How Do I Know if My Pain is Tension Myositis Syndrome (TMS)?
How Do I Know if My Pain is Tension Myositis Syndrome (TMS)?
I imagine, if you’re reading this, it’s probably because you’re experiencing some kind of pain in your body, perhaps an all-too-familiar twinge, dull ache, or maybe a stabbing pain, and you’re wondering, “Is this an injury, or could it be something else?” If you are reading this you have probably heard of Tension Myositis Syndrome (TMS) (also referred too, as Mind Body Syndrome (MBS) and Pyschophysiological Disorder PPD) and are curious to know if it could be the culprit behind your pain. Don’t worry! You're in the right place, and we’re going to break it down in a way that's easy to understand and totally digestible.
What is TMS, Anyway?
I know that I cover this a lot and so please feel free to skip this if you’re already well endowed with knowledge about what TMS is, but for those who need a quick refresher, let’s start with a recap of what Tension Myositis Syndrome actually is.
TMS is a condition where pain in the body is caused not by physical injury but by repressed emotions, stress, or psychological factors. The pain is real, but it’s not because of damage to the muscles, tendons, or ligaments. Instead, it's your brain's way of trying to distract you from uncomfortable feelings or emotions.
Imagine your brain as a security guard. When it senses emotions like anger, fear, or stress creeping up, it tries to protect you by creating pain in your body to distract you. It’s like, “Hey, look over here! Don’t think about that annoying email from your boss, focus on this lower back pain instead!”
But how do you know if your pain is actually TMS or a physical injury? From years of personal experience and working with others I have highlighted some of the key clues that might help you figure it out.
Clue #1: The Distraction Test
One of the most telling signs of TMS is that the pain often changes or subsides when you’re not thinking about it. Have you ever noticed that when you’re really focused on something you love—whether it's playing a game, solving a puzzle, laughing with friends, or losing yourself in a good movie—the pain seems to take a backseat? That’s classic TMS behavior!
TMS pain is kind of like a toddler throwing a tantrum for attention. The moment you stop paying attention to it, it loses some of its power. Try to remember: when you’re completely absorbed in something fun, does the pain lessen or even disappear? If the answer is yes, you might be dealing with TMS.
Clue #2: Physical Injury Pain Gets Worse with Activity
Physical injury pain has a pretty clear MO: the more you use the injured part of your body, the worse it gets. Let's say you sprained your ankle. The more you walk on it, the more it hurts, right? And if you ignore it and keep going, the pain will increase, and you might even cause more damage.
TMS pain doesn’t behave like that. Instead, it’s unpredictable—it might hurt when you’re sitting down but feel fine when you’re walking around. It doesn’t follow the rules of physical injury, which are all about cause and effect. Physical injury pain tends to be steady and predictable, while TMS pain is more like a mischievous gremlin—hard to pin down and always changing its game.
Clue #3: The Timeline of Healing
Here’s a handy fact: all human tissue—muscles, tendons, ligaments, etc.—generally heals within 6 to 8 weeks. Physical injuries have a timeline. They might hurt a lot at first, but as time goes by, the pain starts to lessen bit by bit until one day, it’s just a memory.
TMS doesn’t follow this healing pattern. It can stick around for months or even years, seemingly for no reason. It’s not linear. One day you’re feeling great, the next day you’re hobbling around for no apparent reason. If your pain is on a rollercoaster ride with no clear progress or timeline, it could be TMS at work.
Clue #4: The Emotional Connection
Another major difference between TMS pain and physical injury pain is how they react to stress. TMS pain tends to flare up when you’re feeling emotionally or mentally stressed. Maybe you’re dealing with a tough decision, work pressure, or relationship drama—next thing you know, your back is aching, or your knee is flared up, your elbow starts to twinge, or your neck is stiff.
In general, physical injury pain doesn’t care if you’re stressed or not. It's just a mechanical response to damage in your body that sends a signal to the brain letting it know it is damaged, the brain then sends an appropriate pain signal back to the site of injury. So, if your pain seems to have a direct line to your mood or stress level, it's a good indication that your mind might be playing a role in your discomfort.
Do keep in mind that in the case of chronic stress the body/nerves can become hypersensitive to stimulus/triggers meaning that even a physical injury could feel more painful when you are stressed out. Keep an eye open for this. It can be an indicator that you are under more stress than you might realise. Under certain circumstances this can lead to a conditioned response between brain and body, whereby, whenever the mind is subjected to a specific negative emotional or mental stimulus the body part that is injured will flare up too. This is refered too as classical conditioning. But this is another, even bigger topic that I’ll dive into in a future post!
Clue #5: The Safety Factor
Here's a crucial point that often gets overlooked: TMS pain has a close connection to our sense of safety. Both emotional and physical safety play a huge role in how our body perceives and experiences pain. When we feel safe, secure, and relaxed, our nervous system naturally calms down, and TMS pain tends to diminish or even disappear completely.
Think of it this way: our brains are constantly scanning our environment for threats. When we're stressed, anxious, or feeling threatened—whether that’s because of a difficult relationship, work pressure, or even self-doubt—our brain goes into "fight or flight" mode. In this state, it releases stress hormones that can intensify pain signals, making TMS pain flare up.
On the other hand, when we feel emotionally and physically safe, our brain relaxes, and it no longer feels the need to use pain as a distraction. It’s like telling that overprotective security guard in your mind, “Hey, everything’s okay, you can put your feet up.” This feeling of safety allows your body to switch off the pain alarm and helps the pain fade away.
How to Create a Sense of Safety for Yourself:
Self-Compassion: Be kind to yourself. Treat yourself like you would treat a dear friend who’s in pain. Simply telling yourself that it’s okay to feel what you’re feeling can bring a sense of calm and safety to your mind and body.
Supportive Relationships: Surround yourself with people who make you feel valued, understood, and accepted. Feeling connected to others is one of the most powerful ways to create a sense of safety.
Grounding Techniques: When you feel your pain flaring up, practice grounding exercises like deep breathing, meditation, or even simply focusing on the feeling of your feet on the floor. These techniques help signal to your brain that you’re safe in the present moment.
Create a Safe Environment: Make your physical space a haven. It could be as simple as lighting a candle, putting on soft music, or creating a cozy corner in your home where you feel at ease.
Play and laughter: Cliché as it might sound but laughter really can be the best medicine. Play is essential for switching our nervous systems from fight or flight to rest and digest (sympathetic nervous system (SNS) to parasympathetic nervous system (PNS).
A key note about play: It is importance that play is enjoyed. If you are just participating in a “fun” activity for the sake of trying to feel better but deep down you’re not really engaged you might find this backfires. Find things that genuinely fill your cup right to the brim. Pain pathways only wire to our limbic brain (fear, anger, anxiety etc) and do not wire to the area of the brain associated with play, creativity, flow and executive functions (the frontal lobe) This is one pain pathways switch off when we engage this part of the brain and hence why they don’t really switch off if we’re not really engaged or enjoying ourselves (we’re still a little, or a lot, I limbic mode)
The truth is, our brains are wired to protect us, and they will go to great lengths to keep us safe. When we give ourselves permission to feel safe, both emotionally and physically, we create the conditions for our nervous system to settle down and let go of unnecessary pain signals.
Clue #6: TMS pain LOVES company
One of the tell-tale signs that your pain might be TMS-related is that it often doesn’t travel alone. TMS pain has a habit of showing up with other mind-body or psychophysiological symptoms. This means you might notice a pattern where your pain coincides with other physical or emotional issues that are also influenced by your thoughts and emotions.
These symptoms can range from things like digestive problems (like irritable bowel syndrome or acid reflux), tension headaches, anxiety, sleep disturbances, chronic fatigue, to even skin conditions. It’s as if your body is finding different ways to express the emotional turmoil or stress you’re experiencing.
Why does this happen? Because the same processes in your brain that amplify TMS pain are also responsible for other stress-related symptoms. When your nervous system is in overdrive, it sends mixed signals to your body, which can result in a variety of sensations or discomforts that seem unrelated but are actually tied to your emotional state.
How to Recognize this Pattern:
Symptom Shifting: Pay attention to whether your pain or symptoms tend to shift from one area of your body to another. For example, you might experience lower back pain one week and then suddenly develop a tension headache or digestive issues the next. This kind of symptom migration is a classic sign of TMS.
Timing of Symptoms: Notice if your symptoms tend to flare up during times of emotional stress, indecision, or when dealing with difficult relationships. TMS pain and its companions often come knocking when life feels overwhelming.
Multiple Symptoms: If you’re dealing with more than just pain—like sleep issues, anxiety, or stomach troubles—it could be a sign that your mind and body are reacting to the same underlying emotional triggers.
This clue is essential because it broadens the scope of understanding that TMS is not just about physical pain. It's about how the mind and body communicate and respond to emotional stress. When TMS pain appears with other psychophysiological symptoms, it’s like your body’s way of waving a big red flag, trying to get your attention.
Rainy days can be so grounding. As well as being practical, I personally love walking in the rain with an umbrella overhead. The pitta patter of the water, the feeling of protection from the umbrella's canopy. It is one of the most calming and soothing things to do on a rainy day. Practicing good physical and emotional hygiene prevents the minds need to create physical distractions in the way of pain, or stress related disorders.
Takeaway Ideas
TMS pain is heavily influenced by your emotions, stress levels, and your sense of safety.
Physical injury pain follows a clear healing path and gets worse with more physical use.
When you feel safe, secure, and emotionally grounded, TMS pain often diminishes.
Joy, laughter, and engaging activities can be great of retraining the brain out of TMS pain.
If in doubt, consult a professional to get the right diagnosis and treatment plan.
Remember, you have the power to create a safe environment for yourself, both emotionally and physically, that allows your body to feel secure and free from the grip of pain. Your journey toward understanding and healing is a courageous step, and every bit of kindness you show yourself brings you closer to the pain-free life you deserve.
Putting It All Together
Let’s recap. Here’s how you can tell if your pain might be TMS instead of a physical injury:
Distraction Effect: TMS pain tends to ease when you're distracted or having fun. Injury pain does not.
Activity Response: Physical injuries get worse with use; TMS pain is unpredictable and doesn’t necessarily get worse with movement.
Healing Timeline: Physical injury pain should steadily improve in 6-8 weeks. TMS pain is erratic and can come and go.
Stress Connection: TMS pain often gets worse when you’re stressed, while physical injury pain does not.
TMS often doesn’t travel alone: Tension Myositis Syndrome is often accompanied by other psychophysiological symptoms like headaches, mouth ulcers, skin rashes, IBS and tinnitus.
What to Do If You Suspect TMS
If you’ve read through these clues and think that your pain might be more TMS-related than injury-related, here are a few steps you can take:
Acknowledge Your Emotions: Start by getting curious about your emotions. Are there feelings you might be suppressing? Expressing writing and journaling can help with this. Sometimes just recognising that you’re stressed or upset can help reduce the intensity of TMS pain. When the brain understands something better it generally feels less threat and fear.
Educate yourself further on TMS with books and courses: it is essential you retrain the way you think about pain and the best way to do this is reading and listening to books about TMS or taking course. Dr. John Sarno viewed education as a key factor in recovery.
Learn to think Psychologically and not physically. Much like education, training your brain to think differently about pain helps to break the fear cycle, allowing you to gradually start using your body again with catastrophising that you’ll create more damage.
Practice Mindfulness and Relaxation: Techniques like deep breathing, meditation, somatic experiencing, TRE, sauna, and mindfulness can help you reconnect with your body and calm your mind. This, in turn, might help reduce the pain.
Find Healthy Distractions: Engage in activities that put you in a flow state—like hobbies, puzzles, socialising, or playing a sport you love. The more joy and laughter in your life, the less space for rumination, habitual worry and pain to take control.
Seek Professional Help: If you're struggling to manage your pain on your own, it might be time to seek out a professional who specialises in mind-body approaches. They can guide you through a more personalised plan to address TMS.
Conclusion
Deciphering whether your pain is TMS or a physical injury is like solving a puzzle, but the clues are there if you know where to look. TMS pain often arrives with an unpredictable pattern, intensifies with emotional stress, and loves to hang out with other mind-body symptoms. In contrast, physical injury pain tends to follow a clear healing trajectory that’s more straightforward.Takeaway Ideas
TMS pain is heavily influenced by your emotions and stress levels.
Physical injury pain generally follows a clear healing path and gets worse when physical use goes beyond its current healing state.
TMS pain often feels better during activity but can creep back in again post activity/exercise.
Joy, laughter, and engaging activities can be great tools for alleviating TMS pain.
TMS pain often coincides with other mind-body symptoms like headaches, digestive issues, or anxiety.
If in doubt, consult a professional practitioner to get the right diagnosis and treatment plan.
Listen to your body and your emotions—sometimes they’re just trying to tell you something important!