"Have you heard of TMS (I think) or Tension Myositis Syndrome, I
think is the name? (Dr. John Sarno coined the term.) I have a
friend who really believes this. He thinks that is my problem since I
keep having one injury after another without an obvious reason. I have a
hard time believing it though I can see how emotional and physical work
together. But I always have a hard time finding a middle ground between
fear of every twinge of pain and stubbornness that makes me ignore the problem
and keep going until something seems horribly wrong."
Yes, I'm familiar with Dr. Sarno's work and I agree with him on some of his ideas.
For those of you who are unfamiliar with him, Dr. Sarno believes that all musculoskeletal back pain is from the mind. It's real, not imaginary pain, but the source is your mind.
Pain is three dimensional - physical, mental, and emotional - and we, both patients and practitioners, tend to focus on the physical aspect only. We search for a "cause" for our symptoms; some structural defect, weakness, inflexibility, etc. And, sometimes, the physical element is the driver of the pain but, sometimes, the pain is not from primarily a physical or structural cause. Sometimes the pain serves as a coping mechanism for subconscious feelings; feelings we do not want to acknowledge or experience and that are below our level of awareness and the pain serves as a way for us to not deal with these feelings. In other words, the physical pain is less painful to deal with than the emotional pain.
The reason that this is so difficult to accept is that the emotional driver is beyond our awareness so we dismiss it. Makes sense. If I am unaware of something, how can I assign value to it? So, instead we look for something that does make sense; something we did, some posture or activity that could be the culprit.
One of the most common physical ailments that most everyone agrees arises from things other than a physical cause is a "tension headache". I often hear, "Well it's just stress. That's why I have a headache" and the person will have a vague idea of the stressor. But the solution that is suggested is usually some type of relaxation or "stress relief" therapy rather than finding the true source of the stress and dealing with it.
Stress is the response of the body to a demand whether it's caused by a pleasant or unpleasant mental, emotional, or physical stimulus and the response can be either pleasant or unpleasant. Love is stressful but most people would agree that it's pleasant. Losing your job is stressful and generally unpleasant. Either way, it's stressful.
So, a tension headache is the body's response, tight muscles, to a demand and in most cases the demand is mental or emotional (the mind) and you might wonder, "Why does my head hurt so much? Do I have a tumor or something?"
Right before I took my orthopedic boards several years ago, I had a terrific headache. At the time, all I could think about was getting through the test. And, this damn headache was in my way. It wasn't until after I had finished the test (and the headache subsided), that I connected the dots. I was afraid of failing and rather than deal with that reality and all that it represented, my mind found a more convenient target. It was an elegant coping mechanism.
Where I disagree with Dr. Sarno is the idea that ALL back pain (or shoulder or knee or hip, etc) is emotionally based. A friend of mine fractured his thoracic spine from a particularly rough boat ride and had immense back pain. How he chose to deal with the injury and pain could then escalate the problem and prolong it (such as ignoring it, forcing his way through it, etc) but the initial injury and resulting pain was physical.
Whenever I see someone with a complaint that just "appeared" one day, I'm a little on edge. Insidious onset of symptoms is one way that some nasty medical problems choose to greet you. A friend of mine once had the sudden appearance of itching in her arms. Both of them . Like she had a rash or some type of allergic reaction but there wasn't a rash. She saw doctors, specialists and finally was diagnosed with a rare form of bile duct cancer. So, you have to take such complaints seriously and rule out more malicious and even life-threatening disease. Once that has been done, now the issue becomes, "why?" What we all want to know, as I mentioned in my post about my own shoulder pain, is Why do I have this? I didn't do anything. It really hurts! I can't do the stuff I want to do (and here's an article I wrote about this on Frozen Shoulder)!
Whenever you have symptoms that just pop up, you have to look at a few basic human emotions in addition to the potential physical (biomechanical, tissue overload, etc): fear, worry, anger. These emotions are hard to accept in ourselves and really deal with. We all have parts of us that are not so pleasing to admit or accept. Or, we may have deep hurts that have festered for years creating a sort of toxic nostalgia. Whatever the issues, they are usually trapped in the shadows of the mind like prisoners in a maximum security prison and just itching to get out. Depending on your view, dreams are a way that these issues do get out. You can safely express these emotions. And sometimes, if you really look at your dreams, they're freaky scary - which is why you're dreaming all that stuff instead of welcoming it as an actual part of you.
So, what do you do? Awareness is the first step and sometimes, depending on the chronicity of the issue, this can take a while - months or even years. And, it's not something that physical therapy or chiropractic or surgery or other forms of physical remedies will fix alone. And, it generally is not just a psychological approach either. It's a mind-body approach. You need both. You have to be open to the idea you could have repressed emotions that are manifesting as physical feelings and also at the same time, realize that gravity is real. Too much physical load, too fast, too often can hurt you.
My friend, Ross, asked me, gently, back in early 2008 after I had injured my self skiing, "So, have you admitted to your self that you're angry about all of this?" This question prodded me to look at not just the anger I had at the injury but other repressed emotions that were stirred into the anger pot. It was the pivot point in my recovery and one of the most important things I did. Maybe the most important.
Sometimes I use this one word at the end of emails or postings and I think it's appropriate here: onward. Just keep working on getting better, being honest with your self, facing things that are scary, and you'll be surprised at what can happen.