From The TMS Wiki
Jump to: navigation, search
For people just learning about TMS/PPD   An Introduction to TMS   So You Think You Might Have TMS   TMS Personality Traits    

Have you struggled with chronic pain or another medically unexplained symptom for a long time? Have you tried everything to alleviate your pain, but nothing worked? Have you had doctors tell you they ‘just can’t find anything wrong?’

Then you may have a Tension Myositis Syndrome (TMS). TMS is a condition that causes real physical symptoms that are not due to pathological or structural abnormalities and are not explained by diagnostic tests. In TMS, symptoms are caused by psychological stress.

You may be at your wits end. However, there is hope. We know this because the authors of this wiki struggled with chronic pain for many years, and that is exactly how we felt. Of course, we can't diagnose you and everyone is different, but for us, the solution didn't involve surgery, needles, or expensive drugs.

Add video about a person describing their experience with chronic pain.

What is TMS?

an image of a woman and chalkboard with question marks
Tension Myositis Syndrome (TMS), also known as Tension Myonueral Syndrome, is a condition originally described by John E. Sarno, MD, a retired professor of Clinical Rehabilitation Medicine at New York University School of Medicine, and attending physician at the Howard A. Rusk Institute of Rehabilitation Medicine at New York University Medical Center. TMS is a condition that causes real physical symptoms, such as chronic pain, gastrointenstinal issues, and Fibromyalgia, that are not due to pathological or structural abnormalities and are not explained by diagnostic tests. In TMS, symptoms are caused by mild oxygen deprivation via the autonomic nervous system, as a result of repressed emotions and psychosocial stress.

This is not to say that the pain is “all in your head” or that it is not real. TMS symptoms are very much real, and we should know. All of the people who wrote and developed this website had debilitating chronic pain and other symptoms. We know, first hand, what it is like to have back pain, Sciatica pain, RSI, Fibromyalgia, Chronic Fatigue Syndrome, Migraines, irritable bowel syndrome, and a wide array of other symptoms. We visited doctors and doctors and were told the same things you probably heard: you have a degenerative disc disease, a herniated disc, you type too much, it is due to overuse, or that you are just aging. Even though we were told this, when we applied the ideas first promoted by Dr. Sarno we became pain free and regained our lives.

How TMS Develops

At the heart of the development of TMS is our desire to be good people, loved by those we care about. This desire leads us to strive for perfection and to have all our actions be considered good. We will cook a three course family meal after working a 10 hour day, because that is what a good mother would do. We will be the first person to volunteer to work on the weekend, because that is what a good employee will do. We will stay up all night making sure our homework is perfect, because that is what the perfect student will do. Our beliefs of what a good and perfect person will do, directly influence our behavior on a day-to-day basis.

But sometimes, as more and more external stress is added and our desire for perfection increases, we develop a very deep seeded resentment toward these tasks. There are some nights when you come home from working a double shift, you are angry that you have cook a meal for your family, while your husband has been watching TV all night. Part of us hates telling our friends that we can't go out on Friday, because we have to get ahead on our reading for class. When our newborn baby wakes us up at 3 am for the fourth night in a row, some part of us has rage at the child, for waking us up yet again. These are all normal feelings and emotions to have. However, when a person has an emotion that goes against their belief of what a good and perfect person would do, the only option available to them is to repress that emotion. If we admit that we are angry at our family, we fear that we would be considered a bad person and will be rejected by those we love. Instead of admitting that we are angry at our spouse for never cleaning up or doing the dishes, we repress it deep in our unconscious. Common emotions that we repress include: anger, rage, and frustration.

As we continue to repress these emotions we create an immense amount of tension in our bodies. In order to keep you from recognizing that you have these powerful emotions of anger and rage, your unconscious creates physical symptoms. These symptoms serve as a way to distract you from the unwanted emotions by having you focus on your back hurting instead.


a student reading in a chair
No two people are exactly alike, and likewise, no two TMS recoveries are exactly the same. Different things work for different people, and one of the keys to TMS treatment is identifying what techniques work best for you. People have reported using a variety of approaches to get better. Regardless of the specific technique, TMS treatment is based on two principles, which Dr. Sarno stated in Healing Back Pain:
  1. The acquisition of knowledge, of insight into the nature of the disorder.
  2. The ability to act on that knowledge and thereby change the brain's behavior.

All of the standard treatments for TMS seek to address help people address one or both of these pillars. The following is a list of techniques that many people have reported being helpful in their own recovery from chronic pain. As a reminder, it is important to see a medical professional before starting this treatment approach to rule out any serious medical condition.

  • Think Psychological: As previously mentioned, TMS serves as a distraction mechanism to prevent unwanted emotions to surface to our consciousness. The idea being that you will focus on your symptoms instead of your emotions. Think of how much time you spend thinking about your symptoms, worrying about when they will come next, or if they will ever go away. Thinking psychologically involves turning your focus from your symptoms to your emotions. Instead of thinking when is my back ever going to stop hurting, ask yourself what am I stressing about now, or how do I feel emotionally right now. Thinking psychologically is a process of using your symptoms as a signal to check in on your emotional state, as well as a method of changing how you view your symptoms.
  • Educate yourself: As the first pillar of TMS recovery states, learning about this condition will give you the knowledge you need to recover. Read a TMS book, forum posts, success stories, Thank You, Dr. Sarno messages, and our wiki to gain a better understanding of Tension Myositis Syndrome, and what it takes to recover.
  • Resume Physical Activity: In Healing Back Pain, Dr. Sarno writes: Perhaps the most important (but most difficult) thing that patients must do is to resume all physical activity, including the most vigorous. It may seem odd to become active when you are still in pain, but it can be extremely beneficial in TMS treatment. By being active you are sending messages to your unconscious that you do not have a physical problem, and will no longer think physical. The more active you are, the more confidence you will gain.
  • Stop all physical treatments: In order to fully accept the diagnosis it is important for people to stop using physical modalities to treat their symptoms, once a medical professional has cleared them for any serious medical conditions. There are a wide variety of physical therapies people in chronic pain use. Whether it is, massage, heating pads, chiropractic manipulation, acupuncture, all of these techniques keep people focused on their physical symptoms, instead of their emotional health. If you wear orthopedics, use ergonomic devices, or any other device to prevent or help reduce your symptoms, it is recommended to stop using them. Full recovery can only happen when a person has full believe in the TMS process.
  • Affirmations:Many people have reported how helpful saying affirmations are in recovering. Essentially this involves talking to your brain. While it may feel slightly odd to talk to yourself, people have reported that it allows them to gain control over their thoughts and take a more active role in their recovery.
  • Interact with Other TMS Peers: Hearing how other people recovered from TMS can be very helpful in your own recovery. This can be anything from posting in our forum to attending a lecture by a TMS doctor. Our organization hosts a number of events for peers including: a weekly TMS discussion group and drop-in chat, in-person support groups, and TMS webinars.
  • Journal/List making: Identifying and understanding what factors are fueling your symptoms is key. Many people have reported how writing about past and present events, as well as their emotions, to be particularly helpful in reducing their symptoms. Simply making a list of events and circumstances that may be creating repressed anger and rage has been enough for some people to recover.
  • Psychotherapy: For some people, identifying and processing their repressed emotions is challenging. This could mean that this individuals simply have a higher level of anxiety or a more traumatic past. In these cases, a trained TMS professional can be helpful in guiding the person through their TMS treatment.

For more ideas on how to recover see: So You Think You Might Have TMS

Medical Evidence

an image of a scientist in lab coat
Dr. Sarno also conducted two follow-up survey of his patients to gauge the effectiveness of his treatment approach. The first, conducted in 1982, selected 177 patients at random. 76% reported being pain free. The second study was done in 1987 and focused on 109 patients who experienced back pain. In this survey 88% reported being pain free. Dr. David Schechter also conducted similar follow-up surveys on his patients, and reported at 57% success rate among 85 patients.

In 2010, Howard Schubiner, MD, conducted a Randomized Control Trial on the effectiveness of the Tension Myositis Syndrome (TMS) approach in treating fibromyalgia patients. This study was the first TMS-specific research study to use a RCT, the gold standard of the medical community. The study was conducted on 45 randomly chosen women who had Fibromyalgia. The treatment consisted of a one time consultation followed by 3 weekly, 2 hour group lecture sessions explaining TMS. After a 6 months follow up, 46% of the participants reported a pain reduction of at least 30%. After these promising results, Howard Schubiner, et al received a research grant from the National Institutes of Health to further explore the effectiveness of this approach.

More Resources

Next: So You Think You Might Have TMS

DISCLAIMER: The TMS Wiki is for informational and support purposes only and does not provide medical advice, diagnosis, or treatment recommendations. See Full Disclaimer.