My bout with Chronic Pain

I had repetitive stress injury / tendonitis / carpel tunnel syndrome / MSD for two years of my life, and am now fully recovered.

Starting in the spring of my third year at Stanford, I started noticing tingling and discomfort in my wrists, hands and lower arms when I typed for long periods of time. This seemed odd to me since I had been using computers many hours at a time since before I could read, and I had never had any troubles before.

It quickly worsened to the point that I couldn't lift heavy objects, I couldn't open tight jar-lids for people, I couldn't type, couldn't write much, couldn't snowboard without experiencing pain every time I strapped myself in. It wasn't so much that doing these things caused me unbearable pain. In fact, the pain was usually pretty mild, and only got bad if I typed for hours after starting to hurt. But the pain was consistent, and daunting, and always threatening to flare up if I wasn't careful. It was this fear of greater pain, a fear of further damaging myself that kept me from doing the things I wanted to do.

In my many attempts to fix myself, I went to a huge assortment of multicolored doctors, physical therapists, acupunturists, massage therapists (that was actually really nice...), and chiropractors. But nothing helped me for more than a couple of hours or days at a time. Of all these doctor-type people, the most helpful was Dr. John Moore of Hoffman and Moore Chiropractic in Portola Valley, CA. He worked on breaking down the scar tissue that had developed in my arms, and on increasing the blood flow to my arms to help them heal faster. But even Dr. Moore finally started saying what other doctors had been saying for about a year: "You're being good to yourself and not abusing your arms. With the therapy we've done, you really should be healing faster. I don't know why you're not almost completely recovered by now."

My friend and fellow RSI sufferer, David Braun (he had been told by multiple doctors that he would never type again at all), told me that he had been tremendously helped by a book that he had read recently: The Mindbody Prescription: Healing the Body, Healing the Pain by John E. Sarno, MD. He said that I should read it as soon as possible. He told me that just reading this book could really help me.

I was a bit skeptical about whether the act of reading and understanding a book could make a big difference in my pain, especially since holding a book open for more than a few minutes started my wrists hurting. But hey, better than going to yet another doctor who would give me posture lessons, arm exercises to do, and then get confused about why I wasn't recovered 6 months later. So I ordered the book, and then one night, a few busy weeks after it arrived, I finally started reading it.

I started reading the book at around 10pm. My wrists were a bit sore after a busy day at work, and I figured, maybe I could learn a few interesting tidbits from this Dr. Sarno. After reading the first few chapters, I already knew that the author was talking about people like me. People who are perfectionists about being "good". People for whom exploding with anger is laughably out of the question. People who put the needs of others first. I didn't stop reading until about 4am when I had finished.

In his book, Dr. Sarno explains his theory of Tension Myositis Syndrome (TMS). In a nutshell, the idea is this:

Most people repress their emotions to some degree. When we think of repression, we often think of extreme cases, like someone repressing the memories and emotions of childhood sexual abuse. But immensely more common than this are people who feel that, for example, being angry at others is wrong, or that sadness and crying are for sissies, and learn to repress these emotions.

Our subconscious minds use many tools to repress emotions. We distract ourselves with work, or music, or in the case of people with TMS, with pain and the careful planning involved in avoiding more pain.

In people with TMS, the subconscious mind increases tension in part of the body in a way that lowers blood flow, causing mild oxygen deprivation, causing pain. This process is the cause of much of the western world's chronic back pain, repetitive stress injury, chronic jaw pain, and of many other chronic ailments.

To stop the existing pain, we need to increase blood flow (this is why accupuncture, massage, exercise, and ultrasound therapies can offer temporary relief, as they increase blood flow). But to stop the cycle of chronic pain, we need to stop the subconscious from inflicting this increased tension. According to the book, many people are able to stop this cycle just by knowing of this process, and by wanting not to do it anymore (despite having no conscious understanding of how to raise or lower blood flow).

Part way through reading the book, I decided to try to increase the blood flow to my arms since they were hurting from holding up the book. I thought the easiest way would be through using biofeedback. I lay down, relaxed, and tried to feel a pulse in my finger tips. After a few seconds I felt a weak pulsing sensation. I fixed my mind on that and tried to make it feel stronger. To strengthen it I tried flexing and relaxing my fingers and arms, but that didn't help. I tried breathing faster, then deeper. I tried taking a real "deep breath" -- the kind that leaves you feeling distinctly satisfied. This helped noticeably, as I felt my little finger-tip pulse get stronger. I played around with this for ten or fifteen minutes (getting a little light-headed in the process, with all of the deep breathing practice) until I started to be able to get the relaxation and blood flow benefits consistently. And then I suddenly realized that my arms felt totally fine!

After finishing Dr. Sarno's book, I was excited, but cautiously so. The next day at work I typed a lot, just to test myself. I was fine for much longer than usual, but after intense computer work for about an hour, my arms began to get sore. I remember thinking to myself "I must be only partly better. I am obviously much better than I was, since I could type for an hour, but since I am again getting sore, I must have more left to figure out." Then I realized that I knew exactly what was going on, and it didn't have to happen. I told myself to stop making my arms sore, relaxed and took a few deep breaths while feeling for a pulse in my hands, and within 30 seconds I was back to feeling completely fine.

A few times since then, I will start to feel pain in my arms, but I just relax for a few seconds and take a deep breath, and I'm back to being fine!