Tension myositis syndrome (TMS), also known as tension myoneural syndrome or mindbody syndrome, is a name given by John E. Sarno to what he claimed was a condition of psychogenic musculoskeletal and nerve symptoms, most notably back pain. Sarno described TMS in four books, and stated that the condition may be involved in other pain disorders as well.

The TMS diagnosis and treatment protocol are not accepted by the mainstream medical community.

Conceptual basis

According to Sarno, TMS is a condition in which unconscious emotional issues (primarily rage, though other practitioners include other subconscious emotional issues such as anxiety, trauma, and fear) initiate a process that causes physical pain and other symptoms. His theory suggests that the unconscious mind uses the autonomic nervous system to decrease blood flow to muscles, nerves or tendons, resulting in oxygen deprivation (temporary micro-ischemia) and metabolite accumulation, experienced as pain in the affected tissues. Sarno suggested that the movement of back pain reported by patients—shifting up and down the spine or from side to side—indicates that the pain may not be the result of a physical deformity or injury. Sarno believed that when patients recognize that the symptoms are only a distraction, the symptoms then serve no purpose and subsequently go away. TMS can be considered a psychosomatic condition and has been referred to as a "distraction pain syndrome."

Sarno was a vocal critic of conventional medicine with regard to the diagnosis and treatment of back pain, which is often treated by rest, physical therapy, exercise, and/or surgery.

Notable patients

Notable people who have been treated for TMS include the following:

  • Radio personality Howard Stern credited TMS treatment with the relief of his "excruciating back and shoulder pain", as well as his obsessive-compulsive disorder.
  • 20/20 co-anchor John Stossel was treated by Sarno for his chronic debilitating back pain. She was later diagnosed and treated for TMS. According to Barber, she was "pain-free one week after [Sarno's] lecture" and able to walk and run within a few months, notwithstanding her "occasional" relapses of pain.
  • Current Golden State Warriors head coach Steve Kerr revealed that he sought treatment for TMS to manage pain stemming from an back injury that he suffered in 2015.

Reception

The mainstream medical community does not accept the TMS diagnosis and treatment protocol. Mehmet Oz, the Republican administrator of the U.S. Centers for Medicare & Medicaid Services during the second Trump administration, a cardiothoracic surgeon (though non-practicing), and a former professor at Columbia University, includes TMS treatment in his four recommendations for treating back pain. Richard E. Sall, a physician who authored a book on worker's compensation, includes TMS in a list of conditions he considers possible causes of back pain resulting in missed work days that increase the costs of worker's compensation programs.

Patients typically see their doctor when the pain is at its worst, and pain chart scores statistically improve over time, even if left untreated; most people recover from an episode of back pain within weeks without any medical intervention. The TMS theory has also been criticized as too simplistic to account for the complexity of pain syndromes.

Notes and references

  • What Is the Mind-Body Connection?