Monday, October 17, 2011

Healing Back Pain

I was searching the Internet for more information on back pain when I chanced upon Dr John E. Sarno's TMS (Tension Myositis Syndrome)  in his book Healing Back Pain  Dr Sarno's starts off by saying that you should not conclude that you has this disorder described unless you has been throughly studied by your regular doctor and he has ruled out all serious conditions.

Dr Sarno hypothesizes that repetitive strain injuries (RSI) and other pain syndromes are entirely psychosomatic in nature and not caused by underlying musculoskeletal injuries. According to Sarno, emotional stress eventually manifests itself as physical pain through tensed, oxygen constricted muscles. Sarno calls this condition TMS. The muscle pain in TMS is similar to what athletes might feel after strenuous workouts. The difference is that for athletes pain relief usually occurs within moments of completing the workout whereas RSI sufferers have constant, lingering pain. TMS says that the brain latches onto tension to divert attention from underlying negative emotions.  By doing this, the brain manages to suppress the negative emotions deeper into the unconscious levels. This can lead to a disastrous cycle where negative emotions cause RSI pain, which end causing more stress and negative emotions and transitively more pain. Sarno boasts very high rates of treatment success (85% - 95%) with his approach, and many RSI sufferers have claimed complete recoveries from adopting this regime. 

Symptoms of TMS
  • No conventional treatment seems to bring lasting results, you’ve tried everything and nothing works.
  • You’re a “Type A” personality. Common personality traits include: Perfectionist, self-motivated, ambitious, neat and organized, in control, responsible, self-critical, tendency to feel guilty.
  • Pain plays a large role in your life. You think about it and/or experience it frequently.
  • You have a history of psychosomatic conditions, not necessarily clinically diagnosed. Earlier trauma or eating disorder for example.
  • The pain coincides with or started at a stressful periods of your life.
Unconscious fear and anger
People are capable of experiencing various negative emotions like fear, anger, guilt, anxiety and shame. During a lifetime a person will likely experience a variety of these emotions to varying degrees. People also tend to construct a self-image of themselves as intelligent, successful, independent, strong, likable, sexually attractive, patient and loyal in the context of some role like a husband or wife, father or mother. When a situation arises that threatens this self-image, the mind tends to do everything possible to divert conscious attention from this threat and avoid confronting it. Psychologically, a persons mind avoids confronting certain negative emotions by embedding them deep into the unconscious mind. This appears to be a built-in defense mechanism. 

Physiological Changes
The underlying premise of Dr. Sarno’s work is that the repressed, unconscious fear and anger described above can actually induce physiological changes.Dr. Sarno came to this conclusion as a result of dealing with patients suffering from back and joint pain. In the vast majority of his patients, Dr. Sarno noticed a history of tension-induced disorders such as heartburn, pre-ulcer symptoms, hiatus hernia, irritable bowel syndrome, colitis, spastic colon, tension headache, migraine and eczema. Whilst not all in the medical profession agree that these disorders are psychosomatically-induced, based on his consistent clinical observations and on the failure of conventional treatments,  Dr. Sarno felt confident that indeed they were.

Sarno also noticed that heating pads, massage therapy and physical therapy seemed to provide significant pain relief to his patients, albeit temporarily. Since those therapies simply increased blood circulation to the applied areas, Sarno further conjectured that the real cause of pain was a reduction of blood supply to soft tissues in the affected areas, initiated by emotionally-induced tension. His texts go into much greater detail on how the limbic and autonomous nervous systems are able to produce such effects.

According to Sarno, TMS is pain syndrome and does not lead to permanent damage of the affected soft tissues, despite the intensity of the pain. Simply understanding that the pain is tension-induced and not a structural problem is the key to a “cure”. Sarno noticed that once his patients understood that they were suffering from such tension, they were able to resume their normal activities without pain.

It is important to emphasize that according to Sarno’s TMS theory, the cause of the pain is entirely psychosomatic in nature and not a consequence of underlying musculoskeletal abnormalities as typically diagnosed by conventional medical practitioners. The pain is not caused by muscle tears, tissue inflammation, herniation, degeneration, decrepit muscles, bad ergonomics, poor posture or bad typing techniques. None of these are the cause. The root cause is entirely a sea of repressed, unconscious, negative emotions which must be confronted. This is a tough pill to swallow for RSI sufferers who have received diagnosis of underlying musculoskeletal disorders from various doctors and who can testify that the pain they feel is indeed frighteningly real.

According to TMS, what is often diagnosed as tendonitis, bursitis, fascitis, metatarsalgia, shin splints, tennis elbow, sciatica, carpal tunnel syndrome, deQuervain syndrome and so are simply areas of soft tissues not receiving enough oxygen. Something interesting to note is that people with real structural problems often don’t experience any pain whatsoever, and yet people with perfect structural composition might undergo excruciating pain. This pattern is common within computer-related RSI sufferers.

So how do the mind and body conspire against you in this way? How do they know what physiological modifications to make in order for these unacceptable emotions to go away? The answer to this question is remarkable. Most assuredly the sufferer will develop symptoms least likely to be attributed to the underlying negative emotions - symptoms attributable to a structural abnormality or something “mechanically wrong”. So long as the conscious mind believes that the pain is mechanical nature, believes that something wrong with their wrist or joint, then this mechanism is doing its job and the  distraction will remain in place with the true cause – the underlying negative emotions – remaining unconfronted and repressed.

Physical Symptoms

The physical symptoms of Tension Myositis Syndrome are many. In fact, throughout its incremental development, TMS symptoms began to accumulate and now range from cardiac disorders to immune system disorders. TMS says that the following disorders are fundamentally emotionally-induced – created by your own system to distract you from underlying and unacceptable negative emotions.
Class of disorder
Specific disorders
Lower back pain Sciatica
Spinal stenosis
Herniated / bulging / degenerated lumbar disc
Piriformis syndrome
torso or hip muscles
Spina bifida occulta
Transitional vertebra.
Neck/shoulder pain Osteoarthritis
Pinched nerve
Herniated / bulging / degenerated cervical disc
Thoracic outlet syndrome
Weak/inflexible neck
shoulder girdle, or rotator cuff muscles
Rotator cuff tears
Knee pain Osteoarthritis
Torn meniscus
Unstable patella,
 Imbalances around the knee joint
Elbow pain Tennis elbow,
Muscular imbalances around the elbow joint
Tendonitis Osteoarthritis
Lower leg pain Tendonitis
Shin splints
Plantar fasciitis
Flat feet
Muscular imbalances around the ankle or foot joints
Plantar metatarsalgia
 Calcium deposit/heel
Wrist/hand pain Carpal tunnel syndrome/repetitive stress injury
Muscular imbalances around the wrist or hand joints
Nerve dysfunction Sciatica
Bell's palsy
Carpal tunnel syndrome / repetitive stress injury
Trigeminal neuralgia / tic douloureux
Gastrointestinal Heartburn/acid reflux
Irritable bowel syndrome
Hiatus hernia
Nervous stomach
Spastic colon
Circulation Tension headache
Raynaud's phenomenon (excessively cold hands/feet)
Genitourinary Urinary tract infections Prostatitis  
Cardiac Rapid pounding heartbeat (paroxysmal auricular tachycardia)
Extra (ectopic)heartbeats
Immune system Allergies
Skin disorders
Asthma attacks
 Epstein-Barr syndrome
Frequent infections
Psychological Depression
Panic attacks
Obsessive-compulsive disorder
Other Dizziness/vertigo
 Laryngitis/spasmodic dysphonia
Tinnitus (ringing in the ears)
Chronic fatigue syndrome

If you have tenderness in any of these areas, it is a reliable indicator or diagnosis that your body holds tension induced pain.

And it will show up in many of the places located in the diagrams below.


How to cure TMS

Conventional treatments such as pain relievers and ultrasound therapies may provide temporary relief from physical symptoms, but they won’t treat the underlying psychological cause – the root cause. If you understand and believe in TMS, there is good news – you can cure your pain, and you can do it without damaging your wallet. Since TMS is designed to distract you from underlying emotional pain through physical pain, understanding and believing TMS is half the cure. The other half requires the identification and confrontation of the repressed emotions which threaten your self-image. Acknowledging these emotions evaporates them and renders the smoke-screen physical symptoms unnecessary. In some people this can occur quite dramatically. They might be emotionally volatile for a few days, then suddenly no more pain and no more negativity, almost miraculously.

Identifying and confronting these emotions is the hardest aspect of the cure since these unconscious emotions may not be apparent. The following suggestions help in this process:
  • Completely believe and accept TMS as the source of your symptoms. If you believe that a structural problem is still a contributing cause, then you are allowing TMS some breathing space. You must accept that these symptoms are emotionally induced.
  • Think about the case of your symptoms in the “emotional context”. Whilst the actual pain comes from mild oxygen deprivation to afflicted areas, the root cause is emotional. You must think about the pain in the emotional context, not in the “structural problem” context. It can be difficult to adjust your way of thinking in this manner, but it is crucial.
  • Write down a list of expectations you have of yourself, identify which ones you think are being threatened or which ones you are failing to accomplish. Think about why you believe you are failing and reason your way out of this way of thinking.
  • Start to get your body in the best physical shape you can. This step is extremely important because it helps clear the mind and relieve stress. Jogging, Yoga, Tai-Chi / Chi-Gong and meditation all allow you to do this.
  • Practice these steps several times a day.
  • Don’t rush, go slow. Resume your activities gradually as your health returns. Jumping straight into the old activities can cause a relapse.

Many people have claimed to have cured TMS by simply reading some of Sarno’s books. If you find yourself not making progress, it may be worthwhile to check out some of his books. If you still aren’t finding relief, meeting up with a TMS professional or standard psychotherapist may be helpful. Empirically, 10-15% of TMS sufferers require some form of psychotherapy to aid them. It is important to be patient and persistent, and to be easy on yourself.  Poking around in your unconscious mind can be difficult. Several suffers have described being very emotionally volatile for weeks during this process.

1 comment:

  1. Thank you so much for this informative blog post. I am experiencing alot of wrist and hand pain and thought I should diagnosis myself (I said I jus pulled a muscle and it would heal on it's own). I was so wrong. I went to Syracuse Orthopedic Specialists where I was diagnosed with Carpal Tunnel.