glasscannon

Thanks for sharing the link - this one goes into more depth: https://jamanetwork.com/journals/jamapsychiatry/fullarticle/...

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 appreciate your skepticism.

> 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.

agumonkey I love this - maybe it's about time a wellness/health "HN" was started. We're living in a time of chronic health dysfunction and lack of clarity. DM (and/or anyone else) if you'd like to jam

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

Hey algo_lover, OP here.

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!

> used me to change my routine and avoid certain activities which only exacerbated the issues, which led to more avoidance. Eventually I couldn’t walk.

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

Would love to connect/chat. Will read over these in the meantime.

> 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 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.

Feel free to get in touch if you'd like to chat Adrig (my contact is in my profile), wishing you the best of luck.

The link between the gut and brain (especially in the case of dietary intolerances) is an interesting one! Keen to see if others have come across good research in the space

Awesome study - thanks for the link!

On your first point, the moving of symptoms is not uncommon in patients with chronic pain - and yes definitely a sign something not normal is going on!

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!).

Thanks for sharing this.

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).

Amazing, I'll take a look at it.

Thanks!

> The problem, CBD never fixes the pain. ~8 hours later you need more.

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

Heavily agree much destruction has come from overprescription. With this note I'm just seeking to cover my bases and be transparent with readers who don't know me.

I recently decided to go all in on addressing chronic pain - a condition which affects an estimated 1/5 adults in the US[1] and nearly the same proportion in my country of Australia.

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]

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[Edit] Thanks so much everyone! Excited to get the next article out soon!

What worked from me when transitioning from dev to product was applying/interviewing internally. If you apply externally, there will likely be the expectation that you have direct experience.

Regarding your question on should you continue working / interviewing for dev roles - if product is what you want to do and your circumstances permit it, I would recommend taking the jump sooner rather than later. Life isn't long enough to do one thing when you'd rather be doing another. I spent 2 years too long being a dev and nearly burnt out because of it.

Something I only discovered recently is how much of an impact sustained mental stress/anxiety can have on your body. It puts your body into a state of fight or flight, which eventually wears you down. It's a very valid root cause to look for in diagnosis.

Not all pain is associated with an existent physical injury. For example I had tears in my achilles last years which have since healed but I still feel pain when I walk. Look into fibromyalgia and nociplastic pain if you want more info. The tldr is that our bodies can react to danger/injuries by increasing our pain sensitivity, which means that minor activities which pre injury caused no pain can later cause debilitating pain even when physically healed. This is why pain is now being explored through a biopsychosocial lens.

As someone with fibro/nociplastic pain, it's great to see more emphasis being placed on the non-biological drivers of pain.

I'm currently building a platform to address pain more holistically. If you're interested in chatting feel free to reach out.