TMS back pain - the most common form of Tension Myositis Syndrome?

Severe chronic back pain was what led the famous Dr John Sarno to discover TMS in the first place; according to him, TMS back pain was the ‘trend’ of the time, which had slowly replaced ulcers after these were clearly linked to stress.

And even though there are dozens of manifestations of TMS, TMS back pain remains one of the most common ailments. Why is this, you might ask? Do we literally have too much weight on our backs these days?

For generations, people have been used to manual labour, working in the fields or in other industries that posed significant physical demands on their bodies. We cannot be sure because we don’t have actual data in hand, but it’s very likely that fewer people complained of chronic back pain in those days than they do today.

Nowadays, in contrast, a lot of people lead sedentary lives, working 8 hour office jobs and returning home to sit in front of the telly for yet another couple of hours. And yet, the number of people who suffer from back pain today is far larger than it was in the past. It’s very normal for a great section of the population to complain of back pain after doing some house chores, lifting a couple of shopping bags, or even sitting down!

Are these people simply making a fuss, were our ancestors extremely fit and resilient, or could it be that something else other than physical demands that is causing chronic back pain?

Sarno on TMS back pain

According to Sarno, our backs couldn’t have become so weakened when compared to previous generations, to a point that they can cause such excruciating back pain. His theory revolved around the fact that the back (the lower back in particular) had become a perfect candidate for chronic pain to manifest.

First and foremost, having ‘back pain’ became a very socially acceptable condition - people do not hesitate in expressing how severe or annoying their back pain is; in contrast, they might feel very ashamed to admit things like extreme rage, ingratitude, depression and anxiety stemming from a past or present traumatic or stressful situation.

As children, we were taught how unacceptable it is to allow rage and other ‘unpleasant’ emotions to take over, and therefore it is very easy nowadays to grow up believing that it is unacceptable to express our deepest emotions (for more info about this, have a look at my Resource about TMS and Emotional Repression). For this reason, our rage and other strong emotions may manifest in chronic pain, and this chronic pain, in turn, is likely to manifest in a location that is deemed to be ‘reasonable’ or ‘acceptable’ - hence, the back for a lot of people.

TMS back pain and the Nocebo effect

Another reason why TMS back pain is so commonplace today is the fact that people actually stopped exerting themselves as much as they did in the past and started to interpret physical activity as more dangerous than it actually is.

For our ancestors, it used to be normal to work out in the fields every day, but for us, it may not feel ‘right’ to use our physical bodies so much. Since childhood we were taught to be careful when doing sports or other physical activities, and we were warned not to lift any heavy objects ‘because we might break our backs’.

In short, a lot of people nowadays grow up believing that their backs are weak and easily prone to damage. It’s very common to hear about someone else complaining of back pain, and therefore we start to believe that back pain is a very normal part of adult life. Each time we hear someone telling us to ‘be careful’ not too exert ourselves too much, our brain fires a warning signal, telling our bodies that a particular activity may be too dangerous for our backs. If we then proceed to do that activity, we become highly susceptible to developing back pain. This is the Nocebo effect at play.

Once back pain strikes, it’s very easy for it to develop into TMS back pain, even if the original cause of back pain was purely physical (say, for example, you really hurt your back while weightlifting). This is because once we treat our back pain, we encounter various caring people who keep telling us to be careful and not overdo it. Each and every time we hear these messages, the brain registers them, and keeps on strengthening the association between exertion and back pain. And hence our episode of pain may develop into chronic TMS back pain, which strikes whenever we undertake an activity which our brain and body interpret as being a bit ‘too much’ for us.

Herniated discs as the diagnosis of TMS back pain

Sadly, a good number of people with chronic back pain get diagnosed with a herniated disc somewhere along their spine. This gives them the ‘proof’ that their back is really damaged and vulnerable, and, according to Sarno and other TMS practitioners, condemns them to a life of pain (as now they know that there is a cause for back pain and therefore expect the pain whenever they exert themselves or, in some cases, every single day!)

What these people may not know is that if you were to take a group of 100 people with chronic back pain and another group of 100 without back pain, and have them do a back MRI, the likelihood is that there will be instances of herniated discs in both groups! And yet people in the second group never experience pain (unless they’re told that they have a herniated disk, perhaps!)

A study by the Cleveland Clinic, for instance, found that “25% of all asymptomatic people who climb into an MRI machine will have a herniated disc... As many as 60% of healthy adults with no back pain have degenerative changes in their spines.” What’s even more surprising is, that in another study conducted by Dr Modic in the same clinic, a second scan was done to people with back pain after six weeks, which found no correlation between the disk and the pain. “Some continued to complain of pain even though their herniated disk had disappeared; others said they felt better even though their herniation had grown bigger”.

“It’s really simple. The disc is not likely the primary cause of the patient’s discomfort. It is simply a radiological finding that doctors should put in their notes while they keep looking for what your real problem is. There are instances where disc injuries can be so bad that surgery is needed to alleviate them, and in those cases surgery should be performed. However, the point is, disc injuries are typically unreliable as pain generators and should not be the scapegoat for your low back pain.”

Albuquerque Journal*.

According to Dr Sarno, herniated disks are nothing but a normal ‘anomaly’, something imperfect about our bodies that does not have to cause such severe pain. He admits that there are some exceptions, or that there may be cases when a herniated disk will hurt in the beginning, but insists that it does not justify such extreme chronic pain that goes on for years. In fact, Sarno even goes as far as to compare herniated disks to white hair in older people; the change or ‘anomaly’ is there, but it has no correlation whatsoever with the pain. However, the very fact that you have a herniated disk may make your back a better ‘candidate’ for TMS, as your subconscious registers that anomaly and uses it to manifest pain.

Could you have TMS back pain?

While this article isn’t meant to indicate that all back pain is TMS and that all instances of herniated disks should be ignored, it is worth taking a few moments to reflect on the nature of your back pain. Does it strike at particular times of the year, for instance, or following difficult or confused times in your life? Does it make sense for you to be in such extreme pain after walking for 10 minutes, when humans were designed for much more than that?

My Tension Myositis Syndrome Questionnaire may help you figure out whether or not you’ve got TMS back pain. Take your time to analyse the nature of your back pain as well as your emotions surrounding it, and if you think you might have TMS, your first step is to check out Sarno’s book, Healing Back Pain (or contact me for a TMS coaching session if reading isn’t your thing). Remember, your pain doesn’t have to last forever!

Resources

• John E. Sarno, M.D, Healing Back Pain: The MindBody Connection, Warner Books 1991.

• Ozanich, Steve, Placebo Yo-Yos and Nocebo No-Nos, The Great Pain Deception, 2011.

• *Albuquerque Journal, Doctor’s Diagnosis, 2014.

Join me on Facebook for inspiration and discussions with like-minded people who want to take charge of their health! Click the link below!