What is TMS and Why Does It Cause Pelvic Pain?

If you’ve been struggling with pelvic pain, bladder urgency, or discomfort during intimacy, you may feel trapped in an endless cycle of treatments that never bring real relief. You’ve tried physical therapy, medications, and lifestyle changes, yet the symptoms persist—leaving you frustrated, confused, and maybe even questioning if something has been missed.

But what if the problem isn’t in your muscles, organs, or tissues at all? What if your pain is a learned response from the brain, a signal driven not by physical damage but by an overwhelmed nervous system trying to protect you?

This is the foundation of Tension Myositis Syndrome (TMS), a concept pioneered by Dr. John Sarno.

How Pain Becomes a Protection Mechanism

The human brain is wired for survival, and one of its most powerful tools is protection through distraction. When the nervous system perceives something as dangerous—whether it’s a real physical threat or an emotional one—it takes action to keep you “safe.”

Dr. Sarno discovered that the brain can convert repressed emotions into physical symptoms to prevent overwhelming feelings from surfacing. He described the unconscious mind as holding an emotional reservoir, a deep well where painful emotions—such as anger, fear, grief, or shame—are stored. When this reservoir fills to a level the brain deems unmanageable, symptoms emerge as a distraction, pulling attention away from emotions that feel too threatening to process.

Why the Pelvis?

TMS can appear anywhere in the body, but pelvic symptoms are particularly common because of how deeply this area is tied to safety, identity, and vulnerability.

From an evolutionary standpoint, the pelvis is a place of protection—it houses vital organs and is involved in reproduction, elimination, and intimacy. It’s also an area where we unconsciously hold tension, especially in response to stress or emotional suppression. Many women experiencing pelvic pain have a history of pushing through discomfort, ignoring their own needs, or carrying unprocessed emotions related to sexuality, boundaries, or past experiences.

When the emotional reservoir reaches its limit, the brain redirects that unresolved tension into the body—tightening the pelvic muscles, heightening bladder sensitivity, and creating pain that demands attention. This isn’t a flaw; it’s the nervous system’s way of trying to protect you from feelings it believes you can’t handle.

Why Medical Treatments Often Fall Short

Because TMS symptoms originate in the brain and nervous system, treating them purely as a structural issue often leads to frustration. While physical therapy, medication, and lifestyle changes may provide temporary relief, they don’t address the underlying cause—the brain’s need to keep you safe by holding onto pain.

This explains why so many women go through cycles of progress and setbacks. When one symptom resolves, another may take its place. The brain is not broken, but it is stuck in a loop of protection, interpreting certain movements, sensations, or even emotional triggers as threats—leading to ongoing pain, urgency, or discomfort.

You Are Not Broken—And You Don’t Have to Figure This Out Alone

The idea that pain can be generated by the brain doesn’t mean it’s “all in your head.” Your symptoms are real, but they are not a sign of damage. They are signals from a nervous system that has been pushed beyond its limits, trying its best to shield you from something deeper.

Recognizing this is the first step—but knowing how to shift out of this cycle is where real healing happens. I work with women every day who feel just like you—stuck, exhausted, and unsure of what to do next. If you’re ready to understand your pain in a new way and start unwinding the fear and tension keeping it alive, I’d love to help.

You don’t have to keep searching for the next treatment or living in fear of your symptoms. There is another way forward. If this resonates with you, I invite you to explore my Neuroplastic Pain Guide or 1:1 coaching, where I guide women just like you in breaking free from chronic pain, bladder urgency, and pelvic tension—for good.