I'd like to give an off switch for pain to every adult. Here you go, just turn it off if you need to. But if someone gave one to me I'd be in trouble, if not dead. When my back pain got severe I may well have killed the messenger, ignored the pain, and not have made the lifestyle changes that eventually gave me relief by fixing the problem. People with congenital insensitivity to pain usually have multiple damaged joints by adolescence. It's not very enviable.
Upper back and neck pain for me. Went to a Phys. Therapist and got a set of exercises. It was largely muscle weakness from bad posture - something many, many people will likely suffer in the coming years thanks to staring at screens on handhelds.
Mine was because I have the posture of a lump of VERY wet clay.
Also, losing weight helped a lot - less to carry around and hold in the right places.
Prolonged sitting deconditions the gluteal muscles, and other muscles often compensate, which can overload them and alter hip/pelvic control. When tissues are strained, the body initiates repair via inflammation—a normal phase of healing. Routine NSAID use can blunt aspects of musculoskeletal healing in some contexts, so it’s worth using judiciously and with clinical guidance. With reduced movement, fascia can lose glide and become stiffer, limiting mobility. Over years, chronic abnormal loading may contribute to osteophytes (joint margins) or enthesophytes (at tendon/ligament insertions). Targeted strengthening, mobility work, and load management from a PT typically help.
I’ve been on a year plus journey with this. My back pain was lower back and every few months I’d “throw out” some part around my shoulder blades and be flat in my back for a day or two. It got pretty bad.
I went to physical therapy for two months because that’s all insurance would pay for. My spine was weak and lacked stability. They had me doing stretches for back mobility and core strengthening. I continued that when insurance ran out and added in a lot of walking and other light weights and calisthenics.
It’s been a long journey and I’m only half way to where I was. The worst part is I did it to myself by becoming sedentary for to many years.
For me it was the combination of deadlifts and couch stretch, because I found my hip flexors were fighting to tilt my hips forward. That combination essentially 'cured' any back pain I had. It's not a real cure because if I'm inactive it comes back but so long as I'm moderately active I have no pain
2 kids under 4 (and another due next month) fixed my back pain. Turns out that constantly picking up babies and toddlers is the exact amount of exercise my back needed.
Swimming 100%. I was injured far enough I had problems even with walking and load bearing activities, but I was able to swim which enabled my recovery.
Aside from resolving the cause, I had to use a foam wedge knee bolster to stabilize me while I slept for an unrelated injury, and I was amazed how much that almost immediately also reduced my lumbar pain.
For upper, I'd highly recommend adding rear delt flys and face pulls at twice the frequency of any chest or shoulder workouts. Most people have overdeveloped front delts and underdeveloped rear delts and that can cause severe imbalances.
We live in a busy world and time is money. Someone else's money usually. So better find that off switch if you want to stay prosper in the land of the free.
Many of the comments here talk about lifestyle changes, and I think those are key, but there are some, (perhaps rarer) conditions that unfortunately won't be improved.
Trigeminal Neuralgia is one of them. The condition is just... pain. Lot's of pain. More pain than anyone should ever have to go through. When I have episodes, I often feel awe that it's even possible for someone to feel such an incredible amount of pain.
Challenges in life help to shape you, make you who you are. But I do feel that this particular challenge was one where it would have been nice to have learned the same lessons some other way. I hope sincerely that treatment based on this research can help.
Very interesting. I’ve been battling a herniated disk. It’s the most pain I’ve ever been in. Debilitating. Stuart McGill’s “Back Mechanic” is an illuminating read. The “big 3” exercises have become my staple and they seem to mask the pain long before the underlying injury heals, which takes about a year. So the ideas in this article resonate with me. In particular pain itself becoming self perpetuating, and mechanisms to block pain like hunger. My issue is temporary, but it’s introduced me to the reality that some have been handed a lifetime of non negotiable pain. So this is important work.
> The drive to look deeper into these neurons grew out of a simple observation Betley and his team made shortly after he joined Penn in 2015—hunger could dampen long-term pain responses. “When it came to chronic, lingering pain, hunger seemed to be more powerful than Advil at reducing pain.”
This in itself is a very interesting observation. I've always been inclined to fast during times of pain and anxiety, and honestly it kind of works? Could well be part of meditative fasting's popularity throughout history.
If you think about it, this has evolutionary advantages as well. No time to feel pain when your life itself may be in peril due to starvation. Finding food for sustenance easily supercedes recovery.
Yeah I fasted for the first time last year, and it pretty much immediately turned off a pain response due to an overactive immune response
I got the idea from a book, and it worked
When I ate again, it came back, but I was definitely relieved of pain for awhile. Thankfully the whole episode subsided after about 6 weeks, but it was comforting to know that I could turn it off by fasting.
Due to said age it was VERY hard to find a doctor willing to replace my hip, EVEN THOUGH I had 2 failed repairs, and had to resort to opioids to sleep.
And long-term opioid usage (not abuse!) can cause higher the risk of persistent pain after a total hip arthroplasty.
Thankfully this is not the case for me. But it was a big concern in this journey.
This is very interesting, and I think points to the psychosomatic elements of pain, which is probably usually dismissed as "it's all in your head". But really, all pain is "in our head", it just tells us that the pain is elsewhere.
The bigger opportunity here may be not to dismiss pain as being in the head, but recognizing that when it is, treating the suspected source is not the best route, or maybe not in isolation.
I’m currently reading a book, The Way Out by Alan Gordon, on his research into this neuroplastic pain, which is when neural pathways carved by the pain remain after the cause is gone, and how he’s treated it in patients with mental exercises.
"The current work started when Nitsan Goldstein, who was a graduate student in Betley’s lab at the time, found that other urgent survival needs such as thirst and fear can also reduce enduring pain. That finding supported behavioral models developed in collaboration with the Kennedy lab at Scripps, suggest filtering of sensory input at the parabrachial nucleus can block out long-lasting pain when other more acute needs exist.
“That told us the brain must have a built-in way of prioritizing urgent survival needs over pain, and we wanted to find the neurons responsible for that switch,” says Goldstein."
I suffer from frequent headaches, as one way to deal with it I sometimes try to find something that will cause me a different type of discomfort, such as walking several miles. Usually works, eventually.
That's interesting about walking. I've done longish walking pilgrimages lasting several weeks (Camino etc.) and some stomach problems and joint problems improved a lot. I usually walked about 25km a day - I realise that's longer walking than what you mentioned.
There are some books about walking putting illness into remission. A famous one is "The Salt Path" where someone with "corticobasal degeneration" brain disease was positively impacted by their walk. (Although the claims are in doubt now because the main author wasn't truthful about other aspects of their walk)
I wonder if more light exposure during walking is also a factor? Many folks don’t get enough vitamin D, and light therapy for SAD and other conditions has shown promise as well. I’ve also noticed that 25km+ of daily backpacking for a few weeks continuously helped my overall fitness and wellness, though I don’t have any chronic conditions or ailments at all to speak of. I do question whether many folks would invest the time and effort to do the work, even if they desire the benefits of the exertion.
"A documentary that follows the largest fMRI randomized controlled trial challenging conventional wisdom about chronic pain, and revolutionizing treatment for millions."
Explains how these neurons get wired to fire when there is no physical stimulus causing the pain. Similar to phantom limb syndrome.
There's a book called The Way Out, which documents the technique used in the study featured in the Pain Brain Film above.
I can fully attest to this technique. It 100% works. I had chronic neck and back pain for 20 years. I thought it was my desk, I thought it was my posture, thought it was my chair. Nope, it was my mind.
Anyone who's experienced or knows someone who has experienced chronic pain appreciates how desperately the world needs a major breakthrough in this arena. Pain management has evolved, there are steady improvements, but unfortunately a lot of people are effectively left behind and the choice becomes a series of profoundly mind-altering drugs... or profoundly mind-altering pain. The way that pain can erode your personality and your life is hard to express quickly in words, but it's both invisible and endlessly corrosive.
I certainly hope that this or another path of research leads to a new generation of therapies that don't depend on opioids and are more effective than current alternatives.
Yup. Treatment these days for chronic and severe pain amounts to your choice of:
1) Ever escalating doses of NSAIDs / acetaminophen and the associated long term health effects of that.
2) Long term opioid management which will leave you treated like a drug seeker by anyone who isn’t your pain doctor and may or may not also require long term escalation and has its own health concerns and complicates your use of other medications. And god help you if you don’t like your pain doctor because changing them is a whole different world of suspicion and poor treatment.
3) Various physical interventions like nerve ablations or back surgery or steroid injections which come with a host of other risks and also tend to be both expensive and temporary.
The company I work at does spinal cord stimulation for chronic pain patients. The stories of the patients are just gut wrenching. Chronic pain is just horrible and very hard to understand and treat.
I’d love an alternative to gabapentin while accepting that it is what keeps me functional enough to be functional, it is for me a remarkable treatment except for the side effects.
I would be hesitant to turn off some physical pain like that of an injury I don't want to overextend, but for something like a chronic headache this would be a godsend.
My most effective treatment for headaches is imitrex but you have to time it correctly and I really hate how it makes my body feel.
Mine was because I have the posture of a lump of VERY wet clay.
Also, losing weight helped a lot - less to carry around and hold in the right places.
I went to physical therapy for two months because that’s all insurance would pay for. My spine was weak and lacked stability. They had me doing stretches for back mobility and core strengthening. I continued that when insurance ran out and added in a lot of walking and other light weights and calisthenics.
It’s been a long journey and I’m only half way to where I was. The worst part is I did it to myself by becoming sedentary for to many years.
Eliminated my back pain and led to a bunch of other non obvious life improvements.
Lower: lose weight, get moving, strengthen hips, glutes and calves.
Upper: lose weight, get moving, strengthen chest, lats, core
so see your doctor
Trigeminal Neuralgia is one of them. The condition is just... pain. Lot's of pain. More pain than anyone should ever have to go through. When I have episodes, I often feel awe that it's even possible for someone to feel such an incredible amount of pain.
Challenges in life help to shape you, make you who you are. But I do feel that this particular challenge was one where it would have been nice to have learned the same lessons some other way. I hope sincerely that treatment based on this research can help.
This in itself is a very interesting observation. I've always been inclined to fast during times of pain and anxiety, and honestly it kind of works? Could well be part of meditative fasting's popularity throughout history.
I got the idea from a book, and it worked
When I ate again, it came back, but I was definitely relieved of pain for awhile. Thankfully the whole episode subsided after about 6 weeks, but it was comforting to know that I could turn it off by fasting.
For example, most headaches I have - drinking a glass of water usually fixes it.
Maybe feed a cold, starve a fever. And now starve lower back pain?
---
I have another. Hanging (dead hang) from a pullup bar or staircase. It fixes it. 30 seconds every day, or 3 sets of 30 seconds
Due to said age it was VERY hard to find a doctor willing to replace my hip, EVEN THOUGH I had 2 failed repairs, and had to resort to opioids to sleep.
And long-term opioid usage (not abuse!) can cause higher the risk of persistent pain after a total hip arthroplasty.
Thankfully this is not the case for me. But it was a big concern in this journey.
The bigger opportunity here may be not to dismiss pain as being in the head, but recognizing that when it is, treating the suspected source is not the best route, or maybe not in isolation.
“That told us the brain must have a built-in way of prioritizing urgent survival needs over pain, and we wanted to find the neurons responsible for that switch,” says Goldstein."
There are some books about walking putting illness into remission. A famous one is "The Salt Path" where someone with "corticobasal degeneration" brain disease was positively impacted by their walk. (Although the claims are in doubt now because the main author wasn't truthful about other aspects of their walk)
Anyway walking probably a real positive overall!
https://en.wikipedia.org/wiki/Moxibustion
"A documentary that follows the largest fMRI randomized controlled trial challenging conventional wisdom about chronic pain, and revolutionizing treatment for millions."
Explains how these neurons get wired to fire when there is no physical stimulus causing the pain. Similar to phantom limb syndrome.
There's a book called The Way Out, which documents the technique used in the study featured in the Pain Brain Film above.
I can fully attest to this technique. It 100% works. I had chronic neck and back pain for 20 years. I thought it was my desk, I thought it was my posture, thought it was my chair. Nope, it was my mind.
I certainly hope that this or another path of research leads to a new generation of therapies that don't depend on opioids and are more effective than current alternatives.
1) Ever escalating doses of NSAIDs / acetaminophen and the associated long term health effects of that.
2) Long term opioid management which will leave you treated like a drug seeker by anyone who isn’t your pain doctor and may or may not also require long term escalation and has its own health concerns and complicates your use of other medications. And god help you if you don’t like your pain doctor because changing them is a whole different world of suspicion and poor treatment.
3) Various physical interventions like nerve ablations or back surgery or steroid injections which come with a host of other risks and also tend to be both expensive and temporary.
My most effective treatment for headaches is imitrex but you have to time it correctly and I really hate how it makes my body feel.