Where to start? Thinking about pain, the first thing that jumped to my mind was to misquote the first line from Elisabeth Barrett Browning’s Sonnet 43:
How do I hate thee? Let me count the ways.
I hate thee to the depth and breadth and height
My soul can reach, when feeling out of sight
For the ends of being and ideal grace.
But then I thought, Well, that’s just not true. I don’t hate pain. It’s one of my greatest teachers.
However, like most people, I don’t enjoy it. I resist it and wish I could avoid it. I research ways to get rid of it. I meditate and exercise, and avoid sugar and gluten and all processed foods. And I’ve pretty much weaned myself off news headlines and politics.
But as time goes by, and the plot thickens on planet Earth, and the world spins ever-more out of control, and everything seems to be dissolving into an unreasonable, incoherent, unmanageable pile of poo …
I find my pain increasing.
I experience mental pain from the loss of trusted belief systems and emotional pain arising from fear, uncertainty, doubt, and confusion. Add psychological angst and spiritual uncertainty to the list of uncomfortableness—all of which could be interpreted as painful—and that’s quite a list!
And then there is physical pain.
I’d always heard that aging comes with a gradual onset of symptoms over the years. You know—aches and pains, stiffness, that sort of thing. But the sudden onslaught of ever-increasing low back and pelvic pain I’ve been experiencing these past two years?
You’d think I’d been hit by a Mack truck. Twice. And then dragged a couple hundred yards the second time around and then backed over.
In other words, I’m usually in a serious world of hurt. And no amount of yoga, stretching, chiropractic, acupuncture, myofascial release, massage, red-light therapy, DMSO etc. touches it.
Absolutely nothing structural has been able to explain the frequently crippling pain and ever-changing symptoms occurring at various ever-changing locations in my low-back region.
And then a friend told me to read the book Healing Back Pain by John E. Sarno, M.D. about what he called Tension Myositis Syndrome (TMS).
Thunderbolt
Shock of shocks, chapter by chapter, I found Sarno describing me—a quintessential TMS patient. Making sense of ALL my symptomology as brain-based and not structurally-based and age-based at all.
Not “psychosomatic” pain. Not imaginary pain. But brain-induced pain resulting from emotional and psychological stress.
If you want to read the original article I wrote, here’s the link to “Back pain: Is it all in your head?”
But because this whole topic stunned and impressed me on so many different levels, and because I have the feeling many, if not most, of my subscribers share the TMS personality profile with me, I’m going to repeat some of what I wrote here, giving it a broader, more global and spiritual context.
TMS
Back in the early 1980s. Sarno—an attending physician in the Department of Rehabilitation Medicine at the New York University School of Medicine from 1965 until his retirement in 2012—became increasingly frustrated treating patients for back pain according to the classical model—a model which, to this day, views back pain as primarily due to structural abnormalities of the spine, most commonly arthritic or disc disorders, compression of nerves due to poor posture, lack of exercise, etcetera. “Over the years I became increasingly troubled with the fact that frequently the pattern of a patient’s pain and the findings on physical examination didn’t match the presumed pathology,” he wrote.
“For example, pain might be attributed to degenerative arthritic changes at the lower end of the spine, but the patient might have pain in places that had nothing to do with the bones in that area. Or someone might have a lumbar disc that was herniated to the left and have pain in the right leg.
“Even more important was the observation that 88 percent of the people seen had histories of such things as tension or migraine headache, heartburn, hiatus hernia, stomach ulcer, colitis, spastic colon, irritable bowel syndrome, hay fever, asthma, eczema, and a variety of other disorders, all of which were strongly suspected of being related to tension. It seemed logical to conclude that their painful muscle conditions might also be induced by tension. Hence, the Tension Myositis Syndrome (TMS).”
A global problem
Chronic back or neck pain (CBNP) is the leading cause of disability in the United States and most other Western nations. And the overwhelming majority of doctors and patients believe that pain to be almost entirely the result of structural issues.
But some studies now suggest that 80 to 95 percent of CBNP cases are nonspecific, with no clearly identifiable peripheral cause.
Indeed, studies with functional magnetic resonance imaging (fMRI) show that the pain response in the brain from an actual injury (for example a burn) is basically the same pain response from hypnotic suggestion of a burn or the pain response from simply imagining being burned.
The World Health Organization has even reclassified chronic pain as either “primary” or “secondary” in nature. Primary pain meaning pain originating in the brain, and secondary pain as directly resulting from physical injury and structural issues.
Emotional basis
So, if not caused by structural issues, what causes the brain to start emitting pain signals, especially to the low back, pelvic and neck regions?
Sarno believed tension, stress and suppressed emotions lay at the foundation of TMS. “We have a built-in tendency to repress unpleasant, painful, or embarrassing emotions,” he wrote. “Anxiety and anger are two of those undesirable emotions that we would rather not be aware of, and so the mind keeps them in the subterranean precincts of the subconscious if it possibly can.
“The longer I work with TMS, the more impressed I am with the role of anger. We have all learned to repress it so completely that we are totally unaware of its existence in many situations. In fact, I have begun to wonder if unconscious anger is not more fundamental to the development of symptoms than anxiety and, indeed, whether anxiety itself may be a reaction to repressed anger.”
From the thousands of patients with unresolvable chronic pain that Sarno worked with, he developed a “TMS” personality profile. A profile that, as I read, fit me to a “T.”
A worrier, a perfectionist, hard on oneself, often a people pleaser, highly sensitive, very responsible for others, concerned about fixing the whole world …
OMG! That was me!
Perhaps you can relate?
Invisible
Despite the fact that clinical studies show that “psychosocial trauma” has a pronounced impact on neural processes, predicting the eventual presence and severity of chronic pain. Despite the fact that many studies show that psychological stress can create “health damaging behaviors.” Despite the fact that post traumatic stress disorder (PTSD) has long been associated with the development of chronic back pain and is known to increase the severity of pain experienced in the body …
Despite the fact that functional MRI studies show that acute pain is experienced in the somatosensory cortex and chronic pain is experienced more in the amygdala, the prefrontal cortex and other parts of the brain that are linked to the psychological centers of the brain related to worries and stress …
Hardly anybody has put two and two together to come up with what Sarno did 30 years ago!
Which means millions upon million of people are dealing with chronic back pain and getting no understanding or help for it whatsoever. (Aside from prescriptions for addictive, health-damaging pain meds.)
Which is why I wanted to write about it here.
Because once the real cause of chronic pain has been identified. Once TMS (aka Mind-Body Syndrome) has been diagnosed and the underlying causative factors addressed, the pain can leave.
Relief
Hundreds, if not thousands of people have been cured of their chronic back pain simply by reading Sarno’s book. One of them was “Jane” who I interviewed for the article. She suffered debilitating, “life altering,” costly, back pain starting at age 29.
For 11 years, she saw many traditional doctors and received many different diagnoses, including, spondylolisthesis, a bulging disc, a pinched nerve, a herniated disc, different forms of arthritis, including gout, even endometriosis. In addition to allopathic doctors and physical therapists, she also saw alternative medical practitioners including acupuncturists, herbalists, chiropractors, masseuses, and a biofeedback specialist. “The message I kept hearing from my doctors and other health practitioners was that I needed to learn to live with this back pain, and that it was likely to just get worse with age.”
Then, in 1994, after her most recent neurologist advised being placed in a body cast for six months, she sat down and read Sarno’s book. “With every paragraph, lightbulbs flashed in my brain and I kept thinking, ‘This is me. This is it! Yes, this makes total sense!’ By the time I finished the book, I knew I was cured.”
And she was.
She got up, pain free, called her husband at work and announced the miracle. Then she gathered up all her back pain equipment—support pillows, back braces, medications, etc.—and tossed them in the trash. Except for a few twinges after extra-strenuous activity like gardening, hiking, and such, she says she’s never had back pain since then.
I, too, temporarily experienced a five week “cure” after reading the book. For five blessed pain-free weeks I ran around thinking YIPPEE!!!
However, like many of Sarno’s more traumatized patients—many of whom, like me, suffered serious childhood abuse—relief for me was temporary, and is requiring deeper therapeutic emotional work.
But for the majority of people dealing with “normal” stress and emotional issues who end up manifesting Tension Myositis Syndrome—all I can say is, if any of this information resonates, read my article, and then read Sarno’s book.
There are also doctors and other healers around the world who understand TMS and work with people to get relief from chronic back and neck pain. I interviewed two for the article.
Bottomline
Life is getting more and more intense. Stress is epidemic and emotions are being stretched to the breaking point. And this trend is not going to stop anytime soon.
In the times to come, people don’t need crippling physical pain added to their list of burdens.
Hopefully this information will become more available to the public soon. Please, pass it on!
And for those who can identify with some or all of what I’ve said here, please know that true relief—at least for much of the physical stuff—can be had.
Much love and aloha ~
Cate