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What is TMS/Mindbody Syndrome?

What is Tension Myositis Syndrome (TMS)?

Tension Myositis Syndrome, also known as Tension Myoneural Syndrome, TMS, Mindbody Syndrome, or PPD,  is a condition that causes physical pain and other symptoms in the body in response to stress, trauma, anxiety, and other psychological factors.

TMS is not a structural or physical problem but rather a functional disorder that affects the brain and nervous system. The pain and other symptoms associated with TMS can commonly vary in intensity and location, and can range from mild to severe.

The condition was first coined by Dr. John E. Sarno, Professor of Rehabilitation Medicine at NYU, who helped thousands of  patients have become pain free through a non-invasive Mindbody treatment. 

Note: It is important for anyone experiencing chronic pain to speak with a healthcare professional to determine the cause and appropriate treatment options.



How do I know if I have TMS?

TMS can only be diagnosed by a qualified medical professional, after ruling out acute medical issues like cancer or infection. 

However, there are clear signs of TMS conditions, and many individuals are able to self-assess their condition. 

See the below test to see if your symptoms match the TMS diagnosis.


Note: It is important for anyone experiencing chronic pain to speak with a healthcare professional to determine the cause and appropriate treatment options.

What symptoms/conditions are commonly associated with TMS?

Below is a list of common symptoms and conditions associated with TMS. Note that the list below is incomplete, and it is critical that you consult a healthcare professional and rule out any serious medical conditions, like tumor or infection prior to seeking treatment for TMS.

  • Back pain (e.g. herniated or ruptured disc, spinal degeneration, etc.)

  • Neck pain

  • Shoulder pain 

  • Hip pain 

  • Knee pain 

  • Plantar fasciitis 

  • Carpal tunnel syndrome 

  • Tennis elbow 

  • Repetitive strain injury (RSI)

  • Fibromyalgia

  • Chronic Fatigue Syndrome (CFS)

  • Irritable Bowel Syndrome (IBS)

  • Migraines & chronic headaches 

  • Tinnitus 

  • Restless Leg Syndrome (RLS)

  • Pelvic Pain

  • Whiplash

  • Vulvodynia

  • Arthritis (excluding rheumatoid arthritis)

  • Piriformis pain

  • Chronic Acid Reflux (some types) 

  • Medically unexplained Vertigo 

  • Chronic Pain Syndrome 

  • Temporomandibular joint (TMJ) dysfunction

Once again, if you suspect that you have TMS, it is important to see a healthcare professional for an evaluation and diagnosis to rule out any serious medical conditions.

What causes TMS (Tension Myositis Syndrome)? 

Tension Myositis Syndrome (TMS) is triggered by a mind-body response to negative events, trauma, thoughts, or emotions. This conditioning can lead to the automatic manifestation of symptoms, without conscious thought. TMS is a result of the mind and body becoming programmed to experience symptoms without needing conscious recognition.

How do we treat TMS?

Treating Tension Myositis Syndrome (TMS) involves a powerful trifecta of education, self-awareness, and action. The first step is recognizing the symptoms as TMS, learning how TMS occurs in the body, and understanding the triggers that lead to pain. Then, the individual must look inward, explore the emotions, thoughts, and negative patterns that are keeping them in pain. By bringing these automatic responses to a conscious level, the brain and body can be re-programmed to stop manifesting pain, resulting in a transformational shift towards lasting relief.

Does this mean the pain is all in my head?

Absolutely not. If your feel your pain, it is real.

There are real, physiological changes that occur in the brain that lead to TMS symptoms. This process, though reversible, is unconscious.

Put another way: TMS is evidence of the Mindbody connection. Ever had a time before a presentation where you felt butterflies in your stomach? Or blushed after being embarrassed? That is the Mindbody connection. You feel an emotion, and you feel the effect of it in the body. The pain and symptoms happen the same way. Fear, anger, shame, and other emotions can be perceived by the mind as threats, and physiological changes occur to keep those emotions out of conscious awareness. The result: pain.

"Overall, currently available treatments provide modest improvements in pain and minimum improvements in physical and emotional functioning. The quality of evidence is mediocre and has not improved substantially during the past decade."

​- Dennis C. Turk, PhD, Professor of Anesthesiology and Pain Research at the University of Washington School of Medicine

The Science:


More than 50% of certain patients have symptoms that defy medical explanation. - Royal College of Psychiatrists, 2001 

“More than 50% of patients seen in medical specialties like cardiology, neurology, gynecology, gastroenterology, dentistry, rheumatology have symptoms for which there is no clear physical explanation.” 

Whiplash: There is no association of chronic pain from rear-end collisions in Lithuania. - Canadian Medical Association Journal, 1999

“ In a country were there is no preconceived notion of chronic pain arising from rear end collisions, and thus no fear of long term disability, and usually no involvement of the therapeutic community, insurance companies, or litigation, symptoms after an acute whiplash injury are self limiting, brief, and do not seem to evolve to the so-called late whiplash syndrome."

Whiplash can be experienced from a simulated (i.e. fake) car crash - The Pain Psychology Center, 2010

"The surprising results of the Lithuanian study led a group of researchers to hypothesize that the cause of chronic whiplash was unrelated to physical injury. To test this theory, they set up an experiment where 51 volunteers were involved in a placebo collision. The study involved a simulated car crash, with corresponding sights and sounds to make it appear to the subjects that an accident had taken place, though there was virtually no physical impact on the body. Three days after this placebo collision, 20 per cent of the study subjects reported symptoms of whiplash, and four weeks after the experiment, 10 per cent were still symptomatic. The mere thought that one was in an accident was sufficient to bring about pain in these subjects. Furthermore, the researchers found that psychological factors were highly predictive in determining who would develop pain”

Knee Surgery: No difference in the surgical outcomes of patients with knee pain who thought they had surgery vs. those who actually did. - New England Journal of Medicine, 2002

A total of 180 patients with osteoarthritis of the knee were randomly assigned to receive arthroscopic débridement, arthroscopic lavage, or placebo surgery. Patients in the placebo group received skin incisions and underwent a simulated débridement without insertion of the arthroscope. Patients and assessors of outcome were blinded to the treatment-group assignment. Outcomes were assessed at multiple points over a 24-month period with the use of five self-reported scores--three on scales for pain and two on scales for function--and one objective test of walking and stair climbing. A total of 165 patients completed the trial."


Just telling individuals to expect symptoms after a procedure increases the risk of those symptoms. - The Lancet, 1981

"A pioneering study reported that of 15 patients receiving lumbar puncture who were told to expect a headache afterwards, 7 experienced headaches. By contrast, of the 13 patients who were not warned about the possibility to have headache, none experienced such side effect. The authors concluded that 'patients should not be told to expect a headache, as this may be a self-fulfilling prophecy.'"

Fibromyalgia:  Mindbody approach showed significant improvement over traditional treatments - Reuters, 2010

“Schubiner’s team found that six months later, 46 percent of the treatment group had at least a 30-percent reduction in their pain ratings compared with scores at the outset. And 21 percent had a 50-percent or greater reduction.”

Surgical success on patients with disc herniations is correlated with presence/absence of an emotional trauma in childhood - Spine, 1992

100 patients who underwent surgery for disc herniations were interviewed to see if they had any of these events in their childhood: Physical abuse, sexual abuse, emotional neglect/ abandonment, loss of a parent (divorce or death), drug abuse at home.

0 of these experiences: 95% had excellent improvement from surgery
1-2 of these experiences: 73% had improvement
3 of these experiences: 15% improvement

Back surgery can often have no long-term impact on pain levels:

"Failed back surgery syndrome is a very common outcome for spinal surgery. One study of lumbar fusion found that 46% of patients experienced the same level of pain or worse after surgery. Other studies have found failure rates between 19 and 36%" - The Way Out, Alan K. Gordon

"Back fusion surgery patients were no better off 4 years later compared with cognitive intervention and exercises. ~1/4 of spinal fusion surgery patients had another surgery within 4 years"Pain, 2006

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