Chronic Pain

Is My Physical Pain Stress-Induced?

Learn about psychophysiologic mind body disorders (PPD) including meaning, examples, symptoms and treatments.

Back pain. Neck pain. Headaches. Pelvic Pain. Digestive Issues.

Chronic physical pain can be debilitating. It can hinder you from doing the activities you enjoy, from having the relationships you desire, and from living the life you want. But, what is causing your physical pain? Not all pain is caused by physical conditions, injuries or structural issues. Some pain is caused by emotions, trauma or stress.

In the early 1990s, Dr. John Sarno, MD, author of Healing Back Pain, explained that “these common pain syndromes are…Tension Myositis Syndrome (TMS)… a harmless but potentially very painful disorder that is the result of specific, common emotional situations.” Today, we know a lot more about TMS, which is now known by many terms including PPD or Psychophysiologic Disorders, Mind-Body Syndrome and Neuroplastic Pain. These terms will be used interchangeably here.

What does this mean?

This means that real physical pain can be caused by our emotions.  TMS/PPD pain is REAL pain. It is just triggered by psychological factors or a dysregulated nervous system, rather than structural abnormalities or other medical conditions. With mind-body syndrome, pain symptoms are caused by pain or “danger” signals being sent to the body triggered by stress, unexpressed emotions or other psychological factors, including unprocessed trauma. 

Put another way, fear, stress and trauma trigger physical symptoms in the body. These and other negative emotions activate the autonomic nervous system, which turn on our fight-flight systems and activate danger signals in the brain. Interestingly, emotional stress or distress is perceived by the brain in the same way as physical danger or injury. So, when danger–emotional or physical–is perceived in the brain, nerves are activated and produce a physical response. The goal of the physical response: to protect you from danger. These physical responses can come in the form of muscle tension, elevated heart rate and pain

TMS or PPD symptoms can manifest in parts of the body commonly associated with stress, such as the back, neck, and shoulders, but also can trigger gastrointestinal issues, irritable bowel syndrome, headaches, chronic fatigue, fibromyalgia, and more.

How do you know if you have PPD?

First, rule out a medical condition. Physical pain can be caused by a variety of factors and it is important that you visit a medical doctor and rule out any structural or medical issues.  If a medical doctor has ruled out these issues, then consider looking at your pain in a different way. Ask yourself:

  • Did you experience a stressful event prior to your pain starting?
  • Do you experience pain in multiple places?
  • Does your pain move around to different places in your body?
  • Are your pain symptoms inconsistent?
  • Do you have a history of anxiety, depression or trauma?
  • Do you find it difficult to tolerate or express difficult emotions?

Why do mind-body symptoms develop?

As described above, TMS/PPD symptoms are triggered when the brain and nervous system perceive a threat or danger, in the form of some sort of negative emotional or physical issue. Past traumas often can cause physical symptoms in the body. When trauma goes unprocessed, the nervous reacts to internal and external stimuli as if it is still in the danger of the trauma. As a result, it continues to send out pain/distress signals to the body. As painful and uncomfortable as these symptoms are, in a sense, it is the brain’s way to try to help us and let us know that something isn’t feeling right or needs to be addressed or processed. And when we listen, we can begin to regulate and calm the nervous system and heal those symptoms.

TMS or Chronic Pain Treatment

Since TMS pain is triggered by emotions and the nervous system, the treatment for mind-body pain is in the emotional and mind/nervous system. In fact, a key to treatment of TMS symptoms is understanding and accepting that the cause of the pain is emotional and not structural. From here, you then can begin to think psychologically. For example, when you experience pain symptoms, you can start to check in with your emotions, thoughts and fears instead of your physical movements.

It also can be helpful to further educate yourself about PPD. Many challenged with TMS have noticed decreases in their pain simply through increased understanding.  If you want to learn more, check out some of these helpful resources:

  • Psychophysiologic Disorders Association:
  • The TMS Wiki:
  • Healing Back Pain by John Sarno, MD
  • Psychophysiologic Disorders by David Clarke, MD, Howard Schubiner, MD, et al.
  • Think Away Your Pain by David Schechter, MD

For some, it also can be helpful to talk to a TMS/PPD therapist. Expressing or getting in touch with buried or difficult emotions can be challenging.  Therapy can provide the support and safe environment to guide you through the healing process. There is help for your pain. You can begin to heal. If you are ready to talk to someone, you 

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