Tension Myoneural Syndrome resources
Find out more about Tension Myositis Syndrome
Here you would be able to learn more about the syndrome, and the medical and scientific literature that supports it. The main concept which emerges in current day cutting edge research is that pain is generated in our brain by a multitude of factors and not solely by bodily tissue changes. Therefore strategies to reduce and eliminate pain could focus on influencing these factors such as our emotional state, thoughts and beliefs, and well structured graded movement strategies.
Research that show there is no correlation between structural changes of the spine and pain:
In a research published in the prestigious medical journal The New England Journal of Medicine, Changes in intervertebral discs were found in 64% of normally pain free healthy adults who undergone MRI scans of their spine.
98 men and women had their spine scanned in an MRI examination. They were all symptom free. In 64% degenerative disc changes were observed, including disc bulges and herniations. The researchers concluded that the occurrence of MRI changes with back pain could probably be coincidental.
In another research published in Spine medical journal, approx. 600 young adults between the ages of 20-22 (equally divided between men and women) undergone MRI scans of their backs. They were symptom free and healthy. Half of them had degenerative changes in intervertebral discs, and a quarter had disc bulges. Here once more, we see that structural changes alone, do not explain or cause pain.
Spine (Phila Pa 1976). 2009 Jul 15;34(16):1716-21. Prevalence of degenerative imaging findings in lumbar magnetic resonance imaging among young adults. Takatalo J1, Karppinen J, Niinimäki J, Taimela S, Näyhä S, Järvelin MR, Kyllönen E, Tervonen O.
Minimal relation between degenerative disc changes (including bulging discs) and pain. A research with 412 40 year old participants. The main objective of the study was to assess the correlation between degenerative disc changes and pain. The researchers could not find convincing proof for such a connection.
Spine (Phila Pa 1976). 2005 May 15;30(10):1173-80. Magnetic resonance imaging and low back pain in adults: a diagnostic imaging study of 40-year-old men and women. Kjaer P1, Leboeuf-Yde C, Korsholm L, Sorensen JS, Bendix T
Cognitive interventions that reduce or heal pain
Surgery Vs. exercise and cognitive training for persistent severe chronic back pain. 349 patients between ages 18-55 who were candidates for a spinal fusion surgery were divided into two treatment groups. They all suffered from persistent back pain of more than one year. Half undergone surgery and half took part in an intensive 3 week rehabilitation program based on personally tailored exercise plan and cognitive training to overcome fears and unhopeful beliefs. Both groups experienced significant improvements after 2 years, with no superiority of surgery over exercise combined with education and cognitive training.
Randomised controlled trial to compare surgical stabilisation of the lumbar spine with an intensive rehabilitation programme for patients with chronic low back pain: the MRC spine stabilisation trial;
A Mind-Body intervention with selected chronic pain patients
Patients with persistent back pain of more than ½ a year duration undergone a Mind-Body intervention program. On conclusion of the program pain reduced by 50% compared to the starting point, patients experienced an increase in their quality of life, a dramatic decrease in pain medication use was evident and most patients resumed normal or almost normal activity.
Outcomes of a Mind-Body Treatment for Chronic Back Pain with no Distinct Structural Pathology – a Case Series of Patients Diagnosed and Treated as Tension Myositis Syndrome Schechter D, Smith AP, Beck J, et al. Alternative Therapies 2007;13(5):26-35
Back pain sufferers were divided into two groups, one group received Neurophysiology education whilst the other received spine anatomical education. There were improvements in the Neurophysiology education group in pain cognitions as well as physical performance
A Randomized Controlled Trial of Intensive Neurophysiology Education in Chronic Low Back Pain
Moseley, G. Lorimer PhD; Nicholas, Michael K. PhD; Hodges, Paul W. PhD
Clinical Journal of Pain: September/October 2004 – Volume 20 – Issue 5 – pp 324-330
121 back sufferers undergone an educational intervention, they either received spine or pain physiology one-on-one educational session. A correlation was found between cognitive perception of the symptoms and movement ability.
Evidence for a direct relationship between cognitive and physical change during an education intervention in people with chronic low back pain
GL Moseley – European Journal of Pain, 2004
Research that show relation between emotions and pain- research that supports Dr. Sarno’s theory and practice
An article that describes the relation between emotions and pain. Past traumas are linked to pain symptoms. Therefore it should be addressed in pain management. South Med J. 2005 Nov;98(11):1099-110; quiz 1111-2, 1138. Psychosomatic pain: new insights and management trategies. Rubin JJ1.
There is a well established connection between adverse childhood experiences such as child abuse and neglect and adverse health issues later on in life. Here research showed a connection between Fibromyalgia tender points and childhood traumas.
McBeth, John & Macfarlane, Gary & Benjamin, Salome & Morris, Stella & J. Silman, Alan. (1999). The association between tender points, psychological distress, and adverse childhood experiences: A community‐based study. Arthritis & Rheumatism. 42. 1397 – 1404
Low back pain sufferers and healthy individuals were tested for reactivity of the deep muscles of the spine and the upper back muscles to emotions such as anger and sadness. The research demonstrated that in the pain sufferers group low back muscle contraction in reaction to anger was longer as well as recovery time compared to the control group. Reaction to sad memories was the same in both groups, and there were no differences in contraction of upper back muscles between the groups.
JW Burns – Emotion, 2006 – psycnet.apa.org
Low back pain sufferers filled out self assessment questioners. It had been validated once more that the fear associated with pain is a far more important factor than pain itself, in determining the level of disability caused by it.
Pain-related fear is more disabling than pain itself: evidence on the role of pain-related fear in chronic back pain disability
G Crombez, JWS Vlaeyen, PHTG Heuts, R Lysens – Pain, 1999 – Elsevier
61 low back pain patients were tested for conflict about expressing emotions and relation to pain. The research showed that for those who had a greater conflict expressing their emotions, and in particular anger, there were higher rates of back pain.
Conflict About Expressing Emotions and Chronic Low Back Pain: Associations With Pain and Anger
In this study, researchers wanted to find out which brain areas are involved in chronic back pain, in contrast to acute pain. Brain MRI scans of chronic back pain sufferers were taken along with brain scans of control participants who received a painful, transient stimulus. The area that was activated in acute pain was distinct from that of chronic pain. In chronic pain, an area that is close to the forehead in which implications on our self image and negative emotions are processed was activated. It shows again that chronic pain is correlated to emotions and self image rather than structural damage.
Chronic Pain and the Emotional Brain: Specific Brain Activity Associated with Spontaneous Fluctuations of Intensity of Chronic Back Pain
In this study, researchers taught chronic back pain patients the Buddhist Loving-Kindness Meditation, in which negative emotions such as anger are transformed into positive emotions of love and kindness. 43 patients were divided to two groups- one group practiced the meditation for 8 weeks, and the other went through normal procedures. Results showed that practicing the meditation reduced pain, anger and psychological distress in the Loving Kindness meditation group.
Loving-Kindness Meditation for Chronic Low Back Pain Results From a Pilot Trial James W. Carson, Ph.D. Francis J. Keefe, Ph.D. Thomas R. Lynch, Ph.D. Kimberly M. Carson, M.P.H., R.Y.T. Veeraindar Goli, M.D. Anne Marie Fras, M.D. Steven R. Thorp, Ph.D. JOURNAL OF HOLISTIC NURSING, Vol. 23 No. 3, September 2005 287-304
Decrease in oxygen levels in Fibromyalgia patients’ muscles.
This study confirms Dr. Sarno’s theory about mild oxygen deprivation in chronic pain. In 10 FM patients low oxygen levels were found in trigger points (the points in which pressure induces pain), compared to healthy people in which oxygen levels were normal.
An article written by Dr, Sarno, in which he explains the connection between emotions and pain.
An article written by Dr. Sarno and his successor Dr. Rashbaum
Link to the summary of the article