What is Tension Myositis Syndrome?

Is Tension Myositis Syndrome (TMS) the diagnosis you have been searching for? Are you experiencing chronic pain or another chronic condition without a physical cause? Have you been looking for answers for months, years or even decades? If this is the case, you have come to the right place. I had chronic fatigue, pain, multiple chemical sensitivities, and several other symptoms for decades before I heard about Tension Myositis Syndrome.

Learning about TMS has changed my life and I believe it can change yours also. Keep reading to find out what TMS is, the causes, the symptoms, and how to cure it.

What is Tension Myositis Syndrome?

Dr. John E. Sarno named TMS. He was a Doctor of Rehabilitation Medicine at New York University and was also a physician at the New York University Medical Center. Dr. Sarno began to notice a trend in patients who suffered from chronic pain where there was no physical injury. The brain causes TMS. It is just making a mistake.

The brain can learn pain and it can form into a habit. Pain’s function is to keep us safe, but sometimes the brain makes a mistake and interprets safe sensations in our body as dangerous.

What Causes Tension Myositis Syndrome

There is no one cause for TMS, but Dr. Sarno became aware of certain personality traits that most of his patients had in common. People with these personality traits are often living in a high alert state even though there is no longer a threat, which can lead to chronic pain.

Common Personality Traits

Dr. Sarno noticed that many of his patients had similar personality traits such as:

  • Worrying
  • People pleasing
  • Self-Criticism
  • Pressure
  • Perfectionism


They tend to be preoccupied and in their heads a lot, worrying about what other people think, consumed by the stress in their lives.

Worrying about what other people think can lead to people pleasing.

People Pleasing

When we try to please others and keep the peace at all cost our lives suffer. We can’t show our emotions for fear of causing discomfort in others, while we end up the ones feeling uncomfortable. This can take a toll on our health. Our suppressed emotions have to go somewhere, and sometimes they reveal themselves as pain in our bodies.


Perfectionism is when we want to be the best and if we fall short we are hard on ourselves. We may quit things often because we feel we just aren’t good enough. Perfectionism comes from a fear state. Striving for excellence on the other hand is when we want to do well, but if we fall short we are kind to ourselves and try again.


People with TMS are often intense and somewhat pessimistic. They beat themselves up. It is not okay for them to make mistakes hence the perfectionism. They look at life as though the stakes are very high, as if there are land mines everywhere. Fear is the common denominator.

Dr. Sarno’s Theory

Dr. Sarno noticed these common personality traits in people that came to him for chronic pain, and went on to theorize that these personality traits caused his patients to suppress emotions, particularly anger and rage. His theory is that the brain creates pain to distract the patient from feeling painful buried emotions. He explains this further in his book “Mind Over Back Pain,” and “Healing Back Pain : The Mind-Body Connection.”

Some people heal from TMS just by reading one of his books. A “20/20” episode reports several patients healing their pain by attending one of Dr. Sarno’s seminars.

There is a possibility that almost any chronic symptom or condition that has no physical cause or known injury is TMS. I have listed some of them below.

Pain may start with an injury and continue even after the injury has healed. For me, the symptoms that were the most debilitating were chronic fatigue, insomnia, and back pain.

  • Back pain
  • Head pain (pressure)
  • Head pain (Migraines)
  • Chronic Itching
  • Tinnitus
  • Indigestion
  • Nerve Pain
  • Sciatica
  • Plantar Fasciitis
  • Hip Pain
  • Nausea
  • Dizziness
  • Carpal Tunnel Syndrome
  • Knee Pain
  • Jaw Pain or TMJ
  • IBS
  • Chronic Fatigue Syndrome
  • Fibromyalgia
  • Insomnia

Read on to learn about neuroplasticity, and how the brain can change.

A Modern Perspective

Have you been struggling for months or years with chronic pain and been to every doctor and practitioner under the sun? I know how frustrating and hard on the pocket book this can be. I was in the same place until I found out about TMS.

Although we may get some relief from watching Dr. Sarno’s seminar, or reading one of his books, this is not the norm. I however, made a shift, and at that time I didn’t understand what exactly was going on.

Many have come after Dr. Sarno and made some adjustments to his theory and cure, but he paved the way for all of us.

Neuroplasticity and TMS

Neuroplasticity simply defined is the brains’ ability to change. It’s the ability of the brain to form new habits. To rewire.

Pain can be learned, just like we learn to ride a bike. Slowly, and with repetition our brains learn new habits by neurons firing together. The more these neurons fire together, the more they are wired together as habits form. Sometimes this is a good thing, as in learning how to ride a bike; however, when it comes to chronic pain, this is not such a good thing.

Chronic pain can become a habit. Other more modern terms for TMS are Neuroplastic Pain, or Mind Body Pain. This happens when the brain changes in a way that reinforces chronic pain, fatigue, and many other conditions. The good thing is that the brain continues to change, so we can change the brain, or train it to unlearn these reinforcements, or patterns. We can teach it to unlearn pain.

How do you Diagnose TMS?

As stated above, pain can be learned. Pain is a danger signal, but sometimes the brain misinterprets what is actually safe as dangerous. Sometimes our brains make a mistake and signal pain where there is no injury.

Normal pain is when you get injured, and TMS is pain when there is no injury, or you had an injury that has healed, but the pain continues.

5 Questions To Ask Yourself To Determine if Your Pain is TMS

  1. Did the pain come on during a stressful time?
  2. Is the pain inconsistent, meaning does it move around?
  3. Do you have symptoms in many different parts of your body?
  4. Does the pain demand a lot of your attention? Are you thinking about it all the time?
  5. Have you been to doctor after doctor and practitioner after practitioner and still have little or no relief?

If you answered yes to several of these questions, there may be a good possibility that you have TMS.


The fuel for the pain is fear. Fear helps us to identify danger, but in the case of TMS or Neuroplastic Pain, there is no danger or there is no longer a danger, but the pain remains.

Fear keeps the brain in a high alert state, or in a Fight/Flight/Freeze/Fawn state. When this goes on for a long time the brain may start to interpret things as unsafe, when in reality they are safe. When fear becomes a habit, sometimes pain also becomes a habit. Our brains are trying to keep us safe. They are just trying to help us.

How do you treat or cure Tension Myositis Syndrome?

If you feel you have TMS read on to find out how to heal. If you’re still unsure, get checked out to make sure that there isn’t a physical impairment that is causing your symptoms.

Teaching our brains to feel safe is how we heal TMS. It’s about breaking the fear habit and the pain habit, or the fear/pain/fear cycle. It all starts from fear, which can cause the brain to make a mistake and send out false alarms (pain), and then we become afraid of the pain, and the cycle continues.

We have to break this cycle in order to heal from TMS.

You can read more about how I was able to retrain my brain out of pain here.

There is no one way to cure TMS but there are many things that work for a lot of people.

7 Steps To Healing Tension Myositis Syndrome

  1. Pain Education – Learning how the brain can sometimes make a mistake and interpret safe sensations in our bodies as dangerous is the first step, and knowing that pain can be unlearned. We can change the interpretation.
  2. Self-care helps our brains to feel safe. Making some simple changes about how we care for ourselves and talk to ourselves can be very helpful.
  3. Working with other triggers such as perfectionism, pressure, and people pleasing.
  4. Somatic Tracking is about going into the body and learning to become aware of our emotions and our pain, and seeing them as safe, instead of dangerous.
  5. Journaling – Getting our troublesome thoughts and emotions out on paper.
  6. Mindfulness and meditation can sooth our brain and bring down our intensity.
  7. Changing our focus from preoccupation with our pain and onto our lives. Learning to live our best life is the best form of healing.

Pain Education

Understanding the process of what exactly is going on in our brains to cause the pain is really important in order for most people to heal from Tension Myositis Syndrome. This is brain to body pain, not body to brain pain. This is no injury in the body that is signaling danger to your brain.

Your brain is misinterpreting that there is danger in the body and sending pain signals. So we are working on the brain, not the body.

Buying into the fact that there is nothing physically going on in the body is the first step to help our brains feel a little safer, but for most people it’s not everything. Read on about why self-care and compassion are so important.

Self-care and Compassion

A big part of my healing Tension Myositis Syndrome has been in having much more compassion for myself, and going easy on myself when I make mistakes. It goes against my conditioning, so it’s not easy, but over time, and with repetition we can change patterns.

Self care and compassion is the antidote for our critic voice. The majority of people with TMS beat themselves up and just plainly aren’t very nice to themselves. This keeps the brain in high alert, where self care and compassion send safety messages to our brains.

When we begin to give ourselves more safety messages than danger messages, our brains will send less pain signals.

Do you care for yourself like you care for your child, partner, or best friend? Changing your relationship with yourself is key. Focusing on what you like about yourself instead of what you don’t like about yourself is one way to do this.

Read my article “Self-Care – The Cure for TMS?” for more ideas on how to care for yourself better, and how this helps to get out of chronic pain.

Because self-care is so important in healing Tension Myositis Syndrome, perfectionism, pressure and people pleasing need to be dealt with.

Perfectionism, Pressure, and People Pleasing

As I mentioned above, most people from my experience that have TMS are perfectionists and people pleasers. They want to do everything in their lives perfectly, and they want to have perfect relationships with all of the people in their lives, which is impossible. This causes them to constantly pressure themselves to do better.

Often people with Tension Myositis Syndrome are highly successful because of this, but in pain. They are successful, but often very unhappy.

The answer to perfectionism, pressure and people pleasing is to do well at less things. You don’t have to be perfect at everything. Pick a few things to do well at, and a few people to have great relationships with, not everybody you know or encounter.

We have to take the pressure and learn to live in the peace and calm to heal from TMS. Lower the steaks. A book that I love to read when I realize that I am back in a perfectionistic state is “The Subtle Art of Not Giving a F*ck.”


For some people learning to feel and accept their emotions is the ticket. Like I mentioned earlier, when we suppress emotions the energy has to go somewhere, and sometimes it shows up as pain in our bodies. All of our feelings are valid. There is no wrong emotion. They are safe.

My blog post called TMS & Emotions, is a very personal writing on how I have struggled and learned to feel my feelings.

Eventually our brain begins to feel safer, and we slowly start to break the fear habit. We realize that we only need to be in a high alert state when there is a true 911 danger. Once we break the fear cycle, we can break the pain habit.

So why do myself and others get some relief just from watching Dr. Sarno’s seminars or reading one of his books? The answer to this question is that these things reinforce safety. We bought into the fact that there was nothing physically wrong, our brains were just making a mistake, and we were indeed safe.

My brain made a shift from danger to safety, and this is the key to healing TMS, however that may show up for you.

So be kind to yourself, cut yourself some slack, and bring the intensity down. Do unto yourself as you would do unto others.

For more information about Pain Coaching with Stacey please click here.

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