel. You just have to feel any and every feeling that comes your way.

You can learn to welcome any feeling without embarrassment or shame.

When you learn to dance with your negative feelings, they get washed away and make space for positive emotions.

Focusing on your Pain … Grows your Pain

When you’re placing so much focus and attention on your pain, your brain is unwittingly growing your pain.

Scientific studies show this through the neuroimaging of people with chronic pain.

If your attention and thoughts are focused on the pain and how awful it is, when you have a hard time thinking about anything but the pain, when you’re ruminating on it and worrying about it, you light up the exact same regions in your brain that are involved in the processing of pain itself. You’re growing your pain by how you place your attention and thought patterns. — Beth Darnall, Professor at Stanford University

If you identify as a “chronic pain sufferer” and spend hours interacting with other “sufferers” online you may be throwing petrol on the fire.

If you want your pain to go away, stop thinking about it.

Do something that brings you to life, something enjoyable, something that you’ve missed because of the pain.

Here’s a list of things that will take your pain away forever:

1. Get a physical exam and make sure there is no serious life-threatening danger.
2. Stop all efforts to heal your back, neck, chest, or any part of your body that is currently in pain.
3. Stop all tips and tricks such as hot water ice, cold packs, CBD oil, stretchers, vitamin supplements, etc. These things send a message to your unconscious mind that there is a physical problem to be treated.
4. You could also stop physiotherapy, yoga, pilates and anything else you do to “manage” your pain.
5. Stop trying to control your pain. Live your life as though you were 100% healthy. The problem could be that you’ve forgotten to live your life.
6. Engage in activities that bring you to life. Do what you truly enjoy. Do the things that you’ve always loved to do. Nothing can stop you from enjoying the gift of life. Doing the things that “pain allows you to do” may be the reason that your pain is still there.
7. Learn to say NO. It may be uncomfortable at the beginning. You may lose a few “friends” in the process but it will feel rewarding in the end.
8. If you sometimes catch yourself doubting the Tension Myositis Syndrome diagnosis that’s OK. Accept your doubts and carry on.
9. Accept the fact that the pain may return. The healing journey is not linear. Quite often when you first experience pain relief, you want to make sure the relief is permanent. This can create anxiety which may trigger the return of pain.
10. If the pain is still there or gets worse, examine your emotions. How do you feel? What could have triggered this feeling?
11. Journal. Put all your negative thoughts onto paper and then tear it up. This illustrates the transitory nature of thoughts and emotions—they come and go.
12. Offload. Imagine you’re a truck that’s carrying a heavy load. How can you make your life simpler? What can you release? If it’s not so easy to change the stress that you put on yourself , can you eliminate some of the external pressures? Give yourself more space for recreation, self-love and self-expression.

How Long Does it Take to Treat Tension Myositis Syndrome?

You can get better at treating your TMS as you learn to work with your emotions.

However, it’s not unusual for the pain to disappear quickly.

I’ve seen clients find 100% relief after just one session in which we explored the reasons behind their negative emotions.

And remember this:

The more you live your life as if you were 100% pain-free and healthy, the more pain-free and healthy you will actually feel.

“Fake it until you make it” is not always the best advice but why no trying it if nothing else has worked?

—Angelos

P.S. Subscribe to receive my tips for chronic pain relief straight to your inbox.

Subscribe