Tension Myositis Syndrome (TMS): Causes, Symptoms, and Treatment


Katie Rapkoch, CHPC

Published on

March 28, 2024

Updated on

March 31, 2024

Medically reviewed by

Dr. Robert Stevens

Chronic Pain

Tension Myositis Syndrome (TMS), also known as Tension Myoneural Syndrome, presents a fascinating intersection between the physical and psychological aspects of health, particularly chronic pain. This condition emphasizes the significant role of the mind-body connection in physical health and has brought a unique approach to the diagnosis and treatment of those suffering from chronic pain.

In this article, we will discuss common triggers and symptoms of Tension Myositis Syndrome, the role that repressing our emotions plays, treatment options, and managing TMS in day-to-day life.

At re-origin, we provide a brain retraining program backed by neuroscience to help people with chronic conditions manage their symptoms. By focusing on neuroplasticity and self-directed brain retraining, you can teach your brain to understand that pain is not a threat and you can heal! 

Understanding Tension Myositis Syndrome

TMS Causes and Triggers

Tension Myositis Syndrome is rooted in the concept that psychological stressors, particularly repressed emotions and psycho-social stress, can lead to physical manifestations of severe chronic pain. This process can take place when we choose not to express our emotions but instead keep them inside, which internalizes whatever discomfort we may be feeling. This causes the autonomic nervous system to go into "Fight or Flight," mode causing oxygen deprivation to muscles and nerves, leading to physical pain and discomfort throughout our body.1

Dr. John Sarno spent a significant portion of his professional life focusing on the treatment of back pain. He became deeply interested in researching the condition after observing that some patients reported back pain while others did not, even though MRI scans showed abnormalities in both sets of patients. This observation led him to question, “How come only some people experienced back pain while others did not?”1

Common Physical Symptoms of TMS

Symptoms of TMS can vary widely, but hallmarks include chronic pain and weakness, particularly in the back, neck, and limbs, as well as gastrointestinal issues and fibromyalgia symptoms. These symptoms are not due to structural abnormalities and cannot be explained by traditional diagnostic testing.2

Challenges Diagnosing Tension Myositis Syndrome

Traditional vs. TMS-focused Diagnostic Approaches

Diagnosing TMS can be challenging, as the symptoms often mimic those of other physical disorders. Traditional medical diagnostics that focus on identifying structural or pathological abnormalities may not adequately identify TMS, which requires a more nuanced approach. This approach is more comprehensive as it takes into consideration the whole person, including psychological factors, a potential history of trauma, and the absence of external causes for physical pain​​.

Psychological Aspects of TMS

Role of Repressed Emotions in TMS

A core principle of TMS is the significant impact of repressed emotions and memories on physical health. Unresolved emotional issues are believed to manifest physically as the body's attempt to distract from emotional pain, trauma, or stress.3

Impact of Psycho-Social Stress

Psycho-social stress, stemming from various sources like work, relationships, and societal pressures, can exacerbate TMS symptoms. This emphasizes the need for a holistic approach to treatment that addresses both the physical and emotional aspects of health​​.

Treatment Options for Tension Myositis Syndrome

Self-Directed Neuroplasticity Training

Self-directed neuroplasticity training involves exercises aimed at retraining the brain's response to pain, emphasizing the brain's ability to change and adapt in response to new information and  experiences​​. Not only does the practice of brain retraining help to create new responses to stressful stimuli, but it helps build resilience to future life stressors. Here at re-origin, we provide expert insights on brain retraining to help you rewire the old neural pathways that are contributing to your pain.


Psychotherapy, particularly cognitive behavioral therapy (CBT), is effective in addressing the psychological aspects of TMS. It helps patients learn to cope with repressed emotions, better manage stress, process their feelings in real-time, and understand the psychological factors contributing to their pain​​. Working with a therapist can be a helpful addition to a brain retraining program.4

Physical Therapy and Exercise

Engaging in physical rehabilitation and exercise can reinforce the brain's belief in the body's capacity for movement without pain. Challenging the fear-avoidance response that many living with TMS experience, especially in the presence of a trained movement professional, can boost confidence and decrease fear with movement.

Living With TMS

Tips for Daily Management

Managing Tension Myositis Syndrome on a daily basis may involve the following activities:

  • Mindfulness. Being aware of one's thoughts and feelings while remaining calm and curious, instead of judgmental, can be a powerful way to decrease the habit of emotional repression. Mindfulness is a practice –starting with pausing for just one minute to check in and slowly building up is a great way to build a habit. When the mind begins to accept that it can feel (and handle) the full spectrum of human emotions, it will slowly understand that it no longer needs to distract you with painful sensations.3
  • Engaging in physical activity. This can be as simple as wiggling hands and feet upon waking in the morning, going for a walk, or performing  some gentle stretches while waiting for your coffee to brew. Keep it simple and take it very slow to begin, and as you build your tolerance and confidence, you can gradually increase intensity and engage more muscles.
  • Implementing stress reduction techniques. It is extremely helpful to find new ways to process the emotions that you may have repressed in the past. Consider trying a meditation or breathwork video on YouTube, journaling when you are feeling down, anxious, or hurt, or visualizing life without pain.1 Allow yourself to sense your feelings without judgment, and then focus your attention on your healing path.
  • Pursuing activities that promote joy and relaxation. The presence of joy in our lives is paramount to healing. Feelings of joy decrease cortisol levels and improve immune function. They also turn off the "Fight or Flight" response, leveling out our Autonomic Nervous System, which may provide a sense of relief from pain. Consider making a list of accessible items  that bring you joy; ones that you can turn to at a moment's notice if you are experiencing pain, anxiety, anger, or any other challenging emotion.

Long-Term Outlook

With the right treatment approach, individuals suffering from TMS can achieve significant improvement in their symptoms, with many becoming completely pain-free. Success in treatment often involves a mind-body approach, which includes actively retraining the brain​​, seeking out support, partaking in gentle physical activity, and slowly re-integrating the things you love.4

Learn More and Get Support

Re-origin offers free live info calls for individuals looking to explore treatment options for Tension Myositis Syndrome, providing an opportunity for personalized advice and support. Furthermore, educating oneself about TMS and engaging with communities of others who have experienced similar symptoms can be incredibly beneficial. 

FAQs About Tension Myositis Syndrome

  • Can TMS symptoms be permanently resolved? Yes, many individuals who have suffered from TMS have achieved complete resolution of their symptoms by addressing both the physical and emotional contributing factors.
  • How can I start my journey toward recovering from TMS? You've already begun- education is the first step! If you have already sought a comprehensive evaluation with a doctor to rule out structural causes, your next step is to focus on the mental/emotional contributors to TMS. Check out the re-origin program to see how we can help!
  • Is TMS recognized by the medical community? Recognition of TMS is growing within the medical community as more research highlights the mind-body connection in chronic pain syndromes.
  • Can lifestyle changes impact TMS symptoms? Absolutely. Lifestyle changes that promote emotional well-being and physical health, similar to the ones listed above, can significantly decrease TMS symptoms.
  • What role do emotions play in TMS? Emotions play a central role in TMS, with the condition often serving as a manifestation of repressed emotional stress and unresolved psychological issues.

For those grappling with chronic pain and seeking alternatives to traditional treatments, Tension Myositis Syndrome offers a promising avenue for exploration and healing. By acknowledging and addressing the intricate connection between mind and body, individuals can embark on a journey towards recovery and a pain-free life.


  1. CTSA_Therapy, & CTSA_Therapy. (2020, December 28). That Pain in Your Neck Might be Tension Myositis Syndrome and How to Cope with It. The Center for Trauma, Stress and Anxiety. https://www.ctsatherapy.com/that-pain-in-your-neck-might-be-tension-myositis-syndrome-and-how-to-cope-with-it/
  2. Manzano Medical Group. (2019b, January 9). Tension Myositis Syndrome (TMS) | Manzano Medical Group. https://manzanomedicalgroup.com/tension-myositis-syndrome-tms/
  3. Medical Management Associates, Inc. (n.d.-b). Tension Myositis Syndrome (TMS) - David Lipsig, MD | Psychiatry in Atlanta. http://www.davidlipsigmd.com/tension-myositis-syndrome.php
  4. Boscutti, S. (2023, May 12). Tension Myositis Syndrome (TMS) treatments. Sarno Clinic. https://www.sarnoclinic.com/tension-myositis-syndrome-tms-treatments/


Katie Rapkoch, CHPC