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Culture War Roundup for the week of September 5, 2022

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Is most chronic pain 'in our heads?'

I spent almost a decade dealing with chronic pain of various sorts. I had many diagnosis such as TMJ, Hypermobility, Repetitive strain injury, Carpal tunnel, Tennis elbow, Conversion disorder, etc. What finally ended my pain was close to 5 years of serious meditation, stretching, dance training, and most importantly yoga. Eventually I developed the ability to relax muscles at will even if they were tense from stress.

Right now 20.4 Americans experiences chronic pain(1), with more people in rural populations dealing with chronic pain than in urban populations. Early research shows that this rate has been rising over time. (2) My pet hypothesis is that over time Americans have become more stressed for a variety of factors, which has lead to an increase in chronic pain. This is also most likely linked to a lack of mobility and a sedentary lifestyle.

However, doctors are very wary of telling a patient something is 'in their head'. This isue has probably gotten worse due to the recent backlash against doctors for ignoring someone's personal experience or opinion. I'm afraid that with the current state of our culture this problem will not get better at any time soon.

The most common way to get chronic pain fixed is seems to be to look for non traditional sources of information, typically 'woo' stuff like crystal or energy healing. Unfortunately I have seen a number of chronic pain suffers fall to these types of outlooks, after 'getting in tune with the universe' seemingly healed their pain. In reality I believe that these people simply develop the ability to visualize and relax their muscles.

I think this is a highly neglected problem and something that many people do not realize because chronic pain is often not talked about, and if you do talk about it most of people will either ignore you, give trite and terrible advice, or stop wanting to listen to you. Perhaps most people innately have the ability to relax their muscles, or lose the skill over time for one or another reason.

Has anyone else experienced something similar or observed it among others?

Sources (Cant figure out how to link text from my mobile device)

1 - https://www.cdc.gov/nchs/products/databriefs/db390.htm#:~:text=Interview%20Survey%2C%202019.-,Summary,65%20and%20over%20(30.8%25).

2 -

https://read.dukeupress.edu/demography/article/58/2/711/168526/Pain-Trends-Among-American-Adults-2002-2018

Edit: fixed spelling/formatting errors.

Eventually I developed the ability to relax muscles at will even if they were tense from stress

Isn't this just a thing one can do with muscles, like moving them?

most importantly yoga

Yoga is physical activity though, this doesn't distinguish between "more physical activity / stronger core / better integrated muscles / stretching muscles" helping the pain and it being mental

Claims that it works, from patrick collison's twitter - the "sarno method", fixing chronic pain just by intent, he claims it worked for 4/4 people he knows and many agree in the comments. Maybe ... the whole "people tense muscles when stressed for a long time, relaxing them fixes pain" is a component - the "stress = tense muscles" thing is certainly true in some sense, but the woo/therapy interpretations aren't quite right imo. And most woo-seeming things that work don't work for the reasons people think they do, and come with meaningless pacifying therapywoo! It just coming down to relaxing the muscles is plausible, but probably not the whole story, idk.

I agree with all of your statements! To be a bit more nuanced, I certainly think strength/flexibility/mobility training is an important component of this, and helped me quite a bit. Perhaps to put it another way even though I spent 10+ years learning various types of strength training regimens and fitness programs, I never found a method that focused enough on the general idea of for instance, "when doing a crunch, make sure to relax your head/jaw/neck etc." Yoga was the first method that actually taught me to do that, eventually, after years of semi-regular practice and six months of daily practice.

I also made huge breakthroughs right after quitting a high stress job so I now think stress was an important factor in many of my physical issues. To be clear I don't believe in Sarno's stuff though I have read through it. I briefly used the Curable app, which is much more nuanced and focuses on body scan meditations and other ways to hone your awareness of your muscles.

Could you give an example of "And most woo-seeming things that work don't work for the reasons people think they do?" I find this topic very interesting.

As an aside, I'm very excited for the new site! The move was a good enough reason to motivate me to post this though I've been thinking about it for months. Thanks for your positivity and hope for this place, your comments were useful in convincing me to join.

And most woo-seeming things that work don't work for the reasons people think they do

Therapy/psychonalysis where you "get rid of negative thought patterns / childhood trauma / latent oedipal desire / condition your lizard mind / remove tensions between different sub-parts of your mind", but the practical outcome is just "the therapist becoming your friend / socially pressuring you to do the thing", with the explanation mostly serving as a distracting trick (although one all parties sincerely believe!). Meditation on chakras, even though the physical location of the chakra is basically random and it'd work if the chakra was just a vague concept instead of having a location. Spiritual claims about specific yoga poses. "The secret", the whole "visualize a thing and it'll come", when "visualize it" is either a "if you look for something you'll see it" trick or a way to get people to try just a little bit to actually accomplish it. These are all very different things, and are only all 'woo' in a broad sense, but there's a similarity!

So do you think the best way to avoid a lot of stress/chronic pain is having a stronger social net and not consciously doing the wrong thing?

I think I can agree with that basic concept, but the problem seems to lie in communicating what exactly is the right thing, how you figure out what you believe the right thing is, etc. This is notoriously difficult to communicate which is why so many specialized and esoteric systems have developed to attempt it.

What would you suggest as an alternative way to help rid people of 'negative thought patterns' etc?