I haven't had this happen for at least a year or so now, and it's quite likely this is linked to various major changes that have happened in my life since then.
But yes, I totally agree with you about your conclusion.
I tend to get them when I'm way too relaxed as that makes me "stretch out" during sleep, which I kinda notice in half-sleep as feeling great, until I seemingly "overstretch" and get fully woken up to a painful calf cramp.
Tho that whole problem kinda fixed itself once I started taking Magnesium supplements before going to bed, to help with teeth gnashing/neck pains.
I might have an absorption issue though. Magnesium salt topical spray (less costly than pills) helps intantly unclench my neck/shoulders, and theres extant literature on that being an effective method of administration.
I only take it when I feel a twinge in my calf. I figure I'm probably deficient in magnesium or something. Even if it is a placebo, it seems to work.
This was the same for me with RSI. It was simply the act of realizing it was psychosomatic and caused by stress that made it disappear completely.
A friend's wife died, and he got sick afterwards. Grief? Illness went away when he stopped eating badly (his wife had prepared most meals for him).
Of course, he had switched to a pretty bad diet, and he was older, more likely to be affected by diet.
Cramps, for example, can be often be prevented with potassium, which is in plants. Some people don't eat plants as much when they are stressed, leading to cramps.
I'm not saying that RSI doesn't exist, but I'm now positive that in my case all those RSI-like symptoms were all in my head -- some kind of a nocebo (an anti-placebo) effect. When I was 27 I had to do an MRI of my hand for an unrelated reason (boxing injury), so naturally I asked them to do an MRI of my wrist since they'll be immobilizing my hand anyway [1]. So either my wrist was healed in those 6 years, or it was fine all along -- can't tell because I didn't have a "before" picture. Just in case, I explicitly double checked with another doctor if he was sure about my wrist and he said that my MRI could be used as a textbook example of a healthy wrist joint.
I am now wondering if all those "mental-health awareness" things could have an adverse effect. I wonder how many hypochondriacs self-suggested themselves an OCD or an ADHD, and while marinating in those thoughts they somehow turned those thoughts into an actual condition (self-fulfilling prophecy?). Like ... you guys already have tidy people joking about having an OCD, and people who like to wash hands are joking about being a germaphobs.
edit: I think I've seen an article "willpower is limited only if you believe so" posted somewhere here on HN, but I can't find it now. Anyway here's another link: [3], and here's the Stanford study they cite [4]. This can be another example of people self-suggesting themselves a handicap.
[1] There are a lot of posts on HN talking about healthcare costs in the US, so I'll share my anecdote too. I did an MRI in Ukraine and the whole thing was like $80: $50 for the hand and extra $30 for the wrist. The machine was 1.5 Tesla one, but there are other clinics that have 3 Tesla machines too (a little bit more expensive). Scheduling an appointment was done by a phone a couple of days in advance and didn't require any doctor referral. There are many small private clinics offering imaging services (MRI/CT/Ultrasound/...), and all of them are very easy to Google and all of the prices are available online, for example: [2]. After the procedure they give you a CD with the info, a print-out on some largish transparent plastic, and their staff doctor's conclusion. You usually take those results to your specialist doctor of choice.
[2] For example: https://translate.google.com/translate?sl=auto&tl=en&u=https... all prices in UAH, to get rough USD estimate divide those numbers by 25 (or 26.75 to get exact number as of 2019-03-13 if you're OCD).
[3] https://lifehacker.com/your-willpower-is-only-a-finite-resou...
[4] https://journals.plos.org/plosone/article?id=10.1371/journal...
But RSI has a clear physical mechanism. I don't know as much about chronic back pain, but considering how much physical stuff there is in our back, I'd assume it's similar.
Or does "physical mechanism" mean something other than it seems to mean?
He was also clear that this is not always the case, and that direct physical causes should be looked for by a specialist before pursuing psychological remedies.
The idea is the pain is very, very real, and very, very painful. But that the cause is psychological.
The reason why RSI and back pain type issues persist is because psychologically they are very easy to justify. Of course we put load on our backs! Of course we do repetitive things! So it's easy to draw the conclusion that this is the cause, especially for your brain. This prevents people from exploring a root cause.
It's interesting material, but I think you have to be pretty open minded to consider it.
Imagine that RSI is not caused by bad posture, lack of exercise, and repetitive motions alone. For example, there are many people with bad posture, who don't exercise, who use repetitive motions and do not have RSI (me, for example ;-) ). Imagine that in addition to these things a required trait is that the muscles are slightly tensed. Imagine that the tense muscles constrict blood flow. This causes an inflamation in the area and with repetitive motion (or even lack of motion) it generates an injury in the area.
Imagine that when you believe that you have solved the problem (by using a special keyboard, or changing the way you sit or changing the way you move) that your muscles relax just that little bit. Now the blood flows freely, there is no inflamation and the RSI goes away. You think it's due to your physical actions, but in reality you are cured only because you believe that what you did worked.
The idea behind the book (as far as I can tell -- I decided not to read it) is that conditions like RSI are real. The physical cause is real. However, the conditions necessary to cause the condition to occur are mental. It's a fairly compelling idea. RSI is a similar situation to the back pain that the author of the book studied. Many people suffer from it and the cure seems to differ widely -- if you can be cured at all. May of the cures don't really have convincing experimental evidence to show that it actually relieves any physical problems. The efficacy is based only on the apparent lack of new symptoms.
Now, I'm of two minds with this book. On the one had, like I said, the idea is compelling. The author believed that most chronic back pain's underlying cause was mental. The physical issues that in turn caused the pain, were in turn caused by the mental issue. The author apparently had considerable success in his practice, but I think it is important to note that his practice was for helping people who had back pain where no conventional treatment helped. So he's working from a point of sampling bias. While he may be correct that this occurs, it is hard to get an idea on how frequently it occurs.
This is different from the general effects of stress, and different from purely physical factors.
Speaking for myself, I don’t have serious back pain, but when I occasionally experience momentary strong anxiety my back muscles get noticeably tight/strained, especially while sleep deprived. Drinking 1 beer typically alleviates that, or I’m sure some other anxiolytic medicine could.
I would not be surprised at all if chronic severe anxiety (e.g. taking care of a chronically ill child, working a high-stakes short-deadlines job, living with an emotionally abusive person, experiencing trauma and then suffering PTSD, ...) might cause me to develop a real back pain problem.
My experience with most serious medical things is that doctors have a clear general-audience explanation, because part of their job is making patients feel like they understand what's going on. But if you get into the details, the good doctors will say, "Well, actually, the picture is much murkier, but here's what we know based on studies X, Y, and Z, but there's a lot yet to learn."
Back pain in particular is an area of open dispute. Many people have many theories, all of them very hard to test. When I was dealing with back pain, a spine-center doctor recommended a book called "Treat Your Own Back" [1]. It was hugely helpful to me. And in it, the doctor explains that he hit upon his method because a patient came in, used a piece of equipment that was set up totally the wrong way, and said, "Gosh, doc, that was great!" It led him to reexamine what he had been taught about backs, coming up with a different "clear physical mechanism" to explain a common class of pain.
That we are still figuring something out does not mean it's psychosomatic. It doesn't mean it's not, but a doctor suggesting otherwise is doing the medical equivalent of "god of the gaps" theology, where anything mysterious is attributed to your preferred cause.
[1] https://www.amazon.com/Treat-Your-Back-Robin-McKenzie/dp/095...
Are there physiological differences between people that explain this? Probably. But I suspect in many cases Sarno is right, it’s not purely physical. Look into neuromatrix theory and non-proprioceptive pain for a somewhat more scientific attempt at an explanation.
I don't find this particular statement very revolutionary. We have known for a long time that physical pain is manufactured by the brain as an evolutionary tactic to help us prevent further harm to ourselves. If we didn't "feel pain" when we were on fire, we would burn to death.
But...you would (or could?, or should?) never tell someone that, because how would you know? Maybe there is some link but to conclude that it could be the case is pretty silly.
So it's not like that's a stigma, it's just a statement not based in fact that evokes a strong reaction because you're telling someone why they're feeling a certain way when in reality you have no idea at all.
As another example, stress was blamed as the main cause of ulcers for decades, when an H pylori infection turned out to be the primary culprit.
Only the good things, of course, because they are all angels.
You are the reason why such reactions occur.
I think the main problem with many doctors is the fact that the patient tends to feel blamed when told that their minds are causing the problem. This is not Sarno’s approach at all, since he states that chronic pain can be seen as a defense mechanism against deep negative emotions.
It depends on how you read it, since the short 12-word summary could be read dozens of different ways. There's ways in which trivially, of course, duh, pain is in the brain, where else would it be? But there's also ways in which it stands in stark contrast to what most people implicitly believe.
Take your (you, the reader, not kimmy1 specifically) beliefs about the nature of pain, and explicitly hold it up to the concept of phantom limb syndrome: https://en.wikipedia.org/wiki/Phantom_limb And make extra sure to read the section about mirror box treatment. (That it works at all, for anyone, is the important point, not whether it's a miracle cure for all sufferers.)
You may already have heard about these things, but have you explicitly examined your beliefs about pain to ensure they incorporpate these ideas?
I don't know about fibromyalgia, but it wouldn't shock me that much if there is something a lot like phantom limb syndrome out there that confuses us by causing phantom pain in body parts that exist. For eminently rational reasons it would be a long time before we worked out way down to that hypothesis.
Actually nociceptive pain is by definition not in the brain and is fundamentally somatic. However somehow it is privileged by society: it’s “real” pain while those others are “all in your head”.
The sad thing is that the scientist is validating these phenomena yet the critics don’t understand that.
E.g. you subconsciously favor your back, leading to overexertion of other muscles, leading to physical degradation and pain from those muscles
Talking with her was eye opening on the amount of sub-major muscle "stuff" that is constantly subconsciously working in our muscular-skeletal system.
"You hold tension in your neck" is a remarkably complex statement (and solution).
It is not true about chronic pain. Acute pain will get better if you rest, chronic pain won't.
Most chronic pain sufferers will feel better if they behave as if the pain doesn't exist, increase their activities, get less depressed, feel less pain...
The core of fibro identity, however, is that fibros don't experience the benefits of exercise, they get the pain but they don't get the gain. That might be true. I have seen fibros try something new and get hurt even more quickly than heroin adicts.
Nothing to do with psychology, and everything to do with destruction of peripheral nerve tissue.
OC is saying that the pain can originate in the brain itself without any external force on the body.
There are also a lot of diseases that were thought of to be psychosomatic that turned out to not be such as peptic ulcer disease. There is also gender bias in play. Pain or illness affecting males are more likely to be classified as physiological while the same thing affecting females is more likely to be classified as psychological.
There is a mind-body connection and the mind can induce nervous system sensation when no physical cause is present.
For me, it didn’t help either, but guided me to search how I could change my emotions. A mix of yoga and meditation plus techniques from “Code to Joy” by George Pratt helped me chronic headaches.
Yoga helps you become more aware of your mind-body. Meditations practiced in Kundalini yoga can help you become more deeply aware of your mind, or trigger certain helpful ideas (they usually have a very specific intention). What was left for me was to change negative beliefs that were created throughout my life, and that I accomplished with Code to Joy (and some of their previous work, which is more focused in emotions rather than beliefs).
I was also helped by Dr Sarno's book, and for me the news that it was "all in my head" was encouraging.
I can control my mind[1], and if my mind is the source of the problem, it's a lot easier for me to fix it that if I required surgery or medicine.
[1] At least partially, the mind is a slippery thing too.
My brain used to have my body act up when I took a certain medication.
I was lucky: Once it got a little ahead of itself and my body started acting funny before I'd even taken the medication.
At that point I knew it was all in my head and never had any more problems with that medicine after that.
This is really interesting! I have a funny reaction to spicy foods: my scalp starts itching. I've notice that the itching can start even before eating when I merely have the spicy food in front of me and I'm anticipating eating it.
I think this applies to all the diseases that are diagnosed as a bucket of symptoms. For example headaches...someday when we understand the mechanisms behind migraines, cluster headaches, tension headaches, etc... we'll probably find that we drew the buckets in the wrong spot.
Fortunately, I found the underlying physical cause and am responding quickly to treatment.
Glad to hear Sarno helped you though :)
I've had two RSI episodes in my life. The first one was similar to what you described and went away without any physical intervention, after I read something similar. The second (specifically, I had carpel tunnel syndrome symptoms) was more recently and didn't go away until I tried these: https://www.mijncarpaletunnel.nl/en/home They say to use them for 6 weeks. For about 4 weeks I didn't notice any change, but by the end of week 5 I was pain-free. They claim that you should remain pain-free for a couple of years after, which wasn't the case for me, I get some symptoms every so often (rarely pain, usually tingling fingers), but between using a Kinesis Advantage2 keyboard with foot pedals and taking regular breaks, its been manageable so far and hasn't caused any problems.
The way to prevent it is to type with a posture such that all of the joints of the arm/hand (not to mention neck, shoulders, etc.) are in a neutral position with as little static load as possible.
This can be accomplished more or less on a standard keyboard, but is much easier with a keyboard that has a split halves, tented. It is also helpful to type with a light, bouncy style, which can be helped by careful choice of keyswitches.
> It is also helpful to type with a light, bouncy style, which can be helped by careful choice of keyswitches.
I use Cherry MX Brown and have a very light touch when typing now. I cringe anytime I see people hammer keyboards.
2) Is the KA2 wide enough for your shoulders? A split keyboard was the ticket for me, due to the set of my shoulders.
2) It seems to be. I find it quite comfortable at least. I’ll keep an eye on it, thanks!
I also have a Microsoft 4000 at home for light/occasional usage and it's struck the point of being good enough for that purpose, and it was quite inexpensive.
(If your wrists are straight on a regular keyboard and your shoulders are not scrunched you probably don't need a split board)
The more direct physical way to "fix" it is to adopt a neutral stance with your body. Let your arms hang down neutrally at your sides without using your shoulders to hold them up. Let your wrists be supported in a good position so the strings and pulleys from your forearms to your fingers function well. Support them off the sharp and low edges of the desk at a good temperature. Let your head be balanced over your neck and shoulders instead of holding it in position with your back and head muscles.
The way to exacerbate the problem is the power through it like a new runner with shitty shoes. Ignore all of it, hold tension in your neck and back and ignore the signals your body is sending. Keep your monitor off-axis. Use a shitty mouse and keyboard. Sit at a laptop for hours and get-er-done in spite of terrible ergonomics. (Do you know there are no OSHA approved laptops?)
The exacerbate case ignores your mind-body connection.
Now, it's not "all in your head" but your head is part of the problem.
Just like it turns out 50%+ of fibromyalgia patients have actual neuropathies, that can unfortunately diagnosed by biopsy only, which is expensive - and it's oh so much cheaper and efficient to write off as a psychosomatic disease instead.
People are not in general evil, academia on other hand is a bit arrogant and engages in needless jargons and complications leading.
I struggled with RSI for a couple of years until I read John Sarno's "The Mind-Body Connection" on the recommendation of someone from HN. Sarno's thesis is that many chronic pain conditions (those without a clear physical mechanism, such as RSI or chronic back pain) are psychosomatic.
A lot of people struggle with this idea, and take it, as they did in the article, as "my pain isn't real". Sarno's book very clearly lays out that the pain is real, it's just caused by processes in your brain, not the rest of your body.
Societally it's all very strange. We accept a "mind-body" connection for certain types of disorders, but, not for others. Anxiety sufferers can fool themselves into thinking they're having a heart attack and hyperventilate. Why is it crazy or anti-scientific to think that the same can cause other symptoms? We've searched for decades for body-based mechanisms for these chronic pain conditions, why not consider causes in the brain?