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Why I left my tech job to work on chronic pain

(sailhealth.substack.com)
334 points glasscannon | 3 comments | 04 Jul 25 12:50 UTC | HN request time: 0s | source
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incomingpain ◴[04 Jul 25 13:32 UTC] No.44464395[source]▶
>Pain Reprocessing Therapy

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.

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1. glasscannon ◴[04 Jul 25 13:49 UTC] No.44464544[source]▶
> 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

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2. incomingpain ◴[04 Jul 25 15:13 UTC] No.44465252[source]▶
>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.

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.

3. __turbobrew__ ◴[04 Jul 25 23:16 UTC] No.44468758[source]▶
> 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.

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.