Tension Myositis Syndrome (TMS) [Causes, Symptoms, & Treatment]

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Tension Myositis Syndrome (TMS) [Causes, Symptoms, & Treatment]

Tension Myositis Syndrome (TMS), also known as tension myoneural syndrome or mini body syndrome refers to notable physical musculoskeletal and nerve symptoms such as chronic back pain, gastrointestinal problems, and fibromyalgia.

To make it easier to understand we will be talking about the syndrome in detail. This article about tension myositis syndrome or tension myoneural syndrome is divided into the following parts.

Tension Myositis Syndrome: All You Need To Know

Keep reading to learn everything about the tension myositis syndrome!


Tension myositis syndrome or tension myoneural syndrome concept was first introduced by Dr. John E. Sarno, a retired professor at the Clinical Rehabilitation Medicine of New York University. Dr. John E. Sarno managed to get a large number of followers, mostly being the doctors practicing in different medical fields. However, even after such large recognition, the concept Dr. John E. Sarno presented about the Tension myositis syndrome has not yet been fully accepted and recognized by the medical community. 

Later in 2007, a medical doctor and former research assistant or Dr. Sarno, David Schechter published a review of tension myositis syndrome that showed a good 54% success rate for chronic back pain.

The basic idea of Tension Myositis syndrome is that when actual symptoms, for example, chronic pain,  gastrointestinal problems, and fibromyalgia are available, yet tests have not had the option to uncover the reason, there is a decent chance that the patient is experiencing a mental condition. This doesn’t imply that the patient is just imagining the indications since they are truth be told happening.

Dr. Sarno’s Claim

Sarno said that tension myositis syndrome is a state where emotional issues(mainly rage) are the root cause of physical pain and other symptoms of tension myositis syndrome. He talks about rage as an unconscious emotional issue as due to this the unconscious side of the mind ses the autonomic nervous system to lower the amount of blood flow to different muscles, ligaments, and nerves that result in oxygen shortage and metabolite accumulation that causes pain in infected tissues. He claims that tension myositis syndrome is not caused because of a physical deformity or injury. 

What are the Causes?

As per Dr. Sarno’s explanation, the cause of tension myositis syndrome is the psychological stress that a person experiences while trying to meet the standards that are set by either the society or other people in their environment. 

An example would be a person who eats lunch at 3 pm as per the home routine. Now even when that person grows up, they will find a way to eat their lunch by 3 pm regardless of their schedule. In case that person does not get food by 3 pm, he or she will be stressed. This is psychological stress. 

This psychological stress builds inside a person over time and at one point, it starts causing physical symptoms that have no authentic and accurate medical explanation. Initially, the symptoms may be little or mild, but with time as the stress keeps on adding, they can add up to a chronic condition. 

Another cause of tension myositis syndrome is hidden, repressed emotions. There are a lot of people, even around us, who are taught to hide their emotions because of society and “what will people say”. This adds up to stress because when they are taught to repress their emotions, it keeps building inside of them. This causes psychological stress that could lead to tension myositis syndrome.

Psychological Stress, How?

According to Dr. Sarno, psychological stress happens due to an emotional condition that triggers the autonomous nervous system which is responsible to regulate body functions such as digestion, blood circulation, and breathing. If stress increases, it triggers the autonomous nervous system that will reduce the flow of blood to nerves, muscles, tendons, and tissues resulting in a shortage of breath and energy. This is what causes pain or tension myositis syndrome. This psychological stress can be any childhood flashback of abusive parents, or an unsuccessful relationship, etc.

What are the Symptoms?

The main symptom of tension myositis syndrome is chronic pain. The other secondary symptoms include digestive problems, temporomandibular jaw malfunctions, headaches, fatigue, and a lethargic state. Some patients also experience pain in different parts of the body from one portion of the back to the other. For instance, neck pain occurs out of the blue and then disappears suddenly. Days or weeks later, there is a pain in the lower back, calves, or knees.

Back pain is frequently experienced as a tension myositis syndrome. Here is what Dr. Sarno defined as tension myositis syndrome symptoms:

Symptoms Types:

  1. Pain
  2. Stiffness
  3. Numbness
  4. Muscle contractures
  5. Cramps
  6. Weakness
  7. Negative sensations

Symptoms Location:

  1. Neck
  2. Knee
  3. Arms
  4. Wrists

However, these pains are likely to move from one part of your body to another pretty quickly.

Diagnosis of Tension Myositis Syndrome

According to the studies of Schechter and Dr… Sarno, the following list is helpful and necessary for the diagnosis of tension myositis syndrome:

No Known Physical Cause

Dr. Sarno and Schechter said that to get authentic and accurate results out of imaginings or physical examination tests, there is a need for serious conditions for instance a tumor or a cyst. The location of symptoms must be relevant and existing.

Psychosomatic Disorders: The History

Dr. Sarno and Schechter state that a prior history of any psychosomatic disorder helps determine whether a person has tension myositis or not. Examples of psychosomatic disorders: irritable bowel syndrome or tension headaches.

Tender Points

According to Dr. Sarno, six out of the eighteen tender points are important and needed for tension myositis diagnosis stating that these are found in 99% of the tension myositis syndrome patients. However, normally doctors use eleven out of eighteen tender points for diagnosis. 

  1. Two in the upper trapezius muscles
  2. Two in the lumbar paraspinal muscles
  3. Two in the lateral upper buttocks

How the Treatment is done?

The basic treatment of tension myositis syndrome includes education, jotting down your emotional feelings or issues, and resuming normal routine life. In case the mentioned treatments do not affect you, consider going to a support group or psychotherapy.

Educational Treatment

This kind of treatment can include any of the following office visits methods:

  1. Lectures
  2. Written material
  3. Audio materials

This will help patients learn the psychological and physiological aspects of tension myositis syndrome. Here is what Schechter had to say about the education treatment for tension myositis syndrome; “learn that their physical condition is benign and that any disability they have is a function of pain-related fear and deconditioning, not the actual risk of further ‘re-injury.'”

Jotting Down Emotional Feelings

Dr. Sarno advises patients of tension myositis syndrome to pick a time out of their schedule to think and write down their emotional issues or feelings that build up to their repressed, hidden emotions.

Here is how Dr. Sarni suggested doing so:

Issue that contributes to repressed emotions:

Dr. Sarno suggested listing out every issue that a patient thinks contributes to repressed emotions. Consider the following:

  1. Any childhood experience (abuse, lack of attention, or lack of love)
  2. Personality attributes (perfectionism, wants to be the center of attention, wants validation)
  3. Current life stress (academic or nonacademic)
  4. Current life pressure (academic or nonacademic)
  5. Aging
  6. Anger management issues (conscious but unexpressed anger)
  7. mortality

Write Essays expressing their feelings

Once the patient has finished jotting down the list of repressed or unconscious/conscious emotional issues, Dr. Sarno suggests that he or she should write an essay expressing their feelings. The longer the essay the better in-depth examination of the emotional issue.

Resuming To The Routine

Although this can be a little difficult for most people dealing with tension myositis syndrome, here is what you can do to make it easier:

Physical Activities: Back To Normal

According to Schechter being more active and beginning a normal life can help patients recover faster and healthier,

Discontinue Physical Treatments

According to Dr. Sarno, patients should stop spinal manipulation or any other physical therapy because the root cause of tension myositis syndrome or chronic pain is usually emotional stress and not physical disabilities.

Support Meetings

In case there is little to no recovery, Dr. Sarno suggests going to a support meeting because;

  1. It allows people to determine emotional issues that cause their symptoms
  2. It helps people to review what they had previously covered in educational treatment


In case there is no prompt recovery, Dr. Sarmo suggests psychotherapy. He states that 20% of his patients and 30% of Schechter’s patients need psychotherapy.

Recovery Programs

In case there is little to no recovery, it is recommended that the patient attends recovery programs that include different mind exercises or exemplifying therapeutic concepts/

Who Suffers From This Syndrome?

 Dr. Sarno states in any case, that experience showed that individuals who are stickler, acceptable practitioners, and yielding are more defenseless to create Tension myositis syndrome. As a general rule, anybody could experience the ill effects of TMS. The issue is far-reaching and is brought about by the pressing factors of everyday living, unexpressed or oblivious feelings, and past or youth traumas. It delivers a lot of us defenseless to this normal disorder.

Bottom Line

Tension Myositis Syndrome refers to notable physical musculoskeletal and nerve symptoms such as chronic back pain, gastrointestinal problems, and fibromyalgia. A person can suffer from tension myositis syndrome if they have any hidden emotional feelings or issues. People tend to repress their emotions due to the fear of society. These emotions build up causing serious health issues such as pain in the neck, back, wrist, or chronic pain also considered as the symptoms of tension myositis syndrome. There are no medical proofs to the treatment yet, however, there are a few things that can be done to prevent or cure it such as writing down emotional feelings or going to a support group.

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