Why I left my tech job to work on chronic pain

1. foobiekr ◴[04 Jul 25 16:28 UTC] No.44465863[source]▶

I have a pretty severe back injury - double pars fracture and significant spondylolisthesis from an accident (not a car accident). For many years i was in incredible pain, but it just kept going, sometimes getting a lot worse. When this happened I would go get some imaging done to make sure there weren't degenerative changes that needed to be addressed - you should never, ever get back surgery if you don't need it, so I am cautious about it. But I noticed something, all on my own, and that is that it seemed to correlate with periods of intense stress. I still have a ton of stress, but recognizing that actually kind of made a tremendous difference.

I hesitate to add a link to this on the thread, but there is an interesting story around chronic pain actually being psychological and there are now some high quality studies coming out.

https://journals.lww.com/painrpts/Fulltext/2021/09000/Psycho...

I especially hate to link to LessWrong but this is an actually decent thread on the topic:

https://www.lesswrong.com/posts/BgBJqPv5ogsX4fLka/the-mind-b...

I didn't know about any of this and had never been exposed to any of it when I drew my conclusions and started to feel less pain. Don't get me wrong, there are still things that will set my back off, but now I probably go actual years without even thinking about it.

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2. polishdude20 ◴[04 Jul 25 16:40 UTC] No.44465958[source]▶

>>44465863 (TP) #

Along those lines is this excellent website: https://www.painscience.com/

3. gleenn ◴[04 Jul 25 18:12 UTC] No.44466695[source]▶

>>44465863 (TP) #

"You should never, ever get back surgery" sounds like that easily could be wrong. It's annoying to have to always caveat but talking to a (good) doctor is important when making such decisions and not relying on tech forum advice necessarily. I know someone who said they went in for back surgery and walked out feeling permanently cured from the specific problem they had and the pain was completely gone. Details matter. Always consult experts when possible.

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4. Aurornis ◴[04 Jul 25 18:30 UTC] No.44466818[source]▶

>>44465863 (TP) #

> I hesitate to add a link to this on the thread, but there is an interesting story around chronic pain actually being psychological and there are now some high quality studies coming out.

This is a misinterpretation of these studies which is common throughout this thread.

The research isn’t showing that chronic pain is a psychological condition. It’s suggesting that some cases of nonspecific chronic pain that specifically do not match the symptoms of typical physically-rooted pain are psychological. The participants in this study were filtered for this criteria.

For some reason, people see this idea and lose the nuance, concluding that most or all chronic pain is actually psychological.

I think if someone matches the description used by the author of the substack for this HN entry (he describes his chronic pain as random and popping up all over his body) then pursuing the psychological explanation would be a very good idea.

However, it’s getting frustrating to see all of the reductionist claims that “chronic pain is psychological”.

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5. Quekid5 ◴[04 Jul 25 19:59 UTC] No.44467401[source]▶

>>44466818 #

> However, it’s getting frustrating to see all of the reductionist claims that “chronic pain is psychological”.

It's incredibly frustrating and disheartening... For obvious reasons, I'm not going to go into too much detail, but chronic (non-visible) pain is the worst of the worst. People will either think you're "faking"[0] or it's "just psychosomatic"[1]. I actually relish being able to work for a good long day because I'm lucky enough to actually enjoy making computers do stuff.

[0] Yes, I love to miss lots of family occasions, just because.

[1] I'll just will myself better. Nevermind the MRI scans and all that.

EDIT: I should add... the cognitive biases at work are understandable because they've probably been around since proto-humanity, but that doesn't change the outcomes.

6. sd8f9iu ◴[04 Jul 25 23:09 UTC] No.44468714[source]▶

>>44466818 #

I agree. I lived with chronic pain for over a decade due to a specific medical problem that, though I could never get a precise diagnosis, was not caused by stress or my mental state. It was incredibly frustrating to deal with family and others who had read articles like this one and insisted all chronic pain was psychological in origin and needed a mind-body approach. I am happy for the author and am sure this approach works for many, but I'm not sure why they think that all chronic pain is common in cause. There are a host of chronic pain conditions that are physiological in origin and not psychological.

7. munificent ◴[05 Jul 25 02:42 UTC] No.44469743[source]▶

>>44465863 (TP) #

> there is an interesting story around chronic pain actually being psychological

I think this is an incorrect oversimplification.

I had a pretty bad accident a year ago and am still dealing with physical therapy and recovery from it. I have spent a lot of last year traveling the land of pain.

It's not that pain (chronic or not) is psychological. It's more that our pyschological state modulates how we experience pain.

If you hit your thumb with a hammer, the pain you feel is absolutely not psychosomatic and entirely in your head. There are real nerves in your hand sending your brain real pain signals.

But if you happen to do that on a day that you're really stressed out, it will hurt worse. And if days after the accident you are still hurting and you find your inner monologue saying things like "See, you hit your thumb because you're such a stupid clutz." then you will experience that pain with greater intensity and for longer than if you had a more positive narrative around the injury.

8. foobiekr ◴[05 Jul 25 02:59 UTC] No.44469810[source]▶

>>44466818 #

I did not say _all_ chronic pain. I would go back and edit that to be "some" if I still could.

9. matwood ◴[05 Jul 25 07:50 UTC] No.44470889[source]▶

>>44466695 #

You left off the 'if you don't need it'. Even back specialists will tell you that surgery is typically the last resort because of the risks of not fixing the issue and/or making it worse. It's not like fixing an ACL.