Neuroplastic pain, Mindbody Syndrome, Tension Myositis Syndrome (TMS), Tension Myoneural Syndrome (also TMS), Perceived Danger Pain (PDP), Distraction Pain, and I am probably missing a few. These are all terms that refer to the same thing, namely pain that originates from our brain misfiring pain signals. Why does it have so many different names you might wonder, well, that is something neuroscience hasn’t figured out yet. Fortunately, neuroscience HAS figured out how this type of pain originates and stays alive. Let’s dive into some history first.
The first mention of this type of pain was by Dr. John E. Sarno, who coined the term TMS in the 1980s, and wrote multiple books on the topic. In the more recent years, many of the other names popped-up, but they all refer to the same type of pain. So, what exactly is this TMS that Dr. Sarno speaks about?
In his time as a physician at the Rusk Institute, Dr. Sarno worked with a great deal of chronic pain patients, all with different pain symptoms and diagnoses, and who had not found any type of relief in years. Yet, by talking to his patients and asking them questions about their emotional state, he started seeing a pattern. His discovery was that their chronic pain originated from stuck emotions, and more specifically: repressed rage, of which they were mostly unaware. Skipping to the end of the story: his patients eventually healed through his lectures on TMS, simply by learning about the mind-body connection and resuming physical activity.
Where’s the global adoption?
That was in the 1980s. Fast-forwarding back to today, anno 2023, I am admiring Dr. Sarno’s work, that has shown incredible results for his patients, with a method that can be considered relatively risk-free AND without any side-effects… You would almost expect a global adoption! Unfortunately, this is not the common trend we see today. Instead, we see more and more chronic pain sufferers going from one doctor to the next, in search of an answer to ‘what’s wrong with them’ because they are in pain, yet doctors often cannot find any structural damage. And when patients finally get a diagnosis, or even multiple diagnoses, the search for pain relief begins…
Mainstream medicine has not only failed to treat chronic pain successfully, but its practices are also creating more of it. The increase in chronic pain, disability, and the reliance on opiates is staggering
writes David Hanscom, M.D. in an article in Psychology Today1.
To me it seems there is an obvious reason for why they haven’t found an actual solution: they are looking in the wrong place. If you are looking in the body for pain that is created and kept alive in the brain, you will not find anything. On top of that, treating the physical symptoms only will not result in long-term relief.
In a previous article2 , I discussed how recent research has shown that the majority of chronic pain conditions – from headaches, fibromyalgia, IBS , pelvic pain, to chronic back and neck pain – have been proven to be primarily brain induced3 4. So the question remains, why do we keep looking for a solution in the wrong place?
In an article from The Guardian, Hannah Millington writes about her own journey with chronic pain, and how she finally found relief: “I began to understand that the mind and body, rather than being separate, are intimately connected, that things started to finally change for the better […] I would never have believed that psychological factors could be the cause of such severe, scary and concrete pain” 5. This can indeed be hard to understand, especially since we have spent the last century separating the two. Yet isn’t true science about following the data and the facts? And if there is proof, backed by neuroscience, that shows this undeniable connection between body and mind, which in itself holds the solution to chronic pain, why is modern medicine not adapting? This is a question I unfortunately cannot answer at this stage.
What I can answer is…
What happens in the body that creates this type of TMS or MindBody pain? When our central nervous system goes in to overdrive, which it can do when trying to protect you from all kinds of perceived pain or danger, it can go into a process called Central Sensitisation6. This is where our nervous system starts functioning like a faulty alarm system, sending out amplified pain messages. This occurs after prolonged stimulation of the pain receptors and leads to changes in how we process pain signals. It doesn’t only apply to pain, it can also apply to other processes, such as our senses and emotions, resulting in heighten sensitivity to odours, sensations, vision, sounds and taste, or increased emotional distress, anxiety, fear and stress.
The two main characteristics of Central Sensitisation are:
1) Allodynia – things that hurt, now hurt more, and
2) Hyperalgesia – things that didn’t hurt, now do.
This brings me to the last question I like to answer in this article, and that is: How do you know your form of chronic pain is TMS (or your favourite synonym)? There are a few very clear indications as to whether it fits into this category, because it shows the pain your dealing with does not behave like, standard or acute pain.
Signs you are dealing with neuroplastic pain rather than structural pain:
- Your pain has lasted longer than 6 months,
- The pain level changes throughout the day,
- Your pain sometimes moves around in the body, when one pain disappears another pops up,
- You have multiple seemingly unrelated symptoms,
- The medication, treatments, or even surgery, only give temporary relief if any and you have not found anything that helps long-term,
- You have the same pain on both sides of the body,
- The pain sometimes diminishes or disappears when you are positively or negatively distracted.
References
1. https://www.psychologytoday.com/intl/blog/unlearn-your-pain/201707/john-sarno-md-american-hero
2. https://mag.foyht.org/a-holistic-approach-to-chronic-pain/
3. https://www.optumhealtheducation.com/sites/default/files/191205-Chronic-Pain-Schubiner-Slides.pdf
5. https://www.theguardian.com/commentisfree/2019/jul/01/chronic-pain-links-mind-body-brain-physical