I had no idea it was the misery of the IT job that was causing most of my pain and suffering, and it had nothing to do with the job itself, it was the endless insanity of everyone else around me doing exactly what they were informed would cause problems instead of having discussions with people that actually knew how shit worked. I was endlessly picking up everyone elses mess and treated worse than a pile of shit all because people were incapable of having a speck of respect for other people since all their hatred for computers fell on me
I GTFO of the career of misery and took half a decade to finally start feeling better
I have now spent years and countless hours working on software and I greatly enjoy doing this work again and find I get even more done than I used to simply by doing life the way I need to instead of how some backwards/abusive control freak "needs it done"
It took about 6 months for the brain zaps to start fading. Then another 6 months for me to start feeling capable of really doing my job well. I'm 18 months into "recovery" and I still think I have another 6 to 12 months before I feel like my old self again (so about 2 to 2.5 years in total).
Time is really the only solution. You can't just think your way through it. You have to left your body's rewards systems re-adapt and re-learn how to be a healthy, happy human.
- taking sport seriously
- regaining control over my life (which I did by creating a startup)
- moving to a city that cares about walking pedestrians and social life (moved from SF to New York!)
That's my experience at least, that it's not healthy to be in environments like that for any length of time. In such a place, my regret is always not leaving sooner...
I have always had a passion for computing so I eventually found my way back with a project of my own
Apropos, I had chronic pain throughout this experience. I thought it was just aging, irreversible, and something that compounded my hopelessness. It's very surprising to be 10 years older now but feel 20 years younger. Books like "The Body Keeps the Score" or "Healing Back Pain" used to seem woo to me, but now I am convicted that health comes from within as much or more than it does from without.
I am on the same fence, just on my notice period in the shit show called corporate IT where there is 90% time spent on toxic politics.
Now dreaming to burn some savings, detox and then play with Raspberry Pi projects.
I made it through the Army (decades ago), I ran my own company, handled employees, etc. I have no problem with hard work and stress. My joy for computers was destroyed for a while, and it had nothing to do with the work itself, it was due to targeted intentionally malicious discrimination from the top
Why is it so hard to explain the solution briefly, or directly present it to me upfront. Why does it need so much of mystery around it?
In this article the OP does not even mention "Pain reprocessing theory" which is what they seems to be talking about (based on the study they have linked)
Just woke up and this post's traction has surpassed my wildest imagination.
Similar to what pedalpete has said, I'm looking to release this in parts to ensure:
1. I am not overwhelming people and losing their interest
2. Quality remains as high as possible (I invested only a few hours into this last week as an experiment). I want this blog to be the most easily accessible, engaging + factual source for chronic pain sufferers. That requires sufficient time to nail (and it seems like I've struck a chord so far).
3. Get signals from readers week by week and tailor to the audience which is forming.
This will help me helpfully reach the most pain sufferers.
RE feel like you're being sold something. This series will cover what is needed to recover from chronic pain and be offered for free. I am looking to build a product eventually (why wouldn't I want help as many people as posssible while building a career which does good - I don't believe they're exclusive), but the information in this blog will remain free.
RE not calling out Pain reprocessing theory/therapy - I'll go through the post today and see if it makes sense to add this into #1 (or if it's better for #4). It's not something I consciously omitted when writting this post last week.
Thanks for the comment!
1. You've lost my interest with no "meat", as the GP stated.
2. There is no "quality" in using a couple thousand words of text to say "I'll be writing about what helped with my chronic pain over time".
3. Here's the signal: I am not in for "weekly" sessions. I do have chronic pain, but what you want to be producing is utterly incompatible with what I need.
Then I had to click a link "a landmark study" to get an idea of what the treatment is. Why not put the title of the treatment there?
Finally, that article is about back pain. But you had tendon pain. Obviously a psychological technique can be applied to multiple diseases, but you might say something about that.
Chronic pain drives people to suicide. You're toying with people's emotions.
- Chronic pain is often generated by the brain, not any actual injury. Not always, but often. Especially if it gets worse during stress or high alert, and especially if the feeling of pain becomes connected to your fear of that same pain.
- In periods when pain is high, you need to kinda nurse it. Lie down, put warm water on it, whatever it takes. Don't try to power through the pain. Avoid situations where you have to power through.
- In periods when pain is moderate or low, take short sessions to examine it. "Ok, this isn't a threatening injury, this is just a sensation. Where is it located? What shape? Hot or cold? More dull or more like tingling?" Etc, etc. Don't hyperfocus, just explore the feeling in a light and curious way.
Yes and: Kelly's freq collaborator Jill Miller (author of The Roll Model, TuneUp Fitness, etc.).
I think there are a few reasons you see this in health/medical community.
1) just helping people understand a different view of the problem is often enough for one blog post. Stuffing new way to look at solution and new solution together can sometimes be a bit much.
2) we have to be cautious from a regulatory perspective about what we say, and sometimes in being too cautious don't give the people who REALLY want to understaned the processes enough to go on. For our company, I used to say things like "we can increase the synchronous firing of neurons which results in reduced 15^% drop in early night cortisol, and 14.5% increase in hrv....".
But prior to regulatory approvals, we can't point directly to neurological or physiological processes, which means we kinda end up talking around the solution a bit.
3) in marketing, they want to connect and build an audience, so they are dripping more information over time. One post gets feedback and interest from one group, then you do another, and another. It's about building the community and connecting with people, not just a "here's a problem, do the thing, thanks". If you are trying to build a business, you probably need to get in front of people 7-8 times, particularly if you're taking a new approach to a problem, to build trust and brand recognition.
It's not the best, but it is the way the world works.
There isn't a "solution" - you're looking at a life-long mitigation and management strategy that will not be "brief".
The time commitment typically goes up as one ages. I could spend 40 hours a week on nutrition, exercise and relaxation if I was trying to optimize for chronic pain reduction.
But then nothing else would get done.
The topic itself is broad, but I agree that posts like this (please subscribe to my substack so you can get the info…) are almost always a prelude to some monetization play that comes later.
In this case, there are numerous existing resources on the topic (as linked by others already) from people with actual academic research experience in the topic that could have been linked in the post.
The claim about having quit a tech job and sold his house to “work on chronic pain” is also a giveaway that some monetization motives are at play.
I’m not opposed to people earning money from their work, but everyone reading this should know that monetization motives inevitably conflict with giving you the best access to information. The more you get from existing resources, the less interested you will be in following this specific author and paying for whatever products or services they are pushing.
This is the first of several blog posts exploring this invisible condition.
If you're passionate about this space feel free to reach out, thanks!
[1] https://www.cdc.gov/mmwr/volumes/72/wr/mm7215a1.htm [data from 2021]
-
[Edit] Thanks so much everyone! Excited to get the next article out soon!
[0] Circadian rhythms and pain: https://www.sciencedirect.com/science/article/abs/pii/S01497...
[1] The disruptive relationship among circadian rhythms, pain, and opioids: https://www.frontiersin.org/journals/neuroscience/articles/1...
[2] Circadian rhythm disruption exacerbates pain behavior in male mice: https://www.sciencedirect.com/science/article/abs/pii/S03064...
I'll read this blog with love!
Thanks
Sometimes I wish there was a medHN
For my recovery my reading/listening was focused on people like Dr Schubiner, Alan Gordon and some folks in Aus like Lorimer Moseley.
I'm engaging more in linking research studies in now as I experienced a lot of people (often not practitioners) making claims without links to evidence (likely to keep things simple), which made my logical brain skeptical orignally and slowed my entry to this field
I’ve been on the slippery slope of chronic pain. Minor post surgery issues caused me to change my routine and avoid certain activities which only exacerbated the issues, which led to more avoidance. Eventually I couldn’t walk.
The American medical system is very focused on avoiding health issues that show up on mri, rather than quality of life health. But quality of life issues quickly become serious.
I think the middle ground of activity: not all out intense as if you are healthy, but also not avoiding movement is so challenging to find for many people but also so crucial. A lot of chronic pain for myself and I suspect for many others could be avoided with short and quick combination of therapy and daily movement. So simple but so challenging to effectively identify and allocate resources.
Not suggesting this is the total solution but it’s the pathway that I took to return to activity and I’ve seen it help a number of my friends as well.
My wife has had two surgeries and each time she had a minor post surgery issue. One of them was an area that was tender to touch; another was chronic pain. Neither was mentioned as a possible side effect of the surgery by the surgeon. The main takeaway even if a bit extreme here is avoid all surgeries unless absolutely necessary.
I had a surgery asked for more pain meds once on day 5 or 6. Instead the surgeon had me come in to look at the wound, made a tiny incision a blob of pus came out and things felt fine the next day. That’s the kind of thing that could have easily resulted in major problems, but just the right treatment at just the right time fixed it.
Anecdotal case: My wife broke her arm some 10 years ago or so. She was really upset about potential recovery time, insurance copayments and such, especially since she was (at the time) a single mother. The doctor suggested setting it and letting it heal on its own, which was absolutely the wrong call. Had she gotten surgery straight away, she would have recovered by the time she actually ended up getting surgery.
I've often wondered if there wasn't a malpractice case that could have been made, but it was before we met so that's lost to time.
Anecdotally, I had a phase where pretty much the same thing happened to me with the Achilles (+ calf/ankle) flare-ups I was having (during this part of my chronic journey). Eventually got through it by doing small walks around my home, then outside but keeping the frequency high each day (i.e. instead of 1 "long" walk, doing 3-4 short ones). I.e. Desensitisation / daily movement
That all changed when I tore my achilles, the pain/recovery/etc. process had me doubting everything I knew about recovery and now 14 months later I still question if it needs more rest or more activity or the whole thing is in my head. Ankle/foot injuries seem to have an entirely different approach because standing and walking are so fundamental that you might overdo it just by deciding to make eggs or something.
I deal with fibromyalgia pain. When I first developed it, I pretty much avoided doing anything, and really that was the opposite of what I should have done. There's no "recovery" and really no avoiding it; all I ended up doing was letting my physical condition weaken to the point that even normal activities were painful, so I was hurting for two reasons.
Treating the underlying cause of the symptom, and training to avoid behaviors that exacerbate the symptom is the real key.
I hesitate to add a link to this on the thread, but there is an interesting story around chronic pain actually being psychological and there are now some high quality studies coming out.
https://journals.lww.com/painrpts/Fulltext/2021/09000/Psycho...
I especially hate to link to LessWrong but this is an actually decent thread on the topic:
https://www.lesswrong.com/posts/BgBJqPv5ogsX4fLka/the-mind-b...
I didn't know about any of this and had never been exposed to any of it when I drew my conclusions and started to feel less pain. Don't get me wrong, there are still things that will set my back off, but now I probably go actual years without even thinking about it.
This is a misinterpretation of these studies which is common throughout this thread.
The research isn’t showing that chronic pain is a psychological condition. It’s suggesting that some cases of nonspecific chronic pain that specifically do not match the symptoms of typical physically-rooted pain are psychological. The participants in this study were filtered for this criteria.
For some reason, people see this idea and lose the nuance, concluding that most or all chronic pain is actually psychological.
I think if someone matches the description used by the author of the substack for this HN entry (he describes his chronic pain as random and popping up all over his body) then pursuing the psychological explanation would be a very good idea.
However, it’s getting frustrating to see all of the reductionist claims that “chronic pain is psychological”.
It's incredibly frustrating and disheartening... For obvious reasons, I'm not going to go into too much detail, but chronic (non-visible) pain is the worst of the worst. People will either think you're "faking"[0] or it's "just psychosomatic"[1]. I actually relish being able to work for a good long day because I'm lucky enough to actually enjoy making computers do stuff.
[0] Yes, I love to miss lots of family occasions, just because.
[1] I'll just will myself better. Nevermind the MRI scans and all that.
EDIT: I should add... the cognitive biases at work are understandable because they've probably been around since proto-humanity, but that doesn't change the outcomes.
I think this is an incorrect oversimplification.
I had a pretty bad accident a year ago and am still dealing with physical therapy and recovery from it. I have spent a lot of last year traveling the land of pain.
It's not that pain (chronic or not) is psychological. It's more that our pyschological state modulates how we experience pain.
If you hit your thumb with a hammer, the pain you feel is absolutely not psychosomatic and entirely in your head. There are real nerves in your hand sending your brain real pain signals.
But if you happen to do that on a day that you're really stressed out, it will hurt worse. And if days after the accident you are still hurting and you find your inner monologue saying things like "See, you hit your thumb because you're such a stupid clutz." then you will experience that pain with greater intensity and for longer than if you had a more positive narrative around the injury.
The question of why is out of scope.
In this case, docs just don’t know why. (I think it kinda pisses them off not know, tbh). And finding out is not really in their wheelhouse.
I’ve made some life changes (new job) to see what happens here. But I also have to be prepared for the possibility that it doesn’t fix it. Been working through The Body Keeps The Score as well.
Looking forward to seeing what the author discusses here.
This exercise fixed it for me. I was diagnosed with GERD last year, I already had it for 2-3 years before that, but it got worse last year. I got ppis for a couple of months and when I finished all of them it came back worse. Fortunately I found this article, and I started doing the exercise daily morning after I woke up(and still do it). I can now eat tomatoes, food with mint, spicy food etc etc :) I have shared my experience with others and it helped them too
Edit - Changed the link, had posted something else by mistake
Since reading the above HN comments, I have lost ten pounds and (mostly) stopped drinking carbonated beverages. My GERD is vastly reduced.
¢¢
Does this mean that total number of daily dry swallows in bridge position was 10 or 10 times 10 (100)?
Chronic reflux as a symptom is almost always initially treated by PPIs because the cause among white collar workers is assumed to be chronic stress[1]. Since doctors can't "treat stress" only its symptoms, they will just tell you to try and manage stressors in your life yourself. Maybe suggest counseling but in general they are limited in what they can do. What they can do, if you are persistent in the complaint, is to just run through all the other less likely causes of it.
I was lucky omeprazole worked for me the first time. I knew exactly what was stressing me out 24/7 and the acid reflux and frequent belching combined with the "pit in my stomach" feeling was all too common and connected around my main stressor. In my case, it started 8 months after accepting a role shift from engineering into management. I was cautiously excited initially, but it just soured very quickly. I would feel physical angst parking at work every morning trying to remind myself of all the web of political infighting "what our team is hiding from this other team", "who we can discuss what with", "how that other team is actively undermining us and their other downstream partners, but how we are circumventing that" how to 4d chess maneuver yourself in the most counterproductive ways possible. It was illuminating on where a lot of those special "business requirements" come from sometimes, but it just wasn't for me. Cutting that out was a massive relief
[1]: Stress and glucocorticoids have well documented effects on the digestive system. I recommend the "Why Zebras Don't Get Ulcers" book chapter on stress and the digestive system.
Thanks for the edit that added this. Very similar experience as this.
It's BS that IC ladders top out at quasi-management roles, but perhaps part of the issue is believing that professional growth is as tidy as a FAANG career ladder (since most companies just copy them wholesale), and that not reaching those rungs reflects on me in any way.
It feels a bit taboo to say, but I believe not everyone can flex into management easily, even part-time. I'm alright at it, but it clearly isn't long-term sustainable.
Oh definitely. Some doctors are physically incapable of uttering the words “I/We don’t know.” I know a few doctors, and have asked a couple of them about this. In private, they’re very frank about the limits of modern medicine. But in front of patients, they’re afraid any sign of uncertainty will lead to patients concluding that some other quackery is just as good as actual medicine. I can definitely understand their perspective, but it does sometimes make them come across as arrogant know-it-alls.
This, but also in particularly litigious countries like the USA, they have to be extremely careful of opening up lawsuits.
A doctor saying "I don't know." followed by a bad patient outcome has a pretty high chance of being a lawsuit.
The diagnosis I got from my therapist is PTSD from my chikdhood due to the strong connection between stress and body.
The only thing I found that alleviates my symptoms short term is lots of Buddhist meditation (1-2 hours per day).
I wish you all the best and thank you so much for sharing.
Foods make it worse, but it’s rarely an issue if I’m in decent shape and not stressed.
-https://www.healthcentral.com/digestive-health/acid-reflux-e...
-https://www.refluxguard.com/the-acid-reflux-game-changer-sle...
Putting my futon on a sheet of plywood with two concrete blocks under the head completely solved the problem within a few days. It takes a while to adapt to sleeping on an incline. I kept it up for about a year, then went back to a flat bed. I've never had acid reflux again.
After getting that diagnosis. I eat everything within reason. I decided not to take medication, knowing whats up with my body is sufficient. I mainly try to do all eating 4 hrs before bed.
What i have read is that covid may be responsible for micro lesions in the esophagus...acidic foods are essentially rubbing salt in the wounds.
Just a note about VH - it is more so over sensitivity to regular digestive function. Which is why feeling super full after eating/dispepsia is common as well. Im sure you did a 24 hr acid monitoring test - i pressed the reflux button during all my trigger foods and was surprised to see ph levels as neutral.
And as you have said, avoid anything that increases stomach acid production (such as caffeine or even tea, along with spicy food).
You might also have success with Venter[1] (Sucralfate).
I suspect I have a histamine intolerance behind it all, as it tends to be comorbid with ehlers-danlos.
But I think there's still plenty more that makes it worth a read. For example, something along the lines of, sometimes a man will pop an antacid and lament that their illness is negatively affecting their work, when in fact the causality is exactly reversed
Worth mentioning is I got the same symptoms (tendinitis) a few months prior to this, but went to PT and got them resolved. Bodies/minds are fun!
I love smoothies with aloe Vera juice and freshly grated ginger. I’ve never felt such a powerfully calming sensation from ingesting something before. Can’t tell if it’s the ritual/association or the ingredients.
> The most consequential problem with BKS is its promotion of a large number of treatments, outside of EMDR, that have limited to no evidence (e.g., massage, acupuncture, yoga, community theater, and neurofeedback), according to the latest treatment guidelines by the International Society for Traumatic Stress Studies (Frank et al., 2020), while simultaneously ignoring or criticizing PE and CPT, the two treatments with the highest quality evidence (Sakaluk et al., 2019).
https://web.archive.org/web/20250120164320/https://journals....
He almost certainly suffered minor brain damage during this episode, and later, after about a decade of taking anti-protonic medications for reflux, developed exactly the abnormally rapidly growing abdominal cancer that patients who take anti-protonics apparently develop at a higher rate than similar GERD patients who don't.
I don't mean to give medical advice. I can only describe what happened in my family (which has a heritable deformation in the esophagus, leading to severe GERD). Take it with a grain of salt (and an antacid) as what it is: an anecdote from some anonymous nonexpert on the internet.
Anyhow, good luck. I'm glad to know you're working actively on the problem, not ignoring it as my father did, and I hope you find some long-term relief and peace.
Don’t let yourself be gaslit that it’s all mental. It seems some do have that, but there are also many hard to diagnose and completely valid physical health conditions that cause terrible chronic pain. And don’t give up on trying to find out what they are. Once I did, I was able to largely manage mine, and more importantly, to stop constantly questioning my own sanity.
I agree, though this is a very difficult subject. Often, the people who would benefit the most from psychosomatic interventions are often the most resistant to accepting those explanations. Meanwhile, many of the physical chronic pain sufferers I know have desperately tried various mind-body programs (without success) because they will try anything that might help.
If people match the description of the author of this post and blog, where the pains are widespread, vague, and popping up around different parts of the body without explanation then you really should explore psychosomatic explanations like this author did.
However, I’m growing weary of the trend of people who fit this description starting newsletters they want you to subscribe to (like this one), writing apps they want you to download/buy, and making comments implying that they know better than doctors about chronic pain (while putting an obligatory “not a doctor” disclaimer juxtaposed to their comments complaining that doctors don’t know what they know). I think it’s great when people share their experience, but it’s getting tiresome to see it productized and generalized as a more universal explanation.
EDIT: Another trend in this space is to productize by building an audience (please subscribe to my Substack) and then introduce the monetization plan later: A subscription app, an e-book, a partnership with some product. It’s possible this person organically decided to quit their job, sell their house, and focus on writing a no strings attached Substack blog series to share information. However, I’ve seen this play out across enough health influencers that I recommend everyone stay cautious about people who claim to hold some information that will change your life but they need you to subscribe first. Be careful.
I am not claiming to know better than doctors whom are proficient in pain science/medicine.
Rather, that most doctors are not adequately educated on this topic. If you ask the average doctor they will tell you how little it is taught in most medical education programs. Case in point, most pain sufferers will tell you how many doctors they had to bounce between before they finally got some answers/direction (if they were lucky).
FWIW I was preparing for two months this year after I left my job to sit the Australian med school entry exam. Ultimately, I decided I would be able to help more people today, with tools readily available (including a computer and substack) than spending the next decade of my life preparing for a medical career.
I would consider amending that part of my post to say something more narrow like "Not a pain doctor", but it seems more straightforward as it is now.
Very much agree it's critical to get an accurate assessment, ideally from a doctor who understands pain science to rule out a structural cause. In saying this, I recognise many practitioners are not fully across this so I'm hoping this series will help increase awareness.
This first blog is meant as a quick intro to the series - blog post #2 will break down the different categories of chronic pain (i.e. broadly including tissue, nerve damage and pain due to brain plasticity - what the series is primarily focused on).
Sounds like an interesting medical mystery.
Actually EDS is interesting because it became a fad I guess on TikTok to claim you had it like Tourette’s, further exacerbating the above issue.
It’s got a wide spectrum. My dad had it so lightly he was just considered “double jointed”. I gained a further thing from mom’s side, which seemed to interplay poorly. Spent 19-26 basically having extreme nausea and vomiting episodes every month or two, often having to go to the hospital to stop it. Had other weird symptoms and pains before that and during too.
Did every scan, met tons of specialists. Kept getting referred down the GI side, had gallbladder removed for no reason.
At one point I was convinced it was psychological. This was after a second doctor suggested it. It sent me down a dark path for a few years of trying to figure out what was wrong with me - didn’t help my mental state was terrible from all the uncertainty, and I had developed anxiety about eating since basically any meal could end up in hours of extreme pain. I was a total wreck. Then it just cleared up finally at 26.
It wasn’t until years later I got the EDS diagnosis, and then a genetic test showed the other immune condition. When looking at the two lists of symptoms it was such an intense moment in my life, finally having closure.
Extra fun fact, a deep research AI nowadays will actually suggest this as one of the treatments given a few paragraphs of information on the symptoms/medications tried/etc.
This is a big problem women have around menstrual cycle pain. "It's normal" is what many doctors say - particularly men. A woman I know was basically bed ridden for a couple days/month until she found a doctor who believed her and addressed the problem.
[0] https://apps.apple.com/us/app/reflect-track-anything/id64638...
Thanks!
Here’s an actual peer reviewed study evaluating a pile (over 1000!) symptom tracking apps, including Bearable.
https://www.sciencedirect.com/science/article/pii/S245210942...
As he does point out he is not a doctor and his solution is not backed by extensive medical studies.
He could just write a document laying it all out, and letting people download it, easier for everyone.
(and try to get some researchers do the chekcing).
This is damn close to snakeoil.
> by selling the "the cure" on a newsletter basis and using organic growth to make more money.
I am not selling anything, the information from what is happening -> to how to recover (if it is relevant to you) is and will be freely available on this substack. It is not paywalled and I'm not intending for it to be.
Additionally where are you quoting "the cure" from? I will be sharing information for people to use to self assess if it applies to them. Recovery from chronic pain is rarely simple as your quote implies - instead it requires daily concentrated effort.
> his solution is not backed by extensive medical studies.
Please read this study from 2021: https://jamanetwork.com/journals/jamapsychiatry/fullarticle/... https://pubmed.ncbi.nlm.nih.gov/34586357/
> He could just write a document laying it all out, and letting people download it, easier for everyone.
Readers are more than welcome to download an offline copy from their browser if they'd prefer to consume it that way.
> (and try to get some researchers do the chekcing).
This is a valid point and I'll see how I can integrate it into future pieces, even if it's just collaborating with (legitimate) researchers. Thanks.
Something to understand is until yesterday no one knew I was in this space. Me DM'ing a researcher and asking them to vet my writing would likely have at best resulted in them letting me know they're busy. That likely isn't the case anymore.
> This is damn close to snakeoil.
Happy to discuss this in more depth. I don't see which part is comparable to snakeoil.
Anyone who is accumulating weird pains in random, different locations should definitely pursue some of these alternative explanations. Another sign that these techniques are appropriate is if the pains come and go depending on your mood or situation (worse when working, disappear when doing something fun) or are prone to suggestion (someone talks about their back pain and then you have back pain for the following days or weeks).
However, I’m also getting tired of the people who benefit from this techniques deciding that their explanation for chronic pain covers everyone. It’s a huge trend in parts of tech Twitter right now to apply these theories to all chronic pain. A small number of people who had unexplainable pain and addressed it through meditation, therapy, and similar techniques are now pushing it as a far more universal explanation. It really needs to be applied to the appropriate situation, not used as a universal treatment for chronic pains.
This parallels similar trends with topics like PTSD, where a smaller group of people have benefited from therapy that addresses past trauma and now they’re trying to export the theory that past trauma and PTSD is the explanation for all psychological ills. Again, matching the right treatment to the condition is critical and being open-minded is important, but beware of people who are preaching that doctors are misinformed and you should subscribe to their app, blog, newsletter, or course instead.
On the second, I've mentioned it elsewhere in this thread (on a different comment) that it's critical to determine if a structural cause is at play (i.e. tissue/nerve damage or something else causing inflammation). It is unfortunate however that many doctors are not familiar with modern pain science so I'm hoping spreading awareness via patients (and some practitioners) will change this.
In the next few blog posts this very thing will be discussed (i.e. exploring when it's likely something is mind related vs the body [though I will focus primarily on the former in this series] - as you're 100% correct sometimes it's the body and sometimes it's the mind, and sometimes it's both!).
But soon after, I developed constant headaches that never went away. At first, I assumed they were related to the procedure, but everything had healed well, and multiple check-ups didn’t reveal anything. Since then, my braces have been removed, but the daily headaches persist. Occasionally, I also feel a strange “foreign object” sensation around the implant site.
A follow-up CT scan of the implant showed perfect integration with the bone. I’ve also had other tests done, including a head MRI. Medically, everything appears normal.
It’s getting really hard to manage—painkillers don’t help at all. Has anyone experienced something similar or have any idea what to try next? I’m even considering having the implant removed, despite there being no medical reason for it.
The pulp in the teeth are quite sensitive and can inflame easily, and that inflamation has nowhere to go (being bound by the hard sides of your teeth and jaw), which can lead to constant pain. I once had a routine filling that took about 3 months to stop aching and I had to take ibuprofen every day during that time to be able to focus. Per the dentist, constant aching pain = it's slowly healing, leave it alone. Sharp intense pain = pulp is dying, need root canal. Granted, this is pain the mouth and not in the head like you described.
If it's been a while and it's still bothering you, I'd definitely consider having it removed too. It would suck to remove it and still have the headaches, but at that point you can start looking at other causes.
To folks dealing with physical pain, I recommend: Built From Broken by Scott Hogan, Rehab Science by Tom Walters.
For joint issues these may help: celadrin, pro-resolving mediators, red mineral algae w/ aquamin, natural eggshell membrane, collagen peptides w/ fortigel.
I recently found out after a violent burn-out that a significant cause was chronic stress and its psychosomatic symptoms. It made me have a hard look at the topic, and I'm gradually adjusting to solve the issue.
If I get better, I'm tempted to do as OP and spend more time working on this issue for others. It seems so much more impactful than grinding the tech / startup life.
Thanks for sharing. I am walking down this path as well. In my experience I can tell I'm deeply out of alignment and it wreaks havoc on the body. My soul says to X but my mind says do Y, it's safer, maintains a stable status quo, income, and relationships, etc., even though it's slowly killing me.
Several doctor visits concluded that it was the long hours and insane amount of stress that was severely crushing his immune system.
Moral of the story is love what you do and take care of yourself: nothing is as important as your own health and happiness
In stressful periods, it's likely not stress crushing the immune system, it's the indirect relationship that stress causes bad quality sleep and low amount of sleep, that in turn crushes the immune system.
If, even if under stress, you manage to work out a system/habit that allows you to get proper sleep, you'd likely be ok.
To me that's the real question. I think either option is defensible, depending on what one values in life. I've known certain people who pulled 80 hour work weeks for years only to give away double-digit percentages of their salaries to charity, because that was what was important to them, and I don't think they were wrong for doing that, just making choices at a margin I would find intolerable far earlier.
He may need his tonsils out. I got mine out in my 30s. It was 3 painful weeks to recover but my quality of life is a lot higher.
Ticks all the boxes:
- not a doctor
- not a physical therapist
- offering tips to solve your pain that somehow nobody could
- emphasizing a single "landmark" study with no other context
- results based off of personal experience
Guy is trying to become the RFK Jr of Aussie land.
First: With the exception of extreme health issues (e.g. Cancer), you likely have a good chance of resolving your health issues. Don’t be discouraged by your chronic pains and think you have to now live with the pain or health issues for the rest of your life. Tackle your health issues like any other engineering problem: understand the problem, make a plan, execute, monitor progress, and iterate over this process (e.g. revise your plans). If you do not take action, nothing will change.
Second: Stress is a killer. I’ve had to visit the emergency room twice because I thought I either had a heart attack or I was dying from high blood pressure. I was way too into my work (due to both passion and commitment), that delays with my projects gave me high mental pressure. Upon re-evaluating my life, I asked myself: which is more important, my work or my health? Once I started prioritizing my health and started pushing back on unreasonable timelines, my stress is gone and none of the chest pain, headache, and high blood pressure issues have come up again.
Last but not least: Your body is a very complex machine and you need to learn how to use it correctly. I had a very sedentary lifestyle and had many chronic pains, e.g. heels, ankles, knees, hip, elbow, wrist, etc. My body was so weak that I even injured my neck and back once just by sleeping in a not-so-great position. I found an awesome PT who specialized in holistic physical therapy and he helped address issues from my feet all the way to my neck. I am now able to resume all the activities from my younger days such as DDR & tennis. There’s too much to explain here but I have two key takeaways: one is my body was extremely tight & inflexible and PNF treatment from my PT was needed for recovery, and another is I just didn’t know my body and muscles well. I did not know how various muscles work, how to use my body & muscles effectively, and what exercises to do and their correct form. Learning and doing the exercises properly and frequently changed my life. Btw: I highly do NOT recommend all the YouTube fitness videos - you simply just cannot tell if what they’re saying is correct and whether their suggestion is even the correct remedy for your problem.
That is all. I wish everyone good luck in addressing their chronic pain!
In 2017, I was laid off of my job (of almost 27 years). I immediately started looking for work. Since the company I worked for, was a marquee-name company, I assumed that it wouldn't be hard.
Boy, was I in for a shock.
I almost immediately learned that no one in tech, is interested in hiring a 55-year-old, regardless of their pedigree. I could have gotten a job, but those companies made it clear that I would be treated quite badly.
So I made the decision to just throw in the towel and retire. I had the means, but I would have liked to have at least another ten years of salary. I have never had any intentions of stopping working, though. I love developing software. It's a hobby and a personal passion; not just a job.
I was really pissed off at the treatment. I suffered great butthurt.
But in the long run, it's the best thing that ever happened to me. I never realized how much stress I was under, while working. I sincerely believe that, if I had kept working, it would have killed me. I have no intentions of returning to the rodent rally; even though I'm quite good at what I do, thanks to all the learning that I've done, in the last eight years.
I now work every day (my GH Activity Graph is quite green), and do a fairly good job on my chosen projects, but I no longer feel that awful weight on my soul.
Sometimes, the only way that we learn how much pain we are in, is to stop suffering it for a while.
My comment is off topic but I have to chime in: while I'm sad to hear of your bad luck, this is YOUR experience, and it is not universal.
At 54, I got my highest paying job ever in tech after being walked out of a "marquee-name" company after 24 years. This was three years ago. There is a tremendous need for senior engineers in smaller companies. The main reason is that all the A+ engineers (clearly I am not one!) have retired from decades of fat equity compensation, and those of us at the B+ level (or me who financially screwed up) are actually now a rare commodity.
So hang in there, greyhairs are still valuable to smaller companies.
I should say that I wasn't particularly interested in a "good-paying" job. I was set, already.
I wanted something that I found interesting.
The places that would hire me, had crappy work.
The places with the interesting work, had no interest in hiring me. Saying that it's because oldtimers are expensive, is a red herring. I would have happily taken half of what they pay people with half my expertise.
In any case, it's all good, now. I have no interest in returning to work. I'm having way too much fun, working harder than I ever did, without managers pissing all over my work.
My own impression is that the software industry is one of the industries where experience and qualifications are completely divorced.
So from my perspective one is really always back at square 0 when looking for jobs - including the need to prove oneself and stay humble.
I actually had one refuse to look at my [extensive] code portfolio, because "I probably faked it." One of the luxuries that I had, which I am eternally grateful for, is that I don't have to eat shit.
If reacting badly to that kind of treatment is "not humble," then guilty as charged.
I should add that I am a high school dropout, with a GED, and no matriculated education. Despite that, I ran a "skunkworks" team, employing some very good engineers, and was kept on by a very demanding Japanese corporation, where I was given an insane level of trust.
I'm pretty used to having to prove myself. I've spent almost my entire career, looking up noses. Someone with my background won't make it far, unless I know how to work well with un-humble people, and deliver the goods. I never was given much latitude. I wasn't really allowed to fail.
not a cure and barely a treatment but it's one of the only tools in the toolbox
Modulates endorphin receptors (by blocking them for a little while)
Not only causes the body to produce more endorphins to reduce pain but is actually proven in studies to make the ion channels work better if dysfunctional
I have had chronic pain and other annoying functional neurological symptoms for the past 4 years. It started about halfway throughout my PhD.
I was born with congenital torticollis (fibrosis of the right sternocleidomastoid muscle) and had surgery for this twice when I was young. I also had 3 other surgical procedures for different reasons as a child.
Because my pain started in my neck and shoulder, I was set on believing that my previous surgeries were the cause of my pain. But as I learned more, meditated more, did yoga more, and faced pushback (and lots of confusion) from health professionals, it became clear that my symptoms are mainly "mind-body" (I hate that dualistic term).
I'd be very interested in talking more.
It seems to be relatively common and under diagnosed. Also somehow controversial and not fully understood
However, looking into it might shed some light on some issues of chronic pain and potential ways to address it
What really struck me was that 1) the midwestern neurologist seemed to have never seen symptoms like mine, whereas the Stanford neurologist had seen them often, and 2) the Stanford neurologist linked it to poorly managed anxiety. At the time I was five years into a data scientist role at a big tech company in the bay area (now it's two year later - the symptoms improved somewhat but are still there). I definitely had burnout and mental health problems and was in denial about them ("I have all these great perks, how could my work be causing my mental health issues?").
The best thing you can say about BFS is it isn't physically painful; I am definitely not equating it with the chronic pain issues that others have described on this thread, which seem much tougher. It's another one of those things that has no known cure (diet / lifestyle / mental health improvements help somewhat), is only vaguely understood ("your nerves are oversensitive"), is linked to mental health issues, and seems overrepresented in the bay area (maybe in other tech/urban centers too, I don't know). Two years in, I don't have any answers, just wanted to share in case it's helpful to anyone.
I have 15 years in data, and 10 years in machine-learning. Back in 2016, I couldn't find a job doing machine-learning. These days, I don't worry anymore about finding work. Things have improved.
The "mind-body" thing is a great tool for doctors who are into abuse and take pleasure in having power over their patients.
"You are still having chronic pain, because you are not working hard enough!"
"No, I will not prescribe you medication. The pain is in your head!"
Oh and abusive partners also love this crap. You have a flare up? No you don't! You are just a lazy slob who doent't want to work and is whinging like a little baby. Stop imagining your pain!
GTFO with this crap.
In reality , nothing more than grifters. I wouldn’t be surprised if there’s a book or "masterclass" pitch at the end of this series.
I myself for example have had headache and migraine issues for more than 25 years. I understand deeply an incredible amount about what causes my migraines, how they feel, how I help with it, and so on. I understand migraines more than anyone else I ever know in my life because I observe, pay attention, study, and try different things so much. I understand it more than most doctors I talk to. But I also know that everyone's migraines are a little different and not everyone gets triggered by the same things (though there's a lot of overlaps) and my solutions may not help for everyone. I'd totally write something like this for migraines if I had the time (I don't :( ).
unnecessary disclaimer here. when it comes to chronic pain treatment doctors are mostly useless or even harmful, proposing surgeries or drugs that will do more bad than anything else because they have no interest in learning how to customize their approach and will parrot and prescribe what they heard from medical representatives. Remember, the opoids crisis was enabled by doctors in the first place.
Those stupid pain face charts you see at hospitals, physician offices. Purdue marketing, nothing else.
Everybody is shitty here. This is what happens when a market has loose regulations.
it was enabled by doctors accepting kick backs for the prescriptions (legal ones but still kick backs). And lets not forget that medical professionals are supposed to have eyes. When most of your patients get strongly addicted to the drug you are prescribing, you are supposed to ask questions not blindly follow what a company tells you.
Our bodies aren’t meant to be in one position for that long no matter the ergonomics unless you know what you’re doing.
Lots of people mock tiktok for the dancing but in observing the dances, I’ve grown an appreciation for full range of movement and trying to increase range of motion in the joints
I was able to find some exercises that helped in this to decompress but I can go into more detail if people want
I started the holiday super jaded with the idea of working in tech forever. I spent my time on everything but tech. Recently my passion has been reignited and I’ve got more clarity around what it is about tech and my career I enjoy, and what I want from my future.
Now, I’m working on a healthcare service for chronic disease.
I wish I could go back to completely undistracted building, but I realize now that I was a bit addicted and that level of intensity was hurting me.
Now what occupies my waking hours is, "How can I debug this failing system?"
The best I've been able to find is kratom, but that's not without its concerns -- drug laws are no friend to pain patients (let alone society as a whole).
Pro tip: get a shingles vaccine if you are able to -- postherpetic neuralgia is no fun.
As stated at the end, the authors of the study have a lot of conflicting interests.
I can't comment on the conflict of interest as I do not know the practitioners personally, but from additional/supplementary research in this space as well as the massive amount of people this work has appearerd to help recover (look at reviews/discussion for books like the 'The Way Out') - it does seem to be having a big impact.
I'm aiming to link supplementary research in follow-on articles (e.g. the relation b/w pain and injury where nociplastic pain is present, the impact of psychological factors on pain etc) to paint a comprehensive (yet digestible) picture.
I asked chatgpt to explain this to me and it did a poor job.
Generally speaking in my friend group. Chronic pain used to be opiods; though long ago medical cannabis came along. I couldnt tell you how many people i know who arent stoners who got into the cbd thing and fully got off opiods. 1 addiction for another, but at least cannabis has far less negatives.
>If you don’t have chronic pain and you’re just here for vibes and to see some cute brains, I really appreciate you .
The problem, CBD never fixes the pain. ~8 hours later you need more.
There's no business case for solving chronic pain. Here's my take.
1. There can be cases where there's something legitimately physically wrong causing chronic pain. In detroit I had a friend who got shot with birdshot, a tiny pellet was in his spine that surgeons didnt want to go after but there's no getting away from that pain. If this is the case, you're not seeking explanation.
2. There's stress/emotional pain. "The body keeps the score" by Bessel van der Kolk. He's big on EMDR and yoga. Your achilles pain and such absolutely could be, Probably something like 'change or abandonment' one of my favourites for yoga: https://www.youtube.com/watch?v=2XhJ63OQ7Ww
Do that 23 minute video and see if it helps.
3. Mindfulness meditation. Get into the most comfortable position possible. Dont move; and far more difficult dont think. Your mind will wander. If the pain is in your achilles. The only thing you're doing is monitoring the pain. What's the exact shape of the pain? Is it 4 inches long or is it only 2 inches? Is it sharp like a knife, or is it round in shape? Do you have any taste, smell, or sound from it? You need to wait as long as you have to, maybe it only makes a sound every 2 minutes, you have to wait and your focus is only on waiting for the sound and nothing else.
4. Yoga nidra or progressive muscle relaxation. Start at your toes, you try to flex the muscles to the maximum and hold for 5 seconds, release. then do your feet, ankles, legs, every muscle has to have been flexed and held for 5 seconds. Then when you're done, you simply do nothing at all. dont even focus on anything; maybe your breath at most.
100%, medication plays a great role in providing comfort and support but it can be ineffective (and often harmful) if relied on solely for recovery from (neuroplastic) chronic pain.
> There's no business case for solving chronic pain
It seems some parties may be incentive aligned (e.g. insurers in Australia) - though I'm still navigating this space to find an approach which makes solving the root cause viable. Keen for your thoughts.
> 1.
Sorry to hear about your friend. This is often referred to as a structural diagnosis - i.e. where a knowledgable/proficient doctor has diagnosed there is legitimate tissue (nociceptive) or nerve (neuropathic) damage.
> 2.
Yep! This is what the series will be targeting, data points to a substantial percentage of chronic pain sufferers solely (or partially in comorbidities) being impacted by psychological disorder (otherwise known as neuroplastic pain / TMS / and a few other names!). There are a lot of causes and factors which have been shown in research to date, but largely it's adverse childhood experience, stress, personality traits, and more.
Will check out that vid!
> 3.
Related to this, there is an exercise called somatic tracking which has helped many people (including myself) - during it people often notice pain shifting throughout your body. This was a big turning point for me seeing how my mind behaves in real time. https://www.youtube.com/watch?v=Lw1D_UvzIDA
Medication can help you get out of a local maxima, sometimes with pain the issue is that your nervous system is hyperactive and just constantly firing which feeds back into itself in a positive feedback loop. If you can take pain meds and/or nerve blockers it can help break that loop and let you do things like go out and walk, exercise, live a life where pain is not always on the forefront of your consciousness. That in turn can let you get into a better state and break the local maxima and then you can wean off the meds.
If however, you do not change your lifestyle/condition when on the meds things will not get better long term as your body will lose responsiveness to the meds.
I am not a doctor.
Ive been sort of part of this sort of approach before. I was sysadmin, not a suit. These do tend to work out.
This is also the mechanism for how they squash and hide stuff that would cut into tylenol sales. Dont sell it, license it for periods of time is my recommendation.
Or you seem to agree much with my post. Put it together. The chronic pain fixer upper place that takes in patients and explains these things and trains them. You hire the emdr and yoga folks.
>Will check out that vid! Big fan of the body keeps the score.
It helped me for sure. I really need to try EMDR but never have. Id bet it works great. Adrienne is one of my favourites, but the science actual says slow yoga is more effective; whereas she needs to go quicker for video length.
>Related to this, there is an exercise called somatic tracking which has helped many people (including myself) - during it people often notice pain shifting throughout your body. This was a big turning point for me seeing how my mind behaves in real time. https://www.youtube.com/watch?v=Lw1D_UvzIDA
3000 year old religious ritual :)
Its very interesting to me how science when i was young called this all hoo-haa pseudoscience but is now giving it a new name and saying it works.
You know what's interesting, my post is pretty heavily downvoted. I wonder what people disagreed with.
THC amongst its most minimal side effects increases my pain, not decreases it.
I would suggest everyone try everything that is open to them, but cannabis is not a miracle cure for every ailment.
It was my experience, and common knowledge in my circles at the time that THC made pain way, way worse, at least in resin form.
Probably simply because you'll tend to isolate things and focus on them very strongly when under the influence, it makes you notice pain more. I remember toking some days after a knee surgery and regretting badly having done it. So much pain I hadn't noticed...
Same.
>THC amongst its most minimal side effects increases my pain, not decreases it.
I had green card before canada legalized and thc was my main go. Higher potency just meant less smoking needed.
Alcohol was what increased pain for me.
>but cannabis is not a miracle cure for every ailment.
For me, I cant do cannabis at all anymore; but you'd be surprised how effective it is as a medicine for a lot of people.
