Pandamonium's letter to her doctor

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Dear Dr. _______,

It was nice to see you earlier this week and I am glad that you don't mind me writing to tell you about how I recovered from my awful back pain, I hope that if you have patients in similar circumstances (where severe pain exists but the physiological reason cannot be found) you could think about this letter and maybe tell them about the book I mention below?

Just to remind you that I had suffered from chronic back pain for 10 years. <add a very brief summary of your TMS story here.>

In Feb 08 I was googling the term “annular fissure” to see if there was anything surgically that could be done for me when I came across a link on “knowledge management”. This then lead on to tell me about a book called Healing Back Pain by Dr John Sarno.

Dr Sarno is professor of Clinical Rehabilitation Medicine at the New York University School of Medicine and an attending physician at the Rusk Institute of Rehabilitation Medicine in New York . When he joined the Rusk Institute in 1965 he observed large numbers of patients with neck, shoulder, back and buttock pain which were attributed to a variety of structural abnormalities of the spine and which he treated according to conventional medical treatment; injections, ultrasound deep heat, massage and exercise. He found that he could never predict the outcome of these treatments with any certainty and in addition he found that the pattern of the pain often did not correlate to the presumed reason for the pain; e.g. someone might have a lumbar disc herniated to the left but have pain in the right leg. Dr Sarno realised that the primary tissue involved was muscle and that 88% of his patients had histories of other disorders strongly suspected of being related to tension such as IBS, eczema, migraine headache, stomach ulcer, colitis and heartburn. He therefore made an assumption that the back pain could also be induced by tension and coined the term Tension Myositis Syndrome (TMS). He treated his patients accordingly and there was a marked improvement in their symptoms. In 2 follow-up studies of 100 patients he had a 75% and an 88% success rate.

In TMS terms the word tension refers to emotional factors, stress, and repressed emotions. Dr Sarno discovered that people who suffer from TMS tend to exhibit the same personality traits; they are perfectionists, very self-critical, and people pleasers. These sorts of people can easily build up resentment and anger and when this emotional tension builds up and threatens to become conscious our mind decides that this could become dangerous or embarrassing and so attempts to distract us. What then follows is that our central nervous system restricts the blood flow to certain muscles, nerves, tendons and ligaments. This results in a lack of oxygen to these tissues and a build up of waste materials causing pain, altered sensations, tension and spasms. This very real and agonising pain distracts us from our emotions and keeps them out of our conscious awareness.

The good news is that once we know what is going on we can easily start to reverse the process. Patients diagnosed with TMS are encouraged to slowly resume physical activity and remove any “props” such as back supports, special pillows and chairs which serve as re-enforcements to our mind that we have a serious structural problem with our backs. Through a process of reading and learning about TMS we effectively start the healing process but this process can be aided by journaling, meditating and occasionally psychotherapy to help process the emotional tension.

Currently there are 3 TMS practitioners in the UK who have trained under Dr Sarno; two are doctors and one is a physiotherapist. The nearest to us is Dr Mark Atkinson based in Farnham, Surrey and his contact details are: <removed>

During the years Dr Sarno has also discovered that there are a number of TMS Equivalents and I know personally of people who have been cured from RSI and Fibromyalgia.

If this letter has piqued your interest in TMS there are a number of websites that you could look at for more information. Georgina Oldfield is the TMS physiotherapist based in the UK and her website has some great information on it, the website is

Another website is, this is a forum for TMS sufferers to chat and support each other and it has helped me a lot in my recovery, just to hear other people's stories of success is so inspirational.

Having been a patient at the Health Centre for many years, I have a huge amount of respect for you and the other doctors at the Health Centre, and I would love to know your thoughts on this subject.

Yours sincerely

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