Is My Physical Pain Stress-Induced?

Back pain.  Neck pain.  Shoulder pain.  Sciatic pain. Headaches.

Chronic physical pain can be debilitating. It can hinder you from doing the activities you enjoy, from having the relationships you desire, and from living the life you want. But, what is causing your physical pain? Not all pain is caused by physical conditions, injuries or structural issues. Some pain is caused by emotions.

According to Dr. John Sarno, M.D., author of Healing Back Pain, “These common pain syndromes are…Tension Myositis Syndrome (TMS)… a harmless but potentially very painful disorder that is the result of specific, common emotional situations.”

What does this mean?

This means that real physical pain can be caused by our emotions.  TMS pain is REAL pain. It is just triggered by psychological factors, rather than structural abnormalities or other medical conditions.

With TMS (also known as PPD), pain symptoms are caused by mild oxygen deprivation to certain areas of the body as a result of stress, unexpressed emotions or other psychological factors. Put another way, instead of feeling or expressing your stress, anger or depression, your body starts to hurt. Your emotions manifest physically instead of emotionally.

TMS pain often is focused around the back, neck, shoulder and buttock area. TMS sufferers frequently notice tenderness when pressure is applied to the muscles around the upper part of the buttocks, the lumbar area, and the upper shoulder muscles. However, TMS also can trigger gastrointestinal issues, irritable bowel syndrome, headaches, chronic fatigue, fibromyalgia, and more.

How do you know if you have TMS?

First, rule out a medical condition. Physical pain can be caused by a variety of factors and it is important that you visit a medical doctor and rule out any structural or medical issues.  If a medical doctor has ruled out these issues, then consider looking at your pain in a different way. Ask yourself:

• Did you experience a stressful event prior to your pain starting?
• Do you experience pain in multiple places?
• Does your pain move around to different places in your body?
• Are your pain symptoms inconsistent?
• Do you have a history of anxiety or depression?
• Do you find it difficult to tolerate or express difficult emotions?

Why does TMS develop?

TMS actually is a type of coping mechanism. It is one way that our brains try to help us.  Emotions can feel overwhelming. Sometimes, it can seem like there is no time to express or really feel our feelings. Perhaps life is too busy, or there are too many other people to take care of, or it does not seem “appropriate” or safe to express what’s going on inside.

So, we push those feelings down or brush them aside.  When this happens, our brains sometimes help us—by sending pain signals to other parts of the body. Physical pain sometimes can feel less overwhelming or even more understandable or manageable than emotional pain. Therefore, our brains choose the physical pain over the emotional pain.

TMS or Chronic Pain Treatment

Since TMS pain is triggered by emotions, the treatment for TMS is in the emotional.  If fact, a key to treatment of TMS symptoms is understanding and accepting that the cause of the pain is emotional and not structural. From here, you then can begin to think psychologically. For example, when you experience pain symptoms, you can start to check in with your emotions instead of your physical movements.

It also can be helpful to further educate yourself about TMS. Many challenged with TMS have noticed decreases in their pain simply through increased understanding.  If you want to learn more, check out some of these helpful resources:

•  Healing Back Pain: The Mind-Body Connection by John Sarno, M.D. (1)
•  The MindBody Workbook by David Schechter, M.D.
•  Unlearn Your Pain by Howard Schubiner, M.D.
•  Tension Myositis Syndrome Wiki (

For some, it also can be helpful to talk to a TMS professional. Expressing or getting in touch with buried or difficult emotions can be challenging.  Therapy can provide the support and safe environment to guide you through the healing process. There is help for your pain. You can begin to heal.