Back Pain - Mind and Body Connection

I never met anyone with pain in the back, neck, or shoulder, who did not think the pain is due to an injury or bruise brought on by some physical activity. "I lifted a heavy box from the floor and immediately started to experience back pain " the idea that pain means injury or damage is deeply rooted in patients' minds.

Of course, if the pain starts immediately or during physical activity, it is difficult not to attribute pain to physical activity. The widespread concept of the vulnerability of the back, of ease of pain, is nothing less than a medical tragedy for the public. Which now has many semi-disabled men and women whose lives are severely limited by the fear of doing further damage or bringing back the dreaded pain again. I can attribute myself to this concept as I have been the victim of back pain for the last 20 years, I underwent two major spine surgeries, yet there is no relief from the pain.

In good faith, doctors and healers have fostered this idea for years. The medical community has assumed that neck, shoulder, back, and buttock pain is due to injury or disease of the spine and associated structures or ineffectiveness of muscles and ligaments surrounding these structures - without the scientific validation of these diagnostic concepts.

Medicine's preoccupation with the spine draws on fundamental medical philosophy and training. Modern medicine has been mainly mechanical and structural in orientation. The body is considered a complex machine, and illness is a malfunction in the machine brought on by infection, trauma, degeneration, hereditary defects, or cancer. At the same time, medical science is focused on the laboratory, believing that nothing is valid unless established in laboratory reports. No one would dispute the role the laboratory has played in the advancement of medical science. Sadly, some things are tough to study in the laboratory. One of these is the mind and the brain. Emotions do not lend to experiments or measurements, so modern science has chosen to ignore them, strengthened by the conviction that emotions have nothing to do with health and illness. Hence, the majority of practicing physicians feel uncomfortable dealing with problems that are related to emotions. On the other hand, some doctors have observed a large number of pain syndromes caused due to a condition in muscles, nerves, tendons, and ligaments brought by the tension. They were able to treat the pain condition with a lot of success using simple, rapid, and thorough treatment programs.

Pain syndromes look so "physical". It is particularly difficult for doctors to consider the possibility that they might be caused by psychological factors, so physicians cling to the structural explanation. In doing so, they are responsible for the pain epidemic that exists in the country.

If the structural abnormalities do not cause pain the in the neck, shoulder, and back, what does? Studies suggest that these common pain conditions are the result of a physiologic alteration of certain muscles, nerves, tendons, and ligaments which is called Tension Myositis Syndrome (TMS). It is a harmless but painful disorder that is the result of specific, common emotional situations.

Who gets TMS?

It occurs in children above the age of 6. Mostly TMS is referred to as "growing pains" in the case of children. No one has been able to explain the nature of "growing pain" since TMS is a condition that leaves no physical evidence of its presence. There is a temporary constriction of blood vessels, bringing on the symptoms, and then all returns to normal.

The emotional stimulus for the attack in children is no different from that in adults- anxiety.

The statistics suggest that the cause of back pain in most cases is emotional for years between 30 and 60 what one could call years of responsibility. This is the period in one's life when one is under strain to succeed and excel, and it is logical that this is when one would experience an incidence of TMS. Further, if degeneration and herniation, facet arthrosis, and spinal stenosis are the primary causes of back pain, then these statistics would not fit at all.

So the answer to the question "who gets TMS?" is anybody. It is most common in the middle years of life.

Where does TMS manifest itself?

Muscle

The primary tissue involved in TMS is the muscle. Back and neck muscles are very susceptible to TMS. These muscles maintain and correct the posture of the head and trunk and contribute to the effective use of the arms. They have a higher proportion of muscle fibers than limb muscles and are perfect for endurance activity, which is what is required of them.

Just above the buttocks are the lumbar muscles, regularly these with buttock muscles are involved in pain. Sometimes gluteal and lumbar muscles are affected separately. approximately 2/3 of TMS patients have major pain in this area. Patients complain of pain in the left buttock or right shoulder, but the physical examination may reveal something else. In TMS patients, one finds tenderness when pressure is applied to muscles in 3 parts of of the back: the outer aspect of the buttocks, muscles in the lumbar area, and upper shoulder muscles. This consistent pattern is important because it supports that pain conditions originate in the brain rather than in the structural abnormality of the spine or incompetence of the muscle.

Nerve

Peripheral nerves are affected in this pain syndrome. Those affected are close to the muscles. The sciatic nerve is located deep in the buttock muscle, the lumbar spinal nerves are under the lumbar paraspinal muscles, and the cervical spinal nerves and brachial plexus are under the shoulder muscles. These are the nerves most frequently affected in TMS

Tendons and Ligaments

TMS can manifest in a variety of locations and tends to move around, particularly if something is being done to combat the disorder. Patients often report pain in a new location as the old one gets better. It is as though the brain is unwilling to give up this strategy for diverting attention away from the circle of emotions.

The symptoms of pain, numbness, tingling, and weakness are intended by the brain to suggest that something is physically wrong. To most people "physically wrong" means injury, weakness, incompetence, and degeneration, singly or in combination. To further this view, the pain often begins in association with some physical activity. The patient cannot help but conclude that something is injured or displaced.

Neck, shoulder, and back pain syndromes are not mechanical problems to be cured by mechanical means. They have to do with people's feelings, personalities, and the vicissitudes of life. Traditional medical diagnosis focus on the machine. the body. while the real problems seem to relate to what makes the machine work - the mind. TMS is characterized by physical pain, but the acute discomfort is induced by psychological phenomena rather than structural abnormality or muscle deficiency.

Nature of Mind and body interactions

The basic idea is that mental and emotional states can impinge upon and alter, for good or ill, any of the body's organs or systems. The mechanism by which this is accomplished is unknown to us. How is it that the brain can take the jumble of sounds that enter our ears and turn them into meaningful words or myriads of shapes and lines we see with eyes that mean nothing until the brain has worked on them and converted them into words or things we recognize? Most of what the brain does subconsciously is a mystery to us. why, then, are we disturbed because we can't explain how mental and emotional phenomena can do things to the brain and the body? In my view, the mind can influence any physical process.

Anxiety which is part of everyone's life may stem from the response of our emotional systems to the stresses and strains of daily living. The greater the stress, the more anxiety is generated. Anger is one of the most important and least appreciated emotions we generate.

The tendency to repress undesirable emotions is a supremely important element of one's emotional life. We repress feelings of anxiety, anger, weakness, dependency, and low self-esteem for obvious reasons. On the other end, the superego tells us what we should not be doing, and it can be a hard taskmaster. It adds to the pressures that make us anxious and angry and so it contributes to the tensions within us. So people who get TMS tend to be hard-working, hyper-responsible, conscientious, ambitious, and achieving, all of which construct the pressure on the troubled self. Just as there is a powerful tendency to repress undesirable emotions, there seems to be an equally strong drive to bring them to consciousness. It is this threat to overcome repression that necessitates the creation by the brain of things such as TMS, ulcers, and migraines.

Anxiety and Anger can bring on any one of the gastrointestinal tract, respiratory and cardiovascular disorders. We know Anger can induce Anxiety. It is a popular opinion that Anger if repressed, can exhibit TMS symptoms related to gastric hyperacidity, colitis, migraine, palpitations, and musculoskeletal symptoms. The physical symptoms exhibited here are to distract attention, it is a mechanism for allowing the individual to avoid feeling or dealing with undesirable emotions, whatever they may be. It is the lack of desire in the mind to cope with these feelings. When patients learn to make the mind cope with these feelings, the physical symptoms experienced stop presenting.

There are several ways by which the mind can modify or eliminate pain. Good spirits, a joyful attitude, and a positive emotional state can block or prevent pain. The therapeutic process of TMS works. The knowledge of what the brain is about renders the process purposeless, the abnormal autonomic stimuli cease, and so does the pain. What we need to discover is how emotional phenomena can stimulate physiologic ones.