Is there a difference between TMS and FND?

"TMS" was not a discovery, but a theory. It is also nothing more than a string of words that Dr. Sarno put together to describe the symptom of muscle pain resulting from muscle tension which he believed was from oxygen deprivation, which he theorized was caused by emotional distress and repression. Forty years ago in the early 1980s.

The thing is, "Tension Myositis Syndrome" is not a meaningful phrase. It simply signifies a condition of muscle tension. Just like FND signifies a disorder of the neurological system which has no discernible cause. We actually joke around here about the number of conditions that we consider to be TMS which have been given descriptive labels by a medical community that is desperate to give some kind of diagnosis to individuals who are desperate to be diagnosed. Chronic Fatigue Syndrome, Complex Regional Pain Syndrome, Irritable Bowel Syndrome, Fibromyalgia, and many more. We collected a bunch on a thread earlier this year, I think it was. Yet none of these tells us anything outside of a description of the symptoms.

Dr. Sarno started out with back pain, but his later two books clearly show how his observations moved on to many other conditions. I'm actually of the opinion that he would have been fully engaged in the many neuroscience advances which have been made since his time, as well as the proliferation of research confirming the stress/inflammation/disease connection.

Many of us here interpret his prohibition against physical interventions with a great deal of nuance, as @Cactusflower has already described. After all, Dr. Sarno himself said that pain relief medications and anti-depressants can give someone the mental breathing room to turn things around and start on the emotional work. He also recommended therapy for individuals who are not able to do this work on their own, which is generally going to be the case when past trauma is an issue. There's no reason that hands-on bodywork or physical retraining can't be used the same way. It will, in fact, only be effective in the long run if the patient/client incorporates the necessary emotional work at the same time, and uses the training as a temporary tool to jumpstart long-term recovery.

I personally use the power of the placebo effect to do this whenever I need to steer my brain along a self-healing path. I also go to my favorite hands-on PT every two months for a tune-up, whether I have symptoms or not, because at my age (more than twenty years past what I believe is the maximum intended useful life of the human body) I deserve it and it feels great. It does not lessen my belief in the mindbody connection, and if nothing else, I like having a licensed professional, who has known me for years (since "before Sarno") keeping an eye on me. Back in the day he was thrilled to see me find the mindbody path, and it has enhanced our work.

Sure, that makes sense to me, and is probably right in line with Pain Reprocessing Therapy, which is Alan Gordon's new program, although back in the day he was the emotional guru. But it reminds me that back in 2011, just "before Sarno", I was being seen at a dizziness & balance clinic where they tested everything and ultimately couldn't find anything wrong (classic TMS as it turns out) so they started making me do exercises designed to challenge my balance. I was still in the beginning of their treatment plan when I discovered Dr. Sarno and this forum, and realized that challenging my fear response is what they were really doing - and that I didn't need it as soon as I stopped accepting fear as my go-to response to stress. I said "thanks very much, but I'm good to go" and I never looked back.

Exactly!

Well, look - this is highly individualized (as @Cactusflower has also said) and I think it depends a LOT on where someone is at in incorporating TMS knowledge and awareness and skills into their life. In my case, I was on my way to becoming housebound, but was still quite far from that eventuality when I discovered Dr. Sarno and started doing the work (the Structured Educational Program, plus Claire Weekes for anxiety). My belief was instant, because for many decades I'd understood the mindbody connection and believed in the power of self-healing - I just hadn't put it all together with my lifetime of anxiety and previously mild symptoms, plus this totally new idea of emotional repression. Dr. Sarno did that for me. As I said, I dropped the balance clinic immediately, along with the clinic owner's theory that I was a migrainer, and I also stopped seeing an "alternative" MD who was attempting to do cranio-sacral work on me. I doubled down on my workouts with an age-appropriate physical trainer (I was 60 at that time) with a goal of less fear and more determination to restore my strength and activity. Which I totally did. Until the pandemic shutdowns in early 2020, but that's another story, and it's 100% stress-related. Living in today's dysfunctional world doesn't make any of this easy, folks.

The bottom line: Don't overthink it! I think you could be susceptible to letting your TMS brain mechanism use overthinking as a means of trying to control the process and thus the outcome. This, of course, is counter-productive, fooling you into thinking you're accomplishing something while the real work is being avoided. The emotional work must be front and center, and it must proceed unencumbered by intellectualizing and monitoring.

Good luck!