Tension Myositis Syndrome (TMS), a psychophysiological disorder (PPD), is a condition originally coined by the late John E. Sarno, MD, a retired professor of Clinical Rehabilitation Medicine at New York University School of Medicine, & attending physician at the Howard A. Rusk Institute of Rehabilitation Medicine at New York University Medical Centre.

TMS is responsible for upward of 85% of chronic or unexplained pain and symptoms. It causes physical symptoms, such as fibromyalgia and gastrointestinal issues that are not due to pathological or structural abnormalities (although they can exist together) and are not explained by diagnostic tests. The latest neuroscience research and empirical data suggests that with TMS symptoms are caused by learnt neural pathways via the central nervous system. Just like phantom limb pain (amputees can still experience chronic pain, even after a limb has been removed), the aching or stabbing in your body is the result of a conditioned response developed between your brain and body and not because of physical damage, structural abnormality or muscle imbalances etc.

According to a survey we did a number of years ago, 40 percent of a typical group of patients reported that the pain began in association with some kind of physical incident. For some it was a minor automobile accident, usually the hit-from-behind type. Falls, on the ice or down steps, were common. Lifting a heavy object or straining was another; and of course running, tennis, golf or basketball were often blamed. The pain began anywhere from minutes to hours or days after the incident, raising some important questions about the nature of pain. Some of the reported incidents were trivial, such as bending over to pick up a toothbrush or twisting to reach into a cupboard, but the ensuing pain might be just as excruciating as that experienced by someone who was trying to lift a refrigerator”  John E Sarno

What exactly is a conditioned response?

A conditioned response is a learned reaction to a specific stimulus that occurs through the process of conditioning. In psychology, this term is often associated with Classical Conditioning, a concept popularized by Ivan Pavlov.

A conditioned response results when two or more neurons repeatedly fire at the same time creating an associated reaction. In neuroscience, there is a saying, “Neurons that fire together, wire together” and this is how acute pain becomes ‘learnt’, causing it to develop into chronic pain.

For example, if a person experiences pain in response to a particular situation (physical or emotional) repeatedly, that situation may become a conditioned stimulus. Over time, even the mere presence or suggestion of that stimulus may trigger a similar pain response, even if the situation itself is not inherently painful. This illustrates how the brain can create automatic responses based on past experiences, reinforcing patterns that can influence both emotional and physical reactions in daily life.

In Tension Myositis Syndrome (TMS) and other psychophysiological disorders, the interplay between emotional experiences and physical symptoms is crucial. Emotions that are not processed can manifest as pain or discomfort, leading to a conditioned response where the brain and body become locked in a conditioned cycle of suffering. This phenomenon is evident in conditions such as post-viral fatigue, chronic fatigue syndrome, and Lyme disease, where the initial physical ailment may have resolved, yet the symptoms persist.

The brain, often likened to a skilled mimic, can reproduce sensations and symptoms with remarkable precision, resulting in chronic pain despite the absence of an ongoing physical issue. This mimicry occurs because the brain has learned to associate certain emotional states with physical sensations, creating a feedback loop that reinforces the experience of pain. Understanding this relationship between mind and body is essential for breaking free from chronic conditions, as it can pave the way for effective recovery strategies that address both emotional and physical aspects of health.