Chronic Pain: Mind Body Syndrome
What is Mind body syndrome?
Mind body Syndrome (MBS), also known as: Musculoskeletal Mindbody Syndrome (MMS), Distraction Syndrome, neuroplastic pain, Psychophysiologic disorder (PPD) Psychosomatic syndrome, or Tension Myositis Syndrome (TMS), is a psychosomatic phenomenon pioneered by Dr John Sarno.
Let me say first that psychosomatic does NOT mean it is all "in your mind" or that you are weak, or you have created the problem yourself. Your pain IS REAL - all pain is real. However it is theorised that persistent pain is not exclusively of biological origin, rather, there is growing evidence to suggest that learned neural pathways in the brain cause many forms of chronic pain and NOT structural problems in the body.
Dr Sarno theorised that pain is a physical manifestation of suppressed emotions. A ploy by the brain to distract oneself from challenging emotions and prevent their conscious expression. Also, sometimes an acute injury occurs, yet the pain continues after the tissues have fully healed as the pain neural pathways have been learnt and the fear of pain continues.
Syndromes commonly due to these psychosomatic processes (Note that most can also be caused by structural disease processes)
Acid reflux
Anxiety
Back pain
Chronic abdominal and pelvic pain syndromes
Chronic fatigue syndrome
Chronic hives
Chronic tendonitis
Depression
Dizziness
Eating disorders
Fibromyalgia
Foot pain syndrome
Gastrointestinal issues
Heartburn
Hypersensitivity syndromes (touch, sound, smells, foods, medications)
Inappropriate sinus tachycardia
Insomnia
Interstitial cystitis (irritable bladder syndrome)
Irritable bowel syndrome
Migraines
Myofascial pain syndrome
Neck pain
Obsessive-compulsive disorder
Parasthesias (numbness, tingling, burning)
Piriformis syndrome
Plantar fasciitis
Post-traumatic stress disorder
Postural orthostatic tachycardia syndrome (POTS)
Reflex sympathetic dystrophy (complex regional pain syndrome)
Repetitive strain injury
Sciatic pain syndrome
Spasmodic dysphonia
Substance use disorders
Temporomandibular joint (TMJ) syndrome
Tension headaches
Tinnitus
Vulvodynia
Whiplash
Causes
Pain is a danger signal. If you put your hand on a hot stove, the pain lets you know to move your hand so that you don’t injure yourself further. But sometimes, these danger signals can get activated even in the absence of structural damage. There’s been a lot of recent research showing that learned neural pathways in the brain cause many forms of chronic pain and NOT structural problems in the body.
It can occur sometimes when there has been an injury. When there is acute tissue damage, the brain creates pain pathways. But the brain doesn’t simply forget these pathways once the injury has healed. So, the body can heal, but the pain pathways in the brain are still there and can still cause pain.
You see, right now, you’re sitting here, and you’re feeling something in your back. But I’m feeling something in my back as well. We’re sitting, we’re using back muscles, so of course, we’re going to feel something in our backs. We have nerve fibers in our back that are sending messages to our brains. These messages are safe. They’re neutral. They’re saying, ‘Just a sensation.” But your brain is interpreting these messages as if they’re dangerous. There are nerve fibers in my back that are sending messages to my brain as well. But my brain is interpreting these messages accurately: “A light amount of pressure, just a sensation, no cause for alarm.” Your brain is getting the same messages but is interpreting these messages as dangerous. So, as a result, it’s amplifying the sensation.
So, here’s an analogy: Imagine you were wearing a hearing aid. Right now, I’m talking at maybe a 2 out of 10 volume. But imagine if you cranked that hearing aid all the way up, you’d be hearing me at like a 7 out of 10 volume. I’m still talking at a 2 out of 10 volume, but your brain interprets it as louder than it is. It’s the same thing with neural pathway pain. There’s a volume knob in our brains. And if this volume knob gets turned up, we can interpret sensations as louder than they are. And the thing that determines whether the volume knob gets turned up or down, is how much danger your brain thinks there is. All chronic pain patients have the same fear: “There has to be something going on in my body that’s causing this.” And when the brain believes that the body is damaged, it responds with pain.
So, treatment involves teaching the brain that the signals it’s receiving from the body are actually safe.
Do you have MBS?
When diagnosing neuroplastic pain, we want to rule out anything caused by a physical injury. A physical injury will obviously cause you pain, but injuries generally heal within about 3 months. With an understanding of injury pain, you get understand when pain is neuroplastic and not caused by injury. The following are taken from the book "The Way Out" by Alan Gordon with Alon Ziv. These are all indicators for MBS:
Pain that starts during a time of stress or is triggered by stress
Pain starts without injury
Lack of physical diagnosis (however a physical diagnosis does not rule out neuroplastic pain)
Symptoms are inconsistent
A large number of symptoms
Symptoms spread or move
Triggers have nothing to do with your body eg pain fluctuates with the weather, time of day etc.
Symptoms are symmetrical
Pain is delayed
Childhood adversity
Common personality traits present: anxious vigilance, perfectionism, conscientiousness, people pleasing.
You may feel that some or all of these may relate to you. Even if none of these seem to apply, you could still have neuroplastic pain. Neuroplastic pain is very good at mimicking structurally caused pain. My knee pain felt like it was caused by wear and tear on my knee caps. I was told they weren't tracking correctly, you could hear and feel crepitus (which is meant to indicate chondromalacea patella). However, I had had no injury. Funnily I had experienced exactly the same pain as a teenager, which I was then told was growing pains and that I would grow out of it. Hence back then I had no fear of it and carried on with life and it went after a few months. My brain would have created a neural pathway for that pain and could easily have used that same pathway to create pain at a later point in my life.
What I encourage you to do is look for evidence of your pain being neuroplastic. Think of any times where your pain has acted like the examples above and write it down. If you are not sure, it can be useful to see a trained practitioner to help you. Why not contact me for an assessment?
