To treat back pain, look to the brain not the spine
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The majority of people don't want to be on pills. They want to get better. If I'm in too much pain to physically get out of bed, how am I supposed to exercise? It sounds like this is just an advertisement for CBT, and 90% of it is summed up as "get an anti-depressant" and "go to therapy." Well everyone is already doing that.
I mean, are we really going to suggest everyone in the medical industry related to pain management is just a scam? That doctors don't try a mirade of tools to help their patients and instead just throw addictive pills at them? Surely some do. But who says "I want to go to medical school to sell pills" instead of "helping people"?
I don't know. I find it hard to analytically process this article since I'm so close to the source. But I literally spend >60% of my days in complete writhing agony. I had to FIGHT to get the medicine I needed and I had to FIGHT to get the back surgeries that took me from almost dying to "surviving." So if the world is really handing out pills and surgeries, it sure as hell wasn't doing it in my area.
I'll never forget having a migraine come back on as I was leaving the ER one night. They had already dosed me up well. All the drugs did though was make me not care that it felt like an ice pick was boring into my head. Still felt the pain.
I've lost way too many things to this pain over the years. It's awful.
They have almost disappeared since I switched to sleeping in a really hard Japanese futon and I switched to an active chair at work (search for Peter Opsvik).
It turns out my migraines seem to originate from extreme muscular tension in my left neck-arm joint.
My latest abortive measure was to apply infrared heat to my trapezius muscle (all the way up to my forehead), tens to the base of the trapezius and back of my neck, and go into the "crocodile" yoga pose for an hour. (I used a very light pillow to make it more comfortable). It took doing all of that over the course of 60-90 minutes and the migraine subsided.
ALSO: Research the anti-inflammatory nabumetone. I don't know why doctors don't bring it up. (not additive, no high)
Do you work remotely? I assume laying isn't an option in an office. Even standing, it may be frowned upon in more conservative work places.
For the record, this is what a good physical therapist would have prescribed.
The issues that come from running are related to where you start from lacking knowledge and lacking physical health. Knowledge guides interpretation of pain(what different types of pain mean, when to stop when to push through). Understanding pain is a communication skill that very few people will teach you, but in my opinion is more valuable then literacy. Knowledge also enables positive feedback loops concerning form and efficiency of movement.
Physical health is the structal integrity of the core and stabilizer muscles. Each of these items are on a sliding scale, and somewhere in that scale is a tipping point where if you pass under it you are hurting yourself instead of healing yourself. I hypothesize that 80% of our population falls on the injury side, but that this could be solved with education and PT.
I'm glad you didn't give up, or had the nerve to push past anyone saying "that's just the way you are, you can't fix that" because I feel that statement couldn't be further from the truth.
Do some strength training and some playful sport instead, like basketball or BJJ. It's fun, you'll look good, you'll move well, and you'll get confident with people, all in 2-4 hours per week.
You also need to do some kind of strength training. A push, a pull, a spinal compression and a spinal tension. Eg pushups, rows, squats, pullups.
Otherwise your core will be weak and you will be missing key stabilizing muscles that prevent injury when you are in an unusual position, like picking up a suitcase or changing a tire. Which is exactly what causes back pain.
Also I'm looking for ways to put together a workstation in the horizontal position
But to get started, deep breathing I feel has had an affect on my overall core strength.
At times, you'll feel like a moron. Deep, deep breathes. I'd suggest starting off for session of like 5 or 10 minutes. It doesn't matter how you do it. Just breathe deep as a practice. But if you need something to get started: something that's standard is X second in, X second hold, X second release. You probably won't be able to do 8 seconds. So start with 4 seconds, and move up.
Then there's deadlifts, squats, bench. Core functional movements. You should feel your core expanded, and activated. You should be recruiting these muscles when doing these movements.
But yoga. for real dog.
Tldr; yoga is great , but not for all.
This is important. Yoga is very powerful and I think everyone should incorporate yoga movements into their fitness regime.
However, typical yoga classes and even established yoga movement series (like the Ashtonga primary series) are heavily weighted towards forward folding/bending which is the last thing you want to do with a weak/injured back.
This doesn't mean you shouldn't do yoga - it means that you should understand the physiology of a bulging/blow disc and build up your strength (perhaps with other yoga exercises/poses) to the point that you are strong enough to do that forward folding ... and even then maintain caution and moderation.
With a fully rehabbed/asymptomatic L4/L5 I am doing heavy freeweight squats and deadlifts and even inverting during BJJ - but I would still be cautious and even modify portions of a typical yoga class ...
The problem is , most yoga practitioners (atleast the ones I consulted in india) consider it like some sort of magical cure for everything. I was asked to do surya namaskar , despite them knowing I had back pain . I went to one of the most reputed centres here, and all I got from them were pseudo science mumbo jumbo.
I have got much more valuable info from this HN thread. Thank you for sharing for you experience. Your story has given me hope , I feel motivated to learn more about backpain and find a solution tailored for me.
I also feel this sort of information (personal stories of knowledgeable people) should be more easily accessible for people.A non profit , trust worthy website like Wikipedia, or even a github wiki.
Do you remember the exact conditions when you fell down (movement, which part of the day, what did you do before, etc). Have you been practicing yoga alone or with a teacher, group?
Did you went in and try figuring out what caused your pain? Are you on track with it now? If yes, what has changed? Will you go back to your Yoga practice or you feel that it is dangerous for you?
Thanks!
I felt ready to start exercising and zeroed in on yoga. I started practicing with a group of people , led by an instructor. It was very intensive (hatha yoga) and most exercises involved stretching your arms and touching your feet.Other exercises like the bow pose, crow pose and head stand was also there. Sometimes, while I was sitting and touching my foot, the instructor would use his body weight to push my spine down from behind so that my stomach touched my knees. This may be the reason , but am not sure. So, after 3 months of this , I felt better and fitter than ever before and joined another yoga studio near to my home. Here, the poses were not as tough as the other place, but was done considerably faster. 1 month after joining there, I am bending down to touch my knees , and lightning strikes.I couldn't walk and was bedridden for a week. The time must have been around 7 pm. I went after work and did some warm ups as usual.
Coming to the reasons, I can think two things : the instructor exerting his force on my spine and the faster pace of the exercising. This is onle conjecture though.
Right now ,after some months of physical therapy and no other exercise, I have no pain while sitting.
I certainly plan to go back to my yoga practice. However , before I do I need to get some expert advice and some tests done.
I hope this answered all your questions!
Edit:just to be clear, the two reasons I stated are in addition to the main point I made, that some yoga poses are not safe for everyone.
The comments about the dangers of doing yoga are valid, but every sport or exercise can be dangerous depending on your condition, even swimming which is usually recommended as a safe sport. General tips are: ask your doctor for movements that you should avoid, tell your yoga teacher about your condition, if it hurts don't do it. More importantly I think, is for you to understand your condition. Read about it, feel your body and how it reacts to each exercise.
For example, even though I should avoid back bends they still help me build strength and improve my posture when done carefully. I am always aware of that during my yoga practice so I either skip the back bends or I do them softly, depending on how I feel.
I tend to avoid recommending specific exercises - instead I like to recommend that you think of your trunk in three dimensions and apply weight bearing loads to at least every 90 degrees around that circle (which implies at least four exercises).
So that would mean your flexing your back, your abs, and each of your two sides (Abdominal external oblique, I think).
I personally try to hit every 45 degrees (which implies at least 8 exercises).
You need to try a lot of different exercises and find the ones that work for you and for your body type.
And you need to walk.
You can do 50 different trunk/core exercises and you will never hit every single muscle and combination of muscles the way that walking does.
Your body is a walking machine. You were built to walk. Walking will heal you. It will be painful and difficult at first - when I blew out my L4/L5 I needed to lie down for an hour after walking 4-5 miles. That doesn't last. Your body will tighten and strengthen up all the right muscles to hold your back in the most natural and healthful position it can be in - the one that supports walking.
And frankly, even if the system doesn't work for everyone, the way you have deconstructed it into 45 degree angles is something I have never come across before, so kudos to you for figuring this out.
I have the same question as the sibling. Where did you read about this stuff?
Anyway, I recommend that people ask their doctor for advice or at least Google up a bit about the pros/cons of this and try to find articles from reputable sources. I did that some time ago and wasn't very impressed with the results.
If you don't mind, could please tell me how do you lie down and work ?
Since I started suffering from back pain , I was thinking if something like this was possible. I was also afraid it would fuck up my eyes, have you had any problems of that sort ?
I have three "workstations" at my office - two of them take place at my adjustable height desk. I can stand or sit.
I also have a full sized couch that I can lie flat on. I prop my laptop up on a pillow just like you might at home.
I move between these three positions as it suits me and can avoid completely any kind of fatigue or unhealthy postures.
I hypothesize that a majority of depression suffering is sourced by subtle spinal/nerve injuries, which the brain could interpret as death. Once a strong enough signal develops in the brain that's saying, "you're in pain, all the time, you probably should isolate yourself and kill yourself" it's not hard to see how that could lead to depression and suicidal thoughts.
I'm not going to bore you with my story except to say, looking back, I'm amazed I was able to endure such pain for so long. I cry sometimes when I remember it.
I too had to fight to get the treatment I needed to "survive". Surviving was still miserable and I was always at the mercy of my pills and my health care providers. Thank god I make good money and managed to remain employed. I don't know how the average person could have afforded to pay for everything modern medicine has to offer like I did. Scans, injections, surgery, pills, PT...
May I suggest that an expert (I mean a top doc) in traditional Chinese medicine can take you from surviving to truly living. There are some things Western medicine truly excels at and for that I am grateful. However it does have blind spots. Some of those blind spots are perfect for eastern medicine. I thought it was vodoo bullshit but I found a few providers that legitimately changed my life. Plenty eastern medicine docs were total quacks. You get that in the west because it's fairly unregulated. I was lucky to stumble upon some of the best, people who even publish.
Needless to say, he healed my pain, and more. Sadly, he retired about 7 years after I met him. I've not found anyone like him since, and I've tried.
>“Even though I believe we should promote Chinese medicine,” Mao told him, “I personally do not believe in it. I don’t take Chinese medicine.”
> In 1923, Lu Xun, China’s most famous man of letters, reflected critically on his father’s visits to a Chinese doctor, visits that bankrupted the family and failed to produce results. “I still remember the doctor’s discussion and prescription,” Lu wrote, “and if I compare them with my knowledge now, I slowly realize that Chinese doctors are no more than a type of swindler, either intentional or unintentional, and I sympathize with deceived sick people and their families.”
http://www.slate.com/articles/health_and_science/medical_exa...
>...Mao’s strategy to deal with these criticisms was quite deliberate—and clever. It consisted of two strategies, both designed to mythologize TCM as being a scientifically sound and harmonious “whole medical system” and to provide “evidence” in the form of testimonials that it worked... "Textbooks were written that portrayed Chinese medicine as a theoretical and practical whole, and they were taught in newly founded academies of so-called “traditional Chinese medicine,” a term that first appeared in English, not Chinese. Needless to say, the academies were anything but traditional, striving valiantly to “scientify” the teachings of classics that often contradicted one another and themselves..." The second part of the strategy was the dissemination of spectacular anecdotes to “prove” the efficacy of TCM.
http://scienceblogs.com/insolence/2013/10/25/chairman-mao-in...
https://www.google.com/search?q=traditional+chinese+medicine...
I don't argue with them. Because at one time I knew TCM was bullshit too.
Then we have this other cohort of people with chronic issues who exhausted, or are unsatisfied with, the treatments offered by western medicine. They go on to discover TCM, are healed and then swear by it.
I can't explain this stuff. I think it's weird, but it works.
I mean, you could say I'm a hypochondriac or I have some sort of psychosomatic illness... but I have the scans, labs, and diagnosis to prove it.
shrug
Except... I'm in that cohort. I've been through the gauntlet too - years and years and thousands of dollars of both real medicine and what I now accept to be fake, that I reached for in desperation. So, I see your anecdata, and raise mine. If only we had some rigorous methodology for determining which conclusion is the correct one, as far as we can tell from the current evidence...
Moveover - trying to present evidence for a field that >specifically< shies away from evidence-based conclusions is a rather silly, IMNSHO. It worked for Mao because he wasn't trying to cure anyone: he was explicitly trying to fool people.
Western medicine may be incomplete, ineffective and often wrong, but it's not founded in willful bullshit.
That being said, there are many ailments that aren't adequately treated by Western Medicine - either because we don't know enough yet or are still constrained by the profit motive to find solutions to symptoms, not cures and whole well being.
http://spartascience.com/blog-post/strength/deadlifts-can-cu...
Note: if you haven't, even though I strongly and emphatically recommend it, its almost certainly best to start with a coach who can teach proper movement mechanics.
It doesn't work for all people.
I get the impression that katastic has made genuine effort to engage in a wide range of treatment, and is still not getting much if any pain relief.
People find it weird that we still don't have good treatment options for some types of pain, but that's the reality. Some people just have to live their lives in near constant pain.
Here's the Faculty of Pain Management with some information about pain: https://www.rcoa.ac.uk/faculty-of-pain-medicine/opioids-awar...
And about the challenges of treating long term pain: https://www.rcoa.ac.uk/faculty-of-pain-medicine/opioids-awar...
More on topic, I'm an anecdote of someone who squats and deadlifts to prevent pain in my back and hips. Stopping for a couple weeks usually allows the pain to return.
> Recent studies have indicated that the deadlift exercise may be effective in decreasing pain intensity and increasing activity for most, but not all, patients with a dominating pattern of mechanical low back pain. This study aimed to evaluate which individual factors measured at baseline could predict activity, disability, and pain intensity in patients with mechanical low back pain after an 8-week training period involving the deadlift as a rehabilitative exercise. Thirty-five participants performed deadlift training under the supervision of a physical therapist with powerlifting experience. Measures of pain-related fear of movement, hip and trunk muscle endurance, and lumbopelvic movement control were collected at baseline. Measures of activity, disability, and pain intensity were collected at baseline and at follow-up. Linear regression analyses were used to create models to predict activity, disability, and pain intensity at follow-up. Results showed that participants with less disability, less pain intensity, and higher performance on the Biering-Sørensen test, which tests the endurance of hip and back extensor muscles, at baseline benefit from deadlift training. The Biering-Sørensen test was the most robust predictor because it was included in all predictive models. Pain intensity was the next best predictor as it was included in 2 predictive models. Thus, for strength and conditioning professionals who use the deadlift as a rehabilitative exercise for individuals with mechanical low back pain, it is important to ensure that clients have sufficient back extensor strength and endurance and a sufficiently low pain intensity level to benefit from training involving the deadlift exercise.
Well I'm sure that even the addicts don't "want" to be on pills. The real question is how many people actually are unnecessarily addicted. Do you believe that most are not? If so how would you substantiate that? If you want I can start listing out anecdotal information that would support the opposite of what you are saying, but that would get us nowhere right?
If I'm in too much pain to physically get out of bed, how am I supposed to exercise?
I would email you, but you have no contact info. I imagine I will regret posting this. I usually do. Some broken part of my brain has yet to master hearing of someone else's suffering and going "Welp, not my problem!" It is still on my To Do list.
Some general thoughts, that may or may not be useful to you:
One of the benefits of exercise is that it moves lymph. This is how the body cleans your tissues. It is a necessary function for doing repair work. Think of how old buildings get rehabbed: The first step is to rent a giant dumpster and start doing demolition work and hauling out the trash.
Any muscle action at all will help move lymph. If you just can't do anything, warm salt water baths and massage can help your body take out the trash.
The other thing is you probably are dehydrated and suffering various nutrient shortfalls. The body needs resources to rebuild. After major surgery, you need major resources. Doctors never seem to prescribe higher nutrition during recovery. Additionally, medications routinely interfere with the absorption of certain nutrients or cause wasting of those nutrients. You should google this for every medication you take and up your intake of nutrients your drugs are known to deplete.
Spine surgery involves both bones and nerves. Nerves need extra B vitamins and specific fats to help heal. Bones need extra calcium, magnesium, vitamin D, vitamin K and B vitamins to help heal. Bone marrow needs healthy fats.
Some best practices:
Keep a food journal. Read up on symptoms of specific nutrient deficiencies. Taking supplements is easier at first than making dietary changes because you can do a better job of isolating specific variables because you can just add X nutrient instead of swapping one food for another. Do one new thing every week or two so you can watch how it plays out.
Sugar, mint and non drug antiinflammatories (like cinnamon and hot peppers) can help make pain more bearable.
Source: 16+ years of firsthand experience. (I used to be bedridden, and I spent 3.5 years in please-kill-me-now pain. I got myself better after doctors basically wrote me off.)
https://en.m.wikipedia.org/wiki/Lymphatic_system
It is surprisingly hard to find a figure for the amount of increase or a study. I say that because I know I have seen this info before and without digging for it. I have no idea why I recall it as easy to find in the past when it seems so hard to find now. But I did find this study:
Exercise increased the clearance rate three- to sixfold
http://onlinelibrary.wiley.com/doi/10.1111/j.1469-7793.1997....
Potentially also of interest:
http://www.bbc.com/news/health-26530269
http://gizmodo.com/why-standing-in-one-place-makes-your-legs...
It is trivially easy to search for "exercise moves lymph" and get a bunch of stuff, but probably not the kind of stuff people on HN want to see.
An interesting development is that there is generally an increased acceptance for psychiatric diagnoses. More are accepting that just as the pancreas may stop delivering insulin, the brain may fail to uphold the proper seretonin levels. Unfortunately it is not as simple as that, fixing seretonin or any other substance is like pouring oil over an engine and hope that it reaches the target. Still, I'm sure that we will see a huge change as true targeted treatments are no longer just sci-fi. Getting people to the right specialist is until then a good start.
Psychiatry is the only medical specialty that has a resistance movement and survivors groups. I think psychiatrists do okay with diagnosis, but commonly-used treatments frequently make the patients' condition worse. Ref: Whitaker's Anatomy of an Epidemic
> More are accepting that just as the pancreas may stop delivering insulin, the brain may fail to uphold the proper seretonin levels.
The MAOIs were reasonably effective as anti-depressants, but fell out of favor as newer & less-effective patent medicines were approved. The SSRIs are slightly better than a placebo, for some patients. I think the Paxil hawkers recently lost a lawsuit over a lawyer who rapidly became suicidal after starting that drug. He threw himself in front of a train: https://www.madinamerica.com/2017/05/change-in-chicago-playi...
This said, there are indications that there is a subset of cases where the pain actually is triggered by the spine. The SweSpine register has some interesting numbers that show the results after surgery over time (http://4s.nu/pdf/Report_2014_Swespine_Engl_ver_141204.pdf page 37, DDD). There is also the very fascinating study by Arlbert et al (https://www.ncbi.nlm.nih.gov/pubmed/23404353) that show that antibiotics may help. As always LBP is most likely a mix of diagnoses where we need to identify the correct subgroups before we even start to test treatments.
> I've seen patients spiraling down into an abyss of pain after repeated failed surgeries.
I think surgery is commonly seen as better than doing nothing. Someone I know has some deterioration from cortisone medications. He just heard that his neck implant didn't fail, now the next joint down is gone. He'd rather not have surgery again, but is rather miserable currently, and some doctors make their money by doing surgery...
Do you have any comments on Inertia in Medicine? Doctors try to stay up to date, but... well, cardiologists seem to resist acknowledging that statins don't actually help many patients, and psychiatrists are very resistant to admitting that antipsychotics prevent their patients from recovering from their psychotic episodes...
What does medicine do well, and how can use of practices and procedures with limited benefit be curtailed?
The biggest problem is that we often have a big problem with discontinuing treatment s, see my post on clavicle fractures http://gforge.se/2017/08/clavicle-gate/ I am not a cardiologist so I don't know the full details on the statins, but I would be careful not to skip them. Cardiovascular mortality has decreased hugely the last decades and this one of the major treatments - they must be doing something right.
Also be careful of flat-earth arguments, there are plenty of people who want to disprove medicine - some of us are researchers but others are just writing blog posts after finding a single article contradicting a treatment. It is incredibly hard to do medical research, it takes years to recruit patients and collect data. You always think that there is a ton of patients with this condition and then you find that the inclusion and exclusion criteria that you believed to be so brilliant (others had forgotten about them in their studies) actually get in your way of being able to finish the study. If this wasn't enough, once you are done with disproving the treatment, you will find that the person that a few years ago popularized it is no longer doing it... They would never do that, now they're doing treatment B, a completely different thing. It's a game of whack-a-mole.
> I am not a cardiologist so I don't know the full details on the statins, but I would be careful not to skip them. Cardiovascular mortality has decreased hugely the last decades and this one of the major treatments - they must be doing something right.
Statins cause massive numbers of side effects: http://www.skepticalob.com/2009/06/doctor-listen-to-your-pat... - this doctor figured out that an elderly patient's "progressive muscle weakness" was caused by the statin that he'd been on for years.
> Also be careful of flat-earth arguments, there are plenty of people who want to disprove medicine - some of us are researchers but others are just writing blog posts after finding a single article contradicting a treatment.
My girlfriend was grievously harmed with the injection of Depot-Provera ~10 years before she met me. This drug is known to be defective - usually it just makes women fat, but sometimes it makes them suicidal - but doctors inject it anyways. One theory is that depot provera was approved by the U.S. FDA because that agency's job is to approve drugs, and was long ago captured by the industry it supposedly regulates.
Medical apologists could say that Provera is very effective at preventing babies, so "they must be doing something right". But you have to ignore the carnage: https://www.youtube.com/results?search_query=depot+provera - "Depo Provera has destroyed me" has a compelling title.
Assuming there is good basis for common medical practices is a great impediment to medical progress.
I wish that we doctors were immune to the industry's influence but unfortunately we also sometimes fall prey to the cunning tricks. I think the OxyContin scandal says it all http://theweek.com/articles/541564/how-american-opiate-epide... Mind-blowing that doctors actually believed that there is a free lunch - a morphine product without addiction...
There is hope though, here in Sweden doctors during the 90:s were frequently taken to nice dinners and other events in the name of drug companies representative costs. In early 00 this basically disappeared and today we get a sandwich during lunch break in order to hear about the new thing that they want to sell us. I think the awareness of the "no free lunch" concept (see http://www.nofreelunch.org/) is much higher today than 20 years ago when I started med-school.
One cost that you have to be prepared for is that the system becomes "communistic": if we prescribe any drug that is outside the recommended set of drugs our clinic has to cover the costs. The adoption of new drugs is generally slower (although not for important drugs e.g. cancer treatments) and we are no longer allowed to make local deals with suppliers, everything has to go through centralized deals (even if we can get a better deal). In my mind it's a small price to pay if it keeps our patients safe and we get to spend the money on our health-care where it matters, but I think this system would never pass the American legislative system...
I've seen through meditation how simply learning to experience pain in a more productive fashion eliminates the vast majority of it. So much of the pain that I used to experience was the result of feeling a small amount of physical pain and my mind blowing it completely out of proportion. Learning to experience pain with equanimity rather than distress causes pain to recede into the background.
In addition to using disciplined thinking to control pain, I've also used it to increase the amount of time I can hold my breath from just over a minute to over six minutes. Like pain, the urge to breath is a little bit physical and a lot mental. Learning to experience it with calmness and acceptance dramatically reduced its power.
The tendency of modern medicine to look for a pill to cure everything is very dangerous when the problem you're dealing with cannot be objectively measured. The mind is a very powerful thing and it's measurements will always be at least partially the result of the patient's thought processes...there's no way to separate them. And with all the negative consequences of these drugs (both painkillers and drugs that target neurotransmitters have very serious side effects), there should be a lot more emphasis on patients exhausting all non-pharmaceutical approaches first.
It is hard to convince people of taking the slow route. This is a similar to convincing people to write unit tests for their code, we understand that it is the right thing to do but we always have a deadline. Some threads here report that they started with physiotherapy after years of other solutions, I would love to know how to change years into months.
For chronic pain, I've given the book Trigger Point Workbook by Davies which makes Travell and Simon's trigger point research easily understood by the layman tona few people and many have improved over time. I've seen carpel tunnel, back pain, scoliosis, SI dysfunction, TMJ all improve
Read "Healing Back Pain: The Mind Body Connection" by Jon Sarno.[1]
I lived with chronic knee pain for over 8 years, and would routinely have "carpal tunnel like symptoms" with my wrists.
Literally within a week of reading that book my knee pain was gone, and my wrists have not had any issues since. My personality type is exactly that described in the book, so it might not work for everyone. But boy howdy it worked for me.
[1] https://www.amazon.com/Healing-Back-Pain-Mind-Body-Connectio...
Edit: As it relates to the article - Dr. Sarno attributes most of the pain to your brain and unconscious emotional rage. It sounds kind of quackish, but he lays out excellent explanations of how your brain works against you to cause this chronic pain. I was a skeptical as well (I won't give away spoilers but the treatment plan is HILARIOUSLY simple) but it has really worked for me.
Seriously? This isn't a novel or TV show. That statement of yours just makes me think it is a scam.
You may want to read up about "tension myositis syndrome" on Wikipedia:
https://en.wikipedia.org/wiki/John_E._Sarno#Tension_myositis...
The bummer is there's no way to know if it's stress or not, but it doesn't hurt to give it a try.
In hindsight, I don't think I presented my question as accurately as I could. I wasn't skeptical of you, and your story, so much as I am skeptical of the results being broad, repeatable, and not due to something unknown. In other words, I am still a bit skeptical of this being viable for most folks,or even many folks.
You mention that you were receptive to the idea, and that makes some more sense. If I understand correctly, you did this by identifying and reducing your stress?
I don't want to ask medical questions, as I have no right to the answers nor do I wish to pressure you into disclosing things you may wish to keep private. The brain is a very powerful thing (though I remind myself of which specific organ it is that tells me that) and it is great that you found a solution.
I guess, I'm curious if there was more to it than being receptive at a specific time and having access to the book. I'm reminded of similar claims about religion and religious texts? That's not meant as a slight, it's just that I wonder if the mechanism is the same, if it's using the same parts of the brain, and things of that nature.
Alas, I am entirely unqualified to speculate, it's just curiosity on my part. It also makes me curious about myself. I'm in remarkably good health, more so if one considers my age and history. I sometimes attribute that to living a life that is virtually free of stress.
So, I wonder if there is more to it. I know low-stress is linked to certain health benefits, though I'm not sure of the rapidity or physiological mechanisms. I believe I read a study that correlated the placebo effect with a reduction in stress. I'm unable to find it, at the moment.
Either way, thank you for your answer and sorry for the novella reply. If you're curious, my low-stress life is due, in part, to being mindful. It works for me.
Again, thank you. I have some free time later today, I am going to do some reading to satisfy my curiosity. I am a doctor, but not that kind of doctor. It's just intellectual curiosity, though it may answer some of my questions for myself.
Do you have any online resources that you might recommend? I'm going to hit up Google Scholar.
i.e. the chronic physical pain is manufactured by the brain as a means to cope with (avoid awareness of) another type of pain.
so, if the person (somehow) becomes consciously aware of that original psychological pain, the brain stops creating the physical pain. the physical pain no longer serves a purpose at that point.
A proper academic with a deep understanding of what's going on but also able to translate that into pragmatic advice for people in pain.
Highly recommended. You can find various YouTube videos with him in then, which gave me the confidence that he was a knowledgeable geek and not some huckster. Often the videos are related to his work with high performance athletes, but his books apply to ordinary Joes or old people just as much.
If I can sum it up poorly, it's about understanding which muscles and bones work together in various movements and avoiding putting them under inappropriate strain, by slightly altering habits and building up muscles to provide support.
He is also skeptical of the benefit of surgery in most cases. He does also touch on some brain related stuff but it wasn't related to my particular pain so I don't know much about that part of his approach.
https://www.cathrynjakobsonramin.com/resources/2016/12/22/dr...
https://www.amazon.com/Healing-Back-Pain-Mind-Body-Connectio...
I had absolutely debilitating pain in a hip joint as if I had a handful of needles loose in there. I had it for several months, I had an MRI, a bone scan, tried physio, acupuncture and what have you with zero effect. At some point got a "procedure" scheduled for some sort of steroid injection directly into the spine column and was prescribed some nasty anti-inflammatory pills to "prep" for the thing (but in the end decided against the whole thing). The only thing that helped _a bit_ were the 600 mg Ibuprofen pills.
In any case, saw this book recommended here on HN, picked it up, read a quarter and realized that it applied. I was under an enormous stress at the time, both on work and personal fronts. On the work side I was running a one-man project with several thousand active daily users. On the personal end we just had a kid and the massive lifestyle change that came with it. A couple of days after realizing that the stress might've been the cause of the pain, the pain disappeared. Just - poof, gone. This was over 10 years ago and it never came back. The end.
The brain activity that people think of as being "just psychosomatic" is actual, physical changes that causes both direct perception of pain within the brain itself and also changes in the rest of the body that result in peripheral pain.
Stress doesn't just make you imagine you have joint pain, it actually causes it directly in measurable ways. Catecholamines are extremely powerful and if you start cranking them out because you're stressed, everything works worse, which often results in pain, which is of course an additional stressor.
Although to be a pedant, tooth drilling is apparently not quite nociceptive as it's the nerve being vibrated that causes an intense sensation that's easy to interpret as 'pain', I try and think about fireworks instead...
I started having back issues about five years ago. It got so bad that getting out of bed in the morning was a struggle. I was diagnosed with a herniated disc at L4/L5. I tried chiropractic, acupuncture, and massage therapy to no avail. Then I came across one of Sarno's books. I remembered Howard Stern singing his praises years ago on his show, so I decided to at least give it a shot. I was very skeptical, but within the first twenty pages Sarno had described my situation to a tee. I started following his advice and saw immediate results. I was back to running and doing yoga within a few days and a couple weeks later I was back in the gym doing dead lifts. Aside from an occasional flare up during stressful periods, I haven't had any issues since then.
However, I don't agree with Sarno's view that the mind uses pain as a diversion from psychological or emotional issues. I think it uses to pain as a way to get our attention, to let us know that we need to deal with those underlying issues.
It makes sense for a psychological component to treatment to be effective for stress-related back pain. And yes, stress can aggravate pain from a physical injury. But there are also plenty of physical injuries that aren't psychosomatic.
That is evident in most of the replies in these threads.
Now I can sit all day (and run) but I need a chair with a seat plate that can tilt forward (basically pelvic tilt while sitting).
If you're new to back injury the most important thing that they don't tell you is: the damage you do today to your back won't be evident until tomorrow. The feed back loop is way too slow.
In my experience, the best treatment for lower back pain is (once the cartilage is repaired) to walk, no matter how bent over you are, walk and walk some more.
I think the stretching etc can be helpful too but I haven't tried that. I'm just very careful about how I use my back when I'm bending over.
10 years of lower back pain. Average of 5 serious strikes a year would take me out for 3 or 4 days completely. A feeling of weakness or mild pain occurring regularly in between those. Nothing on MRI. Lots of different Physio etc at different times. Special chairs, special cushions, Difene (diclofenac) ... too much.
Late 2016 got sciatic pain for the first time. Took me out for 5 days. Got over it. Started Pilates. Early 2017 got hit with sciatic pain again - decided to just go through it. After 6 weeks I gave in and took some very heavy anti-inflammatories. Woke up with massive stomach pains and assumed I was reacting to the drugs. Went to the hospital and was diagnosed with Appendicitis. They took it out. Spent a couple of days taking lovely drugs. Got out. Back still rough but different somehow. Took a valium just once, slept 16 hours.
Have not had any back pain for 9 months. No drugs. No special exercise. No idea what happened. My back just feels different.
I am a programmer and I used to work 11 hour days frequently. After some years I started experiencing excruciating lower back pain. The pain would flare up if sit for more than 30 minutes. I went for physiotherapy and the pain lessened. The therapist told me I had no core strength and I started taking yoga lessons.
Yoga felt good and I continued for 3 months, when things got worse. I consulted a specialist and he advised against yoga and all sorts of exercise.
I haven't done any exercise in the past 6 months . And I have no pain in my back if I sit for 8 hours. Sit longer, and mild pain appears.
The point I want to stress is when doing exercise and yoga, I felt good and pain lessened, but the mild pain was there at all times when I was sitting. Now with no exercise , I can sit pain free for 8 hours easily.Consequently ,I am much more productive at work , but the lack of exercise makes me sometimes feel dull and unhealthy :( .
I knocked myself out at the lake when I was 17 years old. I mostly recovered over the following six months, but rapidly developed an inflammatory condition when I went off to college a year later. Retrospectively, my apathy towards my degree program was an important factor. After the fourth doctor I said to myself, "screw you guys, I'm going to figure myself out."
I wrote about this previously: https://news.ycombinator.com/item?id=13123659
When I was suffering through college I decided it would be helpful to be able to "relax" (mind awake, body asleep), and to visualize. What a long, strange road it's been...
I gave notice at my job of 4.5 years for unrelated reasons and had a complete reversal of pain within a couple of weeks.
While it is great to be out of that hell, it is completely terrifying that I wasn't able to recognize what was keeping me in pain.
As a computer programmer who has just gone through 1 year of bullshit therapies and recommendations, this book is a godsend.
If you have back or neck problems and want some non-bullshit explanations, read this book immediately.
https://www.cathrynjakobsonramin.com/books/crooked/overview/
[0] https://qz.com/1010259/the-100-billion-per-year-back-pain-in...
I had a lot of other aches and pains (wrist, knees, hips, feet, etc.) by my mid-20s that were hitting me hard pretty much all day every day.
It took A LOT of learning, stretching, strengthening, massaging, etc. but I'm in my mid-30s now and can do more than I have ever been able to do before. I've made it a career helping people in chronic pain as a trainer with a different perspective.
A couple resources that may help someone in severe back pain: Back in Control by David Hanscom, MD. The author is a spine surgeon who, after years of performing spine surgeries and seeing the real effects and real research results, realized that surgery was NOT a good answer for back pain. This is an excellent read with some very practical advice.
Also an excellent read is this article that appeared in Vox recently: vox.com/science-and-health/2017/8/4/15929484/chronic-back-pain-treatment-mainstream-vs-alternative
I would also echo the sentiments of others here. It is VERY possible to beat back pain without surgery and pills, but the level of complexity varies from individual to individual. From the last 10 years of professional experience, I've seen some people solve back pain in two weeks, and I've seen some people take more than a year.
I have a client that I still train who had unremitting back pain for nearly 13 years. She had radiating leg pain and eventually had microdiscectomy that helped a little. Even after that and after more PT and all kinds of alternative medicine, she still had debilitating back pain daily.
For her, working on her hips has been the big key that now keeps her feeling really good. She's now able to go dance classes, do long road trips, sit on a plane for vacation, etc. The process was difficult and required patience, but together we figured out what helps her. Exercises that restore muscle balance is HUGE. And shockingly this is not an approach you'll see in medical or physical therapy textbooks.
For a little more perspective, Framework is another good book by an orthopedic surgeon who generally advises against surgery. He notes that the vast majority of doctors receive a maximum of 2 weeks of musculoskeletal education. Most receive far less. Doctors who know muscular anatomy in-depth are a very small minority. It's just not something covered in standard medical education.
However bad things may seem, DO NOT GIVE UP. Focus on taking control.