top of page

What is TMS? (Tension Myositis/Myoneural Syndrome)

TMS is the term Dr. John Sarno coined to explain psychosomatic disorders and mind-body conditions. Tension Myoneural Syndrome or Tension Myositis Syndrome is explained as a condition that causes real physical symptoms, such as chronic pain, gastrointestinal issues, and fibromyalgia, migraine headaches to name a few disorders, that are not due to pathological or structural abnormalities and are not explained by diagnostic tests. 

Dr. John Sarno explained in his books that TMS initiated a process that causes physical pain among other symptoms in the body. His theory suggests that the unconscious mind uses the autonomic nervous system to decrease blood and oxygen flow to muscles, soft tissues, and nerves.


This oxygen and blood flow deficiency would be experienced as pain and dysfunction in the affected soft tissues and sometimes organs. It has been stated that the underlying cause of the pain is the mind's defense mechanism against unconscious mental stress and emotions such as anger, fear, or grief. The conscious mind is distracted by physical pain. 


 The TMS theory proved true time and time again while improving thousands of patients with depression, anxiety and stress. 

Sarno believes that when patients recognize that the symptoms are only a distraction, the symptoms then serve no purpose, and they go away. TMS can be considered a psychosomatic condition and has been referred by some Sarno doctors as a "distraction pain syndrome.


With our patients, we invite them to answer these important questions to help us both have clarity whether their symptoms are TMS or not.

Information on this form is provided by a research organization that was started by many Doctors and Health Professionals who treat patients with TMS as well as childhood trauma causing psychosomatic symptoms that lead to chronic pain and autoimmune disease.

There is a growing amount of research and patient studies as well as professional books written to support the theory of Tension Myoneural Syndrome.  It is outstanding how many doctors and health professionals are able to help their chronic pain patients with this growing body of information. 

Research Supporting the TMS Hypothesis

  • Research paper below by Dr. David Schechter who was treated by  Dr. Sarno when he was a medical student and also worked with Dr. John Sarno before he went into private practice -

  • Outcomes of a mind-body treatment program for chronic back pain with no distinct structural pathology--a case series of patients diagnosed and treated as tension myositis syndrome

  • Effectiveness of Psychosomatic for Severe Somatoform Disorders. Dr. Allan Abbass MD -

  • Somatization: Diagnosing it sooner through emotion-focused Interviewing. Dr. Allan Abbass MD - 

  • The Role of Emotion in Psychotherapeutic change for Medically Unexplained Symptoms by Dr. Allan Abbass MD  

  • The term “medically unexplained symptoms” does not refer to a specific disorder. Patients with TMS/MUS or FUS constitute a large number of referrals to neurological and medical clinics. MUS are associated with higher levels of disabilities and costs of management and treatment of these patients in medical and health settings is significant. Psychosocial Stressors contribute to the experience of TMS/MUS as does adverse childhood experiences (ACES) and interpersonal conflict, which can  lead to anxiety, low self esteem, depression,  defensiveness and the various vulnerabilities that can make life miserable. 

  • Hidden from View: A Clinician's Guide to Psychophysiologic Disorders. Dr. Allan Abbass MD, Dr. Howard Schubiner MD Using cutting edge psychotherapeutic and neurophysiologic principles, Hidden From View explains how the brain developed neural pathways that cause symptoms, such as headaches, irritable bowel and bladder syndrome, fibromyalgia, fatigue, insomnia, and chronic neck and back pain. It illustrates powerful emotion focused interviewing techniques to both detect and treat psychophysiologic disorders. 

  • Direct Diagnosis and Management of Emotional Factors in Chronic Headache Patients - Dr. Allan Abbass MD.

  • Alexithymia and Treatment Preferences among Psychiatric Outpatients Dr. Allan Abbass MD -

  • Implementing a Psychotherapy service for Medically Unexplained Symptoms in a Primary Care Setting. Dr Allan Abbass MD-

  • Psychotherapeutics for Chronic Pain Extends Beyond Cognitive Behavioral Therapy, Dr. Allan Abbas -

  • Exploring the Impact of a Brief Psychotherapy Service on Physicians and Residents Attitudes towards Medically Unexplained Symptoms. Dr Allan Abbass MD -

  • Psychology of Medically Unexplained Symptoms: A practical review. Sirous Mobini is a senior clinical lecturer in Neuropsychology at University College London and a lead clinical psychologist at the regional Neurological Rehabilitation Unit in the Homerton University Hospital.NHS Foundation Trust  - Many patients with MUS/TMS present with somatic symptoms such as pain, fatigue, headache,chest pain, dizziness, swallowing problems, weakness, tingling and sensory disturbances, gait disturbances, blackouts and dyspnoea. Others present with a constellation of symptoms such as conversion disorder, and psychogenic non-epileptic seizures disorder. Factitious disorder or dissociative amnesia.

  • Early Life Emotional, Physical, and sexual abuse and the development of Premenstrual Syndrome: A Longitudinal Study -

  • ***Conclusions: Findings from this large prospective study suggest that early life emotional and physical abuse increase the risk of PMS in the middle-to-late reproductive years. The persistence of associations after control for potential confounders and mediators supports the hypothesis that early life abuse is importantly related to PMS.

  • A Comparative Case Study of the Impact of Psychotherapy On Inflammatory Bowel Disease Patients. Allan Abbass MD -

  • Short-term psychodynamic psychotherapies for anxiety, depression and somatoform disorders (Unknown) Allan Abbass MD -

  • A Pilot Study of Reduction in Healthcare costs following the application of Intensive Short-Term dynamic Psychotherapy for Psychogenic nonepileptic seizures. Dr. L. Russell PhD, Dr. Allan Abbass MD -

  • Editorial: Advances in Emotional Regulation: From Neuroscience to Psychotherapy. Jon Frederickson

  • Telemedicine vs. in-person delivery of Intensive Short-Term Dynamic Psychotherapy for patients with Medically Unexplained Pain: A twelve month Randomized, controlled trial. Behzad Chavooshi PhD -

  • A life Stress, emotional awareness and expression interview for patients with medically unexplained symptoms: A randomised controlled trial - The interviewer elicited disclosure of the patient’s stressors, linked them to the patient’s symptom history, and encouraged emotional awareness and expression about unresolved relationship trauma or conflict.

bottom of page