This will be a longer post, so here’s the "TL;DR": Can TMS develop without any emotional distress or psychological issues? If so, how do I cure it if I've got no emotional issues to resolve? That being said, here is my story. I have been experiencing low back pain since last March, which has been persistently present every day. I've seen every type of doctor you would think could treat this: My primary care doctor, an orthopedic spine specialist, a rheumatologist, two different chiropractors (for 15 sessions each), a massage therapist, an acupuncturist, and now weeks of physical therapy. Nothing has helped. I've gotten xrays, MRIs and bone scans, none of which revealed any abnormalities. The rheumatologist ordered a bunch of blood tests done. Everything came back normal (which is good news). My physical therapist had me go through the McKenzie protocol, which is basically a series of back extension exercises. That was uncomfortable but I told myself "it might hurt at first, but it's going to make you better, so just do it." Yet my pain persists. There was no physical event or injury that caused this pain (that I am aware of). It just started one day, and never went away. I am an otherwise completely healthy, active 46-year old male. I eat a squeaky-clean diet (most of the time). Outside of work, I am a competitive mountain biker, which has been my hobby for years. (I actually had a full professional bike fit done last summer, thinking my setup might be my problem, but the fitter didn't really make any major changes. Besides, the pain started before I was training for the season.) I took about six weeks off around December from most physical activity (except some occasional yoga and stretching). Didn't help. I've continued to do research to try to figure this out. A few weeks ago I heard about TMS and read Dr. Sarno's book Healing Back Pain. My symptoms seem to match those of TMS: unexplained, chronic low back pain. The pain actually "moves around," meaning certain parts of my back hurt more than others on some days. Lately the pain has occurred in the front too (groin area). This week it hurts most around the upper corners of my pelvis. Movement and stretching relieve the pain, but it always returns. I can ride my bike without aggravating my back, and gym workouts diminish the pain also. But when I wake up in the morning, it's always there. However, I can't explain the cause of TMS: I wasn't under significant stress when the pain started. I have no psychological trauma in my past. I am in general happy and satisfied in my life. I am married to a wonderful woman. We're financially stable. I grew up in a normal household, one of four children with parents who remained happily married. (My mother passed away from cancer about 15 years ago.) I don't have any hidden fears, I'm not a perfectionist, and am generally pretty self-confident. The ONLY thing I can think of was that I was very unhappy in my previous job for about a year (2018), but I eventually found a new job and left my previous one in November of 2018. So I don't think that would have been the cause. Dr. Sarno discusses the "delayed-onset reaction" in his book, but states that "one or two weeks after it's all over, they have an attack of back pain." My pain first appeared in March 2019, over four months later. So is it possible for TMS to occur without any significant psychological stress? Could this maybe not be TMS? It is going on a year now, I am incredibly frustrated and keep waiting for the day I wake up in the morning and it's gone. I recently ordered Dr. Schubiner's book Unlearn Your Pain. I've contacted two TMS practitioners in my area (the only two listed in the Philadelphia area) but neither are seeing new patients. At this point I am willing to do almost anything to be rid of this. I've tried all the mental exercises I can think of and lately have been telling myself "just quit worrying about it!" but that doesn't magically make the pain go away.