This has just been my experience with RSI (now recovered), so please take it with a grain of salt.
I used to have debilitating RSI when typing. I tried everything and it just got worse over time. Stretches. Typing a certain way. Taking breaks etc. My wrist would become locked after 10 minutes of typing and stay that way for the rest of the day.
I then read a book claiming that all pain is just based on expectation, so if you think it'll be painful it'll be painful, and get worse overtime as the expectation reinforces.
Quite literally within the space of 5 minutes, it all went away. All gone. That was around 8 years ago and I've not had it since. Doesn't matter how long I type, in what position etc. Doesn't affect me at all.
As per Acceptance and Commitment therapy (not the book, something I discovered much later) this can be defined as "the solution is the problem". When you focus on the solution, it defines itself as the problem and it simply becomes worse (think for example, someone who's overweight so eats to make themselves feel better, thereby becoming more overweight and the cycle repeating itself etc.)
Interestingly, the only time my wrist gets sore is when I get really stressed. So I think there's some merit to it being a response from the brain.
I think a large part of it has to do with the eastern idea of letting go. The basic idea is that suffering is a result of holding on too tightly, as opposed to observing intently. Once you observe, the suffering goes away.
I fought RSI for several years, where wrist pain got so bad that I was afraid I would have to stop using keyboards altogether. Went to doctors, did lots of tests, even got various treatments.
I eventually found out that the problems were psychosomatic. The key observation was that when I started reading John Sarno's "The Mindbody Prescription", my symptoms suddenly started shifting from wrists to ankles. "Hey wait a minute…" was my thought — and it turned out that my mind was the cause. I don't buy all of Sarno's stuff, but even thinking about this and considering it carefully caused major effects for me.
Fast forward many years, and taking care of my mind helped my overall health tremendously. Many problems I had are simply gone. And I have a finely tuned radar now whenever something new appears — if it isn't easily diagnosable and attributable to a medical problem, it's likely psychosomatic.
For those unaware: psychosomatic issues are not "hallucinated" nor are they hypochondria. These are real issues, just caused by your mind, for example causing muscle tension or restricted blood flow.
Looking around me, I can see many people whose issues are likely psychosomatic. Unfortunately, it's very difficult to help them, because "no one can be told what the Matrix is, you have to see it for yourself" — you have to be ready to accept this explanation and deal with the mental problems.
Obviously not all RSI problems are psychosomatic, but at least some are, so it's worth looking at.
I had intermittent, debilitating back issues for years after a grappling injury in my 20s - spasms that would come in an instant or appear overnight and take me off my feet for weeks. Brutal. Multiple people recommended Sarno’s “Healing Back Pain’, and I resisted it as woo for years until yet another recommendation got the best of me. I needed to read only the first chapter to recognize that while some of Sarno’s conjecture about the actual mechanism of action may be wrong, his thesis about much (not all) back pain applied perfectly to my situation, and since then - years ago now - I’m effectively cured of my issue.
Passed the book to my dad, who had similar issues, and he’s had only a few such incidents in the intervening years - a huge improvement.
Sarno’s book saved one of my friends’ life. Her pain was so debilitating she was suicidal, but the book unlocked her ability to work through the mental connection to her pain and start to heal it.
Funnily enough, I'm facing an issue at the moment, which I assume is related, but I haven't quite figured out how to resolve.
Basically my body gets really hot when I try to fall asleep and it really sucks, but I get the sense it's related. Like I can't let it go, so it becomes this whole thing, except I'm not quite sure how to approach it in this context.
You probably already know this because it's absolutely the top cause of what you describe, but eating raises your core body temperature, and people who eat within an hour or so of going to bed frequently experience this symptom.
I think if he multitasks during said hot shower he might have an easy solution to try tonight. Also keep the thermostat/ambient temp like way down at night. If its freezing around him the body heat is actually an adaptive thing potentially
1. Have you tried a weighted blanket? I bought one this summer as I don't have a/c but find it hard to fall asleep without the feeling of a big blanket covering me. I found this one[0] from Bearaby which is wonderful. It's weaved together so doesn't provide much/any warmth. Just a lot of soothing weight.
I have similar issues with sleeping hot. I bought a similar open-knit weighted blanket from yaasa this year and really like it.
Having a small fan blowing air over me also helps quite a bit (the Vornado 5303DC has a remote and can adjust in 1% increments which is very nice for adjusting temp a bit during the night).
He should fiddle with the thermostat first (low low low) but I agree with the fan thing, although its more of a white noise thing to me as opposed to the sensation of wind blowing (over) you
Sorry, is this an insomnia discussion or like a "I'm hot before bed" independant of how the sleep goes kinda deal?
I would advise against cold showers/baths/immersion as the will shock you into wakefullness and vigilance. Can't see how there's any evidence for that actually working. Its like saying "Ya, I turned my phone as bright and blue as it goes up to and I STILL couldn't sleep" :/
As a counterpoint, some years ago I developed a severe case of elbow pain (classic golfer's elbow, not that I play golf) in my right elbow. I stopped bouldering, got a vertical mouse, started carrying my kid only on the left arm. Nothing helped.
Then I did a little research and found a YouTube video that recommended muscle exercise instead of rest, using torsion bars. I bought those and did the exercises for a few weeks. Pain went away and hasn't returned.
Sarno doesn’t claim that soft tissue injuries are never real. Stuff like golfers/tennis elbow usually manifests with a clear overuse cause from strain in exercise. But this sort of thing where people experience debilitating pain from… typing, or their back seizes up when they pick up a bag of groceries. A lot of those cases can have a big psychosomatic component. There were two things in particular that I found interesting and that made my back pain shift around and leave when I read his book (paraphrases):
Chronic pain is culturally dependent, some countries have a lot of RSI, some don’t. Chronic neck pain from whiplash is a bigger deal in some places or in some decades than others.
If you give an X-ray to some one with chronic back pain a certain percentage of them will show bulging disks. If you give X-rays to a random group of people of the same demographics a similar percentage of them will show bulging disks, with no correlation to back pain.
The Tyler method you used for golfers elbow is a different example of a a rethink in treating other types of pain. It does have a plausible mechanism that runs counter to the traditional treatment, and it probably works as explained, encouraging healing and tissue remodelling through increased exercise-induced inflammation from eccentric reps. But… it’s also plausible that the quality of the paper describing it and the thrill of counter-knowledge helps make it work even better.
Both the right exercise and not obsessing about a change or pain in your body is a good way to get rid of join pains, trapped nerves, stiff muscles, etc.
Obviously people should watch out for the signs of common chronic diseases, but in my experience I get far more aches and pains when being less active. Going to the gym once or twice a week and doing some compound exercises will help vastly, even after just a few weeks of regular exercise.
Oh, and get a good chair if you are sitting a lot, it's definitely worth it.
John Sarno's book "The Mind Body Prescription" is the book that's always mentioned on HN when this topic comes up. But there's a more up to date book with actual science to back up what you described, it's called "The Way Out" by Alan Gordon. In this book he uses the term "neuroplastic pain" for those sort of pains, it's also called central sensitization in some research papers.
Anyone suffering from any sort of chronic pain should give this book or a similar book a try.
Similar to you, I convinced myself out a chronic tendonitis that would just not disappear even after physical therapy. It was gone a few weeks later. Just by following the recommendations in the book. It's basically self talk therapy.
I had a very similar experience with insomnia. My whole life I couldn't fall asleep on time. At one point, having tried everything, I just stopped caring. If I didn't sleep much one night, then whatever, I've survived many sleep deprived days. So I totally stopped thinking about sleep. Then I just started getting sleepy around 10pm every night and falling asleep soon after. I think that insomnia is perhaps the most mental of all ailments. I also started reading by candlelight at night and that helped too.
This was realized by me after reading the sleep solution by Chris Winters, who also has a podcast that has the same theme.
Everyone has insomnia sometimes, it's abnormal to be able to sleep easily. Candlelight is bad for the air around you and for your eyes the flickering damages your eyes, although the higher CO2 might help with oxygen diffusion.
Didn't know that about flickering, interesting. Maintaining the candle properly by e.g. trimming the wick does help with a clean burn. Beeswax has almost no flicker and gives off light that's the most similar to sunlight, but it's quite expensive.
Refer to the refresh rate on your screen and make it even slower. There is a such thing as candle meditation, so the flickering not always regarded as bad. It'll definitely tire your eyes due to them fatiguing, Ikea makes LED candles if you're interested and anudril firmware flashlights have candle mode too.
> I also started reading by candlelight at night and that helped too.
Ha, i wish i could read in bed without falling asleep. One or two books did something to my brain where i could read them in bed, all the rest i have to fight sleep and re-read paragraphs after 20 mins max.
Recovery from addiction became so much more meaningful when you realize that failing at recovery is part of the process.
I was trying to keep a death grip on sobriety. The clenching and clawing while putting up appearances... life brings us sadness. sometimes at times of desperation, the only thing I have left is my reaction.
When I look back on my mistakes, it all feels insane; the pathology of feedback loop neurosis had me chasing tornados with a butterfly net. What would catching it do for me?
Recognize the stillness where you are _right now_ my friend, and we can sit here for awhile and watch those clouds join the others as they roll over the horizon.
This struck a chord with me. If you don't mind, could you please explain more about how you changed your mindset? It seems like you're talking about letting go as opposed to maintaining tight control.
I've had the same experience with money. When I thought I had no money, I was poor. Then I changed to a "rich" mindset and my bank account has been full ever since.
Poverty is not a mindset. But a particular mindset can lead one to poverty and keep them there.
Say, spending 3 hours to save $10 is usually a bad deal, that time can be invested much better. But if one keeps doing that, they end up in a situation where spending 3 hours for $10 is what they have to do, because they don't have a spare $10, and there are pressing needs.
It's a trap. But it ensnares you through a mindset, not through a want of $10 initially.
> if one keeps doing that, they end up in a situation where spending 3 hours for $10 is what they have to do, because they don't have a spare $10
To add to this: if one keeps doing that, or they're unlucky: Being born into the wrong family, or socioeconomic class. Being the victim of a crime. Having your transportation stolen or break down. Etc.
If spending that time causes you to lose your job then yes. I can only see that for addicts really. I guess you could be addicted to that pursuit though in a negative way. I wonder how Richard Thaler would see it. In that sense it probably is the same reward pathway in the brain. Interesting possibly worth a phd.
You can definitely become povertybrained. My heartrate gets over 120 any time I am buying something that costs more than ten dollars. And thanks to inflation, that's basically everything now. I know it's stupid, but I guess we all came from somewhere.
Well… true poverty is a real thing. But there is a view that you are poor even when you just don’t have as much as others. There are people who get pay rises (significant ones) and who find they are still poor.
There is a mindset to some degree with feelings of poverty. Though, yes, real poverty is a reality.
Exactly this same thing happened to me! I now realize I had an impoverished mind and saw every tbh I got from the perspective of a poor person from a poor town instead of just a person from somewhere like anyone else.
Basically, the news was “everyone is getting rsi from computers!” And then everyone did. And the news fad faded and most cases, obviously many people do get it, also faded away. The brain is weird.
Gosh, I remember when I was a kid, and my Sunday school teacher told me that all my father had to do was pray to get rid of his asthma! I came home and told him, and, well, he was very nice about it, but it doesn't work that way.
Your idea that RSI is in your head has the same issue: "It doesn't work that way." SOME pain is in the mind. Some pain in the body can be mitigated with mental techniques. Some.
> all pain is just based on expectation
This statement is wildly false.
Now, I studied pain control, and when I fell into a hole and was injured in Bali, I was able to function and even continue to speak Indonesian until I got to medical help and could pass out, simply with breath control. I almost never take painkillers. The technical of detaching from pain has significant value, and I have taught it to others.
But some things are wildly painful and can't be dismissed that way...
You know, I'm not even going to type about some miserable things I have briefly experienced, and some horrible things I saw happen to other people, other stoic people even, or about objectively provable imaging (X-rays, etc) of damage caused to people by RSI.
Life is too short for such downers. We both know they exist.
Your ideas do not agree with the consensus of medicine, or the experience of humans. You should re-examine your beliefs.
I do hope you never get first-hand experience of how very wrong you are.
Can't say anything on the internet without someone coming in to shit on it and remind everyone that SOME things don't apply to ME. They never said it was ALL pain. They never said it was a panacea. They strongest they said was "It worked for me" and "I think there's some merit to it".
> "The technical of detaching from pain has significant value, and I have taught it to others. But some things are wildly painful and can't be dismissed that way..."
They explicitly aren't dismissing the pain, controlling the pain, being stoic about the pain, or arguing that you should ignore or suffer through pain. Read it again.
Fair enough. Like I say, take it with a grain of salt. Certainly, I'm no expert on pain, only what I personally went through with RSI.
While my understanding/explanation might be wrong the result was undeniable: I had terrible RSI and now I don't.
I personally could care less why it happened. All I know is that it happened, and this is what I did to make it happen. Ultimately if it works, it works. And you can't deny in this particular case, that it worked.
If expressing my experience can help at least 1 person, in the same way that someone else had expressed the very same experience to me, then I'll take my chances.
If I have a headache, all I have to do is take a shower to get rid of it. I suspect it’s because my brain is so overwhelmed by sense that it doesn’t have the capacity to emit pain. Probably wrong, but I don’t really care how it works. It just does.
Given the myriad comments in agreement, you seem to be either behind on research or research itself is behind. I hope you’re able to expand your thinking.
My severe mouse-clicking induced RSI turned out to be not caused by the clicking itself, but constantly being in a "ready to click" state, i.e: holding your click-fingers(...) slightly tensed on/over the mouse buttons all the time.
Simultaneously this hinders precision movements with the mouse, so my other fingers also tensed up as a result of it.
The solution that cured my RSI for 90% was to route mouse button triggers to keys on an external number-pad, which I operate with my other hand. (I use the "Karabiner" app on macOS to route keys).
In other words: I move the mouse with one hand, and do the clicking with the other hand. This relieves so much tension my RSI was basically gone in a few months.
That seems harder to solve, but if it becomes a problem; maybe using a keyboard with more resistive keys (which sounds counterintuitive) might enable you to rest your fingers on the keys in a more relaxt way.
I think you might have had temporary pain that created a bad position and a lack of flexibility (the words I want to use are typically the words I don't know in English, sorry if I'm not accurate, I try).
The same thing happened to my left ankle. A double sprain (both tear) made me walk with an angle and a locked feet for years, which didn't help with rehab at all and caused pain (because I was locking it in uncomfortable positions). Part of it was psychosomatic: like you said, expectation of pain, most of it was real pain caused by myself.
Also I stopped doing sport, kept eating the same, became fat and changed carrier towards CS, because clearly I couldn't keep working my jobs without the ability to run.
So definitely not as simple as you made it to be but true enough that this can be good advice to people with chronic pain.
Sounds like an extreme example, but i know this as the biopsychosocial model of pain, which as far as i know is the current state of science. Your pain experience will often be created not only by expectations and underlying anatomy, but also how the people around you think and behave about it.
It people tell you constantly something causes back pain, odds are you'll be more susceptible to experience it yourself. Even though your back is physically fine.
I had debilitating carpal tunnel typing pain twice in my life, one in college and once 10 years later.
Both times was when RSI ) carpal tunnel was a very popular fad topic to discuss. Both times my interventions had no effect and the pain cleared up on its own.
I never developed "good typing habits" and when smartphones came out I developed new terrible habits, but that never caused RSI / carpal tunnel pain.
lol I just made it up. But a lot of this knowledge is based on a book called The Happiness Trap which describes all these interactions in much greater detail and by an actual mental health professional.
My post is kind of a shitty abridged version of that which does it no justice.
I agree in part with this philosophy and had success for many years that way, but at some point I started having pain of which simply observing just revealed to me that it was my posture that was partly to blame, at which point I did everything I could to optimize the ergonomics of my workstation. So I conclude that the observational mental approach has merit, but so do ergonomic keyboards and a properly arranged chair and monitor which can pick up where the mental aspect leaves off. At least for me.
I had the same issue and may have posted about it, but for me it took a whole year while it gradually got better after accepting that it was mental (and only then after a doctor did a whole batter of tests and actually investigated the issue, and came up with nothing).
Not a doctor, but I would be worried if there are other similar symptoms elsewhere in the body, or if your injured wrist had an sudden/forceful injury recently (eg falling down and breaking your wrist type, not a gradual buildup/repetitive injury). Chronic damage/injury is definitely a concern but it won't get worse by itself without something else. But going to the GP/family doctor isn't a bad idea at all.
Right, that's why I was only ready to believe it after the doctor did the battery of tests. The checks were very thorough: nerves, vascular system, blood tests, etc. They took a week, and I received diagnoses from doctors of two specialties which were reviewed together.
Interestingly, I got the idea from a coder on his blog detailing how he literally tried everything for his RSI, and wasn't until he tried this approach that it all went away.
Some people (like myself) must fail every single way before finding the solution (because we're stubborn) but this also keenly describes the idea of "the solution is the problem". It's not until we give up, do we actually find what we're looking for.
I think this is what RSI represents for a lot of people. It's such a shitty experience that they literally pour all their effort to try and resolve it, not realising that it's actually making it worse and only until they let go, will it be resolved.
I used to have debilitating RSI when typing. I tried everything and it just got worse over time. Stretches. Typing a certain way. Taking breaks etc. My wrist would become locked after 10 minutes of typing and stay that way for the rest of the day.
I then read a book claiming that all pain is just based on expectation, so if you think it'll be painful it'll be painful, and get worse overtime as the expectation reinforces.
Quite literally within the space of 5 minutes, it all went away. All gone. That was around 8 years ago and I've not had it since. Doesn't matter how long I type, in what position etc. Doesn't affect me at all.
As per Acceptance and Commitment therapy (not the book, something I discovered much later) this can be defined as "the solution is the problem". When you focus on the solution, it defines itself as the problem and it simply becomes worse (think for example, someone who's overweight so eats to make themselves feel better, thereby becoming more overweight and the cycle repeating itself etc.)
Interestingly, the only time my wrist gets sore is when I get really stressed. So I think there's some merit to it being a response from the brain.
I think a large part of it has to do with the eastern idea of letting go. The basic idea is that suffering is a result of holding on too tightly, as opposed to observing intently. Once you observe, the suffering goes away.