What is Tension Myositis Syndrome?

Tension Myositis Syndrome (TMS) is a fancy term for something that you already know and have experienced.  TMS is the result of mild oxygen deprivation that is signaled by the autonomic nervous system, resulting in muscle tension and pain somewhere in your body.  It is a consequence of a repressed emotion and/or in the presence of psychosocial distress.  We have all heard the phrase, “You’re a pain in the (ahem) neck.”  This phrase stems from the muscle tension in your neck due to the frustration or anger you feel over what someone is doing or has done.  Headaches, back pain, neck pain, glute pain, stomach pain, and many other areas of pain can be directly linked to the process of TMS.

The late Dr. Sarno devoted much of his career to treating individuals with back pain.  What intrigued him and sparked his research was seeing some individuals complain of back pain while others did not, despite both groups of patients having abnormalities in their MRI results.  That begged the question, how come only some people experienced back pain while others did not?

Repressing Emotions May Cause You Harm

The culprit was the subconscious emotional state.  The brain has a unique way of protecting us from perceived threats.  At times, the event of intense emotionality is considered a perceived threat.  If you are a person who is known for being calm and pride yourself for not getting angry with people, it would be a common practice to repress the intense emotions you feel.  Expression of said emotions could threaten the identity that you have invested time in creating.  Therefore, because you are suppressing your emotions, the brain has one choice, to internalize how you feel.  Joe Dispenza has defined emotion as “energy in motion.”  Energy cannot be created nor destroyed, so it must go somewhere.  If not outward, then inward is the only other option.

Once the emotion is repressed, the autonomic nervous system then activates the process that I mentioned earlier – TMS.  Physical pain ensues in the form of muscle cramping and/or spasming.  It is safer for the brain to rationalize and process the physical pain rather than the emotional pain.  If you expressed the emotional pain of anger outwardly, then your identity of being a calm person is now in jeopardy of being replaced with being “an angry person.”

*As a side note, anger is an emotion like any other.  No one is an angry person.  It is important to not confuse aggressive behavior by labeling it as angry behavior. 

I Couldn’t Run Because I was Emotionally Injured

Let me explain this process by using myself as an example.  I once found myself in an emotionally abusive situation.  In that situation, there was no where for me to put my emotions.  If I expressed them to the person who was being emotionally abusive, I would face more of the same abusive treatment.  So, I held it inside.  I bottled it up and sat on my emotions.  One day after a typical week of running, when nothing out of the ordinary happened in my weekly mileage, I stood up from the couch to go to the kitchen and experienced a sharp, stabbing pain in my right piriformis.  For those of you who are not familiar with the muscular skeletal system, the piriformis is a small muscle deep within your glute.  In essence, I had a real pain in the butt!

When I walked, it hurt.  When I ran, it felt like a knife stabbing me.  My piriformis was spasming due to the slight oxygen deprivation process of TMS.  There was no physical injury, only my emotional state suffered damage.  Despite this, the physical pain was real, and it inhibited me from racing for weeks.  Despite all of the stretching and massaging of the area, the origin of the pain was coming from my brain.  It was my inability to express the anger and emotional pain I experienced that caused me such strife.  This was one of numerous TMS moments of my life, and none of them equaled the pain that this one created.

The longer I practice therapy, the more prevalent this issue seems to be.  In our society, we have developed ways to talk about it and normalize it, yet we have not learned how to address it and manage it effectively.  If you keep having physical pain that seems to move around the body at different times and in different places, you may be experiencing TMS.  One of the hallmarks of TMS is that it travels throughout the body, consistently moving to different areas.  Your back might hurt for a few days or weeks, and when that feels better, your feet or hands might hurt.  The typical target muscles of such pain are postural muscles, muscles that are consistently being engaged without conscious focus.  These muscles include the back, neck, glutes, and other soft tissues in the feet, hands, stomach, etc.  It is important to note that before the idea of TMS is considered, it is recommended that you consult a doctor to make sure there isn’t a medical condition that is in need of treatment.

6 Tips to Address TMS

Now comes the good part.  If TMS is the cause of your physical discomfort, here are a few ways to help manage the pain.

1.Write down all of your responsibilities

Most people who experience TMS are known to cope too well with stress.  I first thought that my experience with TMS was a flaw and a weakness.  Dr. Sarno talked about those who cope too well with stress are those who are able to compartmentalize to a fault.  Many who have a lot of responsibility are prone to this condition.  Therefore, it is important to write down all of the responsibilities and roles that you have in your life. Be mindful of any need to be perfect, self-critical, or in complete control.  After you have listed all of your thoughts, write what it is that you feel and think about each one.  You are making the unconscious stress that you typically carry around with you all day visible and conscious.  Repeat this process as needed.

2. Don’t judge your anger

Another group of people who are vulnerable to this condition are those who view themselves as Spiritual.  It is a common belief that in order to be Spiritual, one must not express anger.  If this is something that you find within yourself, it is important to remember that anger is an emotion like any other.  It serves a purpose as much as sadness and happiness does.  Don’t judge the anger that you feel.  Anger is an emotion, not an action.  Allow the anger to be felt and choose a healthy form of expression.

3. Try finishing these sentences

When you are feeling the physical pain, finish this stem sentence; “I am feeling angry because….”  or “I am feeling fearful because….”  Even if nothing comes immediately to mind, fill in the blank with potentials to be ruled out.  Just by brainstorming potentials, you will come closer to unearthing the repressed feeling.  Write those responses down in a journal.

4. Thank your brain

Don’t judge the pain.  The pain is a distraction from the unconscious emotional turmoil that may be brewing.  Recognize that it is there for a purpose.  The more you get angry with the pain, the more intense it becomes.  The brain is attempting to protect you from emotional distress.  Thank the brain for doing what it believes is helpful and tell it that it no longer needs to protect you from your emotions.

5. Envision yourself without pain

Envision yourself acting in ways that are currently bringing pain but erase the pain from your imagination.  See yourself doing whatever it is you want, but pain free.  Practice this state of imagination when you are not performing the action that is currently bringing you pain.  When you are completing an action that is bringing you pain, keep the memories of a time when you didn’t feel the pain during those actions.  Feel the feelings of being pain free.  For instance, when I was sitting down, I would imagine myself running pain free.  I would hold onto that image in my mind.  When I started running, and the pain began, I would remember the moments of what it felt like to run pain free.  Once again, don’t judge the pain, just let it be and refocus on what it would feel like if it weren’t present.  The goal is to replace the frustration during the event of physical pain with happiness and contentment.

6. Call out your brain

When you feel pain, remind your brain that you are aware that there isn’t an injury.  Call out your brain for the tactic that it is trying to employ.  Sometimes the “calling out” action is all that is needed to allow the pain to leave.  That’s because you are acknowledging that the pain is not due to an injury, but due to an unconscious emotional response.  You are taking away the pain’s need for existence.

If there continues to be physical pain in your life, and there isn’t a medical diagnosis that supports the existence of the pain, please feel free to call The Center for Trauma, Stress, and Anxiety, LLC at 443-567-7037 to speak to a therapist or request an appointment.