Oh My Aching Back !
Tension Myositis Syndrome -
One of the most frequently tried
personal injury case before a jury is the muscle strain to
the neck or back which does not respond to traditional medical
treatment and get better in 10 to 16 weeks. The plaintiff
continues to have severe recurrent episodes of pain and goes
through extensive diagnostic testing and pain management
protocols and is still left with the same severe recurrent
episodes of pain. All diagnostic testing is negative for
permanent injury and the pain management protocols while
providing temporary relief - the episodes continue to recur. It
is not uncommon for the medical bills to total in excess of
$30,000 and treatment to extend over several years. The
plaintiffs usually are sincere individuals and family, friends
and co-workers attest to the debilitating effect of the
recurrent episodes of pain and changed life style of the
plaintiffs. Yet juries rarely compensate these injured
individuals more than several times medical expenses and
frequently render verdicts of medical specials only. I have
experienced these results in trials conducted in my court room
well over 100 times. Typically the defendant has a highly
qualified orthopedic surgeon or neurosurgeon testify that there
are no objective tests which would support a casual connection
between the accident and the plaintiff’s complaint of pain. To
make matters worse for the injured plaintiff they are left with
these painful conditions for perhaps the rest of their life.
They feel tremendously let down by the system of justice and
lawyers and many times become very
same scenario troubled a young New York City orthopedic surgeon
in the 1960’s - Dr John E Sarno. Dr Sarno then began a lifelong
quest and study to provide help for these individuals. His
study led him to a new medical diagnosis - Tension Myositis
Syndrome or TMS. Basically this diagnosis was a recognition
that tension is a cause of muscular pain. It should be noted
that this diagnosis is distinguished from hypochondria and a
purely psychological disorder. Thus while TMS is induced by an
emotional phenomena it is a physical disorder. The muscles and
tissues actually spasm and therefore cause pain. The medical
community has difficulty recognizing and making the diagnosis.
The psychologist may suspect that the patient’s symptoms are
emotionally induced, but is untrained in physical diagnosis. On
the other hand since very few orthopedic physicians are trained
to recognize a disorder whose roots are psychological, TMS
″falls through the cracks″ and patients go undiagnosed. This
leaves the patient vulnerable to being labeled - that the pain
is ″all in the head″.
The lawyer then has an
opportunity to help his client even though the system of
justice seems to have failed by directing his client to TMS
resources. After all the first objective of a lawyer is to make
sure the clients gets the best possible medical
Fortunately, Dr Sarno has written
several books and trained a subsequent generation of physicians
- most notably Dr. David Schechter - who are capable of
providing treatment for this perplexing and frustrating
condition. Still, broad acceptance in the medical community
does not exist and many individuals are ″left standing at the
altar″ by the medical community. In the thousands of cases
which I have evaluated and listened to testimony at trial I
have yet to read or hear of a TMS diagnosis or referral. At
best a physician will suggest that psychological counseling
TMS treatment generally consists
of a two pronged approach:
1. The acquisition of
knowledge and insight into the nature of the
2. The ability to act on that
knowledge and thereby change the brains
Dr Sarno suggests the
1. Think psychological not
physical. With good reason this is possible since the
medical community has run all of the tests and concluded
that there is no physical disorder. So why then does the
pain not immediately disappear?
a. “pity me that the
heart is slow to learn - What the swift
mind beholds at every turn” ( last two lines of
poem by Edna St. Vincent Millay)
2. Talk to your
3. Resume physical
4. Discontinue all physical
5. Review the daily
6. The pain is due to TMS,
not a structural abnormality.
7. The direct reason for the
pain is mild oxygen deprivation.
8. TMS is a harmless
condition caused by my repressed emotions.
9. The principle emotion is
10. TMS exists only to
distract my attention from my emotions.
11. Since my back is
basically normal there is nothing else to fear.
12. Therefore, physical
activity is not dangerous.
13. And I must resume all
normal physical activity.
14. I will not be concerned
or intimidated by the pain.
15. I will shift my attention
from the pain to emotional issues.
16. I intend to be in control
- not my subconscious mind.
17. I must think
psychological not physical at all times.
Here is a
list of study resources that are a must.
See the Links at the
Bottom of the Page
The Mindbody Prescription: Healing the Body, Healing the
Pain by John E. Sarno M.D. (Paperback - Oct 1,
The Divided Mind: The Epidemic of Mindbody Disorders by John E.
Sarno (Paperback - Mar 27, 2007)
Healing Back Pain: The Mind-Body Connection by John E. Sarno
(Paperback - Feb 1, 1991)
The Mindbody Prescription: Healing the Body, Healing the Pain
by John E. Sarno (Kindle Edition - Mar 15, 2001) - Kindle
The MindBody Workbook by David Schechter M.D. (Plastic Comb -
Nov 1, 1999)
The MindBody Audio Program by David Schechter (Audio CD - April
New Title 1 (The MindBody Workbook) by MD David Schechter
(Kindle Edition - Jul 15, 2008) - Kindle Book
The MindBody Workbook with Patient Panel DVD by David Schechter
(Plastic Comb - Oct 1, 2004)
by Judge Arthur M. Monty Ahalt ( Ret.) - July 21,