5 ms·

This will probably be controversial, but I believe that RSI (and typing-related carpel tunnel) is psychosomatic. I experienced what I thought was chronic RSI

by nileshk 16y ago

This will probably be controversial, but I believe that RSI (and typing-related carpel tunnel) is psychosomatic. I experienced what I thought was chronic RSI that I wasn't able to solve through any other means but reading Dr. John E Sarno's "The Mindbody Prescription" which I highly recommend reading. For 1.5 years I was not able to type without pain. I was able to rid myself of this pain in weeks through a psychological approach. It's been over 7 years since then and I haven't had problems. I also play guitar, bass guitar, and drums. It can be painful sometimes to play a lot if I haven't been practicing, but that pain goes away immediately, and I don't believe it contributes to a permanent or long-standing problem. Ergonomics is good for being comfortable and pain-free. And exercise is good for general health. But I don't think not doing so is going to give you chronic pain. Of course you should see a doctor to rule out diseases like multiple sclerosis. Here is a document that explains Sarno's ideas: http://www.rsi.deas.harvard.edu/handout.doc http://www.rsi.deas.harvard.edu/handout.doc Google cache of it for HTML: http://www.google.com/url?sa=t&source=web&cd=2&ved=0CBoQITAB&url=http%3A%2F%2Fwebcache.googleusercontent.com%2Fsearch%3Fq%3Dcache%3A6ZpktcdKS0kJ%3Awww.rsi.deas.harvard.edu%2Fhandout.doc%2Bhttp%3A%2F%2Fwww.rsi.deas.harvard.edu%2Fhandout.doc%26cd%3D1%26hl%3Den%26ct%3Dclnk%26gl%3Dus&rct=j&q=http%3A%2F%2Fwww.rsi.deas.harvard.edu%2Fhandout.doc&ei=eM9eTLyWCML58Abz7byzDQ&usg=AFQjCNFDePk4TJUp7Sv8KeGlXMzQIEYArw&sig2=WpLK0EBD_odWgNcFL4_Etg&cad=rja http://www.google.com/url?sa=t&source=web&cd=2&v... Keep in mind that this does not mean "it is all in your head"... The problem does cause a physical condition in your body, but the cause of it is psychological.

mmt 16y ago
Of course you should see a doctor to rule out diseases like multiple sclerosis. Autoimmune (e.g. Lupus) diseases are another important set to rule out. The good news is that, though not curable, many of the inflammatory ailments are easily and cheaply treatable. My advice: have your doctor consider the old NSAIDs first.Ketoprofen is my favorite, though Wyeth pulled it off the OTC market[1], so the lowest single-pill dose is pretty high[2]. Among friends and relatives who've tried it, it consistently counters inflammation, even though its pain relief varies down to nothing. Being old, it's cheap, too. [1] shortly after buying the company who marketed it under the brand "Orudis KT". The cynic in me says it's because Advil has a much higher profit margin. [2] 50mg compared to 12.5mg. Sometimes, 12.5mg once a day is all I've needed. Especially with the recent concerns over the safety of NSAIDs, needlessly quadrupling the dose seems foolish, so I hack the dosages. I could probably get a compounding pharmacy to do this for me, but that would eliminate the "cheap" advantage.
mattchew 16y ago
It's definitely controversial--so I feel obliged to mention that Sarno's methods also worked/work for me. I also ran the gauntlet of standard medical treatments and therapies before trying Sarno's approach. If you have seemingly untreatable RSI, it's worth giving Sarno's ideas a look.
zedshaw 16y ago
I agree, it is psychosomatic, although that's usually a term used by bad doctors to wave away real problems with people. I think a better way to explain it is that your body is controlled by your brain, and if you control it wrong you can cause damage. Same way if you punch or kick something wrong you can break your hand, if you spend 8+ hours a day typing with tension, poor technique, bad posture, and ignoring pain signals then you'll hurt your hands. So yes, learning to control you body and how you use it is generally a good idea. In general I think that's all Sarno's method does. It just makes you focus on how the motions should be done in a more relaxed manner, rather than tense and harmful. Combine that with the wrist exercises and you'll be even better off.
xenophanes 16y ago
I agree with you that it is sometimes (perhaps often) psychosomatic. I myself experienced much improved condition when I stopped being fearful. Would you agree that in at least 5% of serious cases, the physical not mental problem is the main thing?
mikeklaas 16y ago
A repost of my comment from the last time this came up (http://news.ycombinator.com/item?id=1270409 http://news.ycombinator.com/item?id=1270409): -------------------- His experience matches mind as well. Horrible RSI persisting for years, with non of the conventional treatments effective beyond a short amount of time. After doing a _lot_ of research into this, I experienced an almost complete short-term recovery. It wasn't just lack of pain... muscles that felt perpetually taut and ropey were suddenly softened, and I became extraordinarily thirsty for a couple of days as healing started again. Unfortunately, I only have speculation about what's going on here medically. As a seasoned skeptic, Dr. Sarno's explanation of psychological causes is unsatisfying to me. My hypothesis is that RSI is caused by a problem in the autonomic nervous system (i.e. the part that regulates your body). Sympathetic nervous system activity is provoked when your body is in "danger" mode: muscles are tensed, ready to act, etc. Now, what happens in RSI is that your muscles are being stressed through use (typing). This isn't normally a problem: when you stop typing, your muscles heal the tiny amount of damage that was inflicted. But if you are stressed out, then your sympathetic nervous system activity is heightened and your muscles don't get a chance to heal. Now this is the insidious bit: the pain and injury eventually becomes a danger signal to your body. The injury thus provokes further sympathetic nerve activity. This negative feedback loop can thus perpetuate without the person feeling actively stressed any more, but is obviously exacerbated by feelings of worry about the RSI. Every time you try to be careful, you make the problem worse. For a more medical take, some pieces are conveyed in this article: http://www.aapb.org/tl_files/AAPB/files/biof_34_2_pain.pdf http://www.aapb.org/tl_files/AAPB/files/biof_34_2_pain.pdf . Some people speculate that similar issues underlie more serious problems, like RSDS and fibromyalgia So that's all well and good, but what about the "cure"? Well, it seems that many people have virtually instantly solved their problems by adopting positive beliefs about the nature of the problem, that it is a problem caused by problematic nervous system signals and NOT an insoluble muscular injury. How does that work, exactly? I have no idea. Obviously, some stress is reduced, but that can't explain the magnitude and suddenness of the change. If anyone has ideas, I'd be very interested in hearing them. If you suffer from RSI, the advice I would have is to think about this explanation while researching the ideas thoroughly to see if you're convinced. In the meantime, the best thing to do is daily exercise that isn't too intense, but gets your blood flowing for 20-30 minutes. Biking, running, yoga all have good benefits. You can do things like lift weights as well, but it is easy to overdo it, so I don't recommend it if your symptoms are severe. It's worth reading Dr. Sarno's book, but keep in mind that he uses words like "freudian unconscious rage", which made it hard to take anything he said seriously. In my mind, he is inaccurately explaining something which isn't true but corresponds to _some_ true phenomenon. I've wanted to write this up for a while, but while I'm relatively convinced that I have a better explanation for RSI than most doctors, I don't really understand how "the solution" works (nor for how many people it does). I also realize that it sounds exceptionally hokey, which fuels my reticence. We'll see how it goes over here... ask me anything.

by nileshk 16y ago

mmt 16y ago

Of course you should see a doctor to rule out diseases like multiple sclerosis. Autoimmune (e.g. Lupus) diseases are another important set to rule out. The good news is that, though not curable, many of the inflammatory ailments are easily and cheaply treatable. My advice: have your doctor consider the old NSAIDs first.Ketoprofen is my favorite, though Wyeth pulled it off the OTC market[1], so the lowest single-pill dose is pretty high[2]. Among friends and relatives who've tried it, it consistently counters inflammation, even though its pain relief varies down to nothing. Being old, it's cheap, too. [1] shortly after buying the company who marketed it under the brand "Orudis KT". The cynic in me says it's because Advil has a much higher profit margin. [2] 50mg compared to 12.5mg. Sometimes, 12.5mg once a day is all I've needed. Especially with the recent concerns over the safety of NSAIDs, needlessly quadrupling the dose seems foolish, so I hack the dosages. I could probably get a compounding pharmacy to do this for me, but that would eliminate the "cheap" advantage.

mattchew 16y ago

It's definitely controversial--so I feel obliged to mention that Sarno's methods also worked/work for me. I also ran the gauntlet of standard medical treatments and therapies before trying Sarno's approach. If you have seemingly untreatable RSI, it's worth giving Sarno's ideas a look.

zedshaw 16y ago

I agree, it is psychosomatic, although that's usually a term used by bad doctors to wave away real problems with people. I think a better way to explain it is that your body is controlled by your brain, and if you control it wrong you can cause damage. Same way if you punch or kick something wrong you can break your hand, if you spend 8+ hours a day typing with tension, poor technique, bad posture, and ignoring pain signals then you'll hurt your hands. So yes, learning to control you body and how you use it is generally a good idea. In general I think that's all Sarno's method does. It just makes you focus on how the motions should be done in a more relaxed manner, rather than tense and harmful. Combine that with the wrist exercises and you'll be even better off.

xenophanes 16y ago

I agree with you that it is sometimes (perhaps often) psychosomatic. I myself experienced much improved condition when I stopped being fearful. Would you agree that in at least 5% of serious cases, the physical not mental problem is the main thing?

mikeklaas 16y ago

A repost of my comment from the last time this came up (http://news.ycombinator.com/item?id=1270409 http://news.ycombinator.com/item?id=1270409): -------------------- His experience matches mind as well. Horrible RSI persisting for years, with non of the conventional treatments effective beyond a short amount of time. After doing a _lot_ of research into this, I experienced an almost complete short-term recovery. It wasn't just lack of pain... muscles that felt perpetually taut and ropey were suddenly softened, and I became extraordinarily thirsty for a couple of days as healing started again. Unfortunately, I only have speculation about what's going on here medically. As a seasoned skeptic, Dr. Sarno's explanation of psychological causes is unsatisfying to me. My hypothesis is that RSI is caused by a problem in the autonomic nervous system (i.e. the part that regulates your body). Sympathetic nervous system activity is provoked when your body is in "danger" mode: muscles are tensed, ready to act, etc. Now, what happens in RSI is that your muscles are being stressed through use (typing). This isn't normally a problem: when you stop typing, your muscles heal the tiny amount of damage that was inflicted. But if you are stressed out, then your sympathetic nervous system activity is heightened and your muscles don't get a chance to heal. Now this is the insidious bit: the pain and injury eventually becomes a danger signal to your body. The injury thus provokes further sympathetic nerve activity. This negative feedback loop can thus perpetuate without the person feeling actively stressed any more, but is obviously exacerbated by feelings of worry about the RSI. Every time you try to be careful, you make the problem worse. For a more medical take, some pieces are conveyed in this article: http://www.aapb.org/tl_files/AAPB/files/biof_34_2_pain.pdf http://www.aapb.org/tl_files/AAPB/files/biof_34_2_pain.pdf . Some people speculate that similar issues underlie more serious problems, like RSDS and fibromyalgia So that's all well and good, but what about the "cure"? Well, it seems that many people have virtually instantly solved their problems by adopting positive beliefs about the nature of the problem, that it is a problem caused by problematic nervous system signals and NOT an insoluble muscular injury. How does that work, exactly? I have no idea. Obviously, some stress is reduced, but that can't explain the magnitude and suddenness of the change. If anyone has ideas, I'd be very interested in hearing them. If you suffer from RSI, the advice I would have is to think about this explanation while researching the ideas thoroughly to see if you're convinced. In the meantime, the best thing to do is daily exercise that isn't too intense, but gets your blood flowing for 20-30 minutes. Biking, running, yoga all have good benefits. You can do things like lift weights as well, but it is easy to overdo it, so I don't recommend it if your symptoms are severe. It's worth reading Dr. Sarno's book, but keep in mind that he uses words like "freudian unconscious rage", which made it hard to take anything he said seriously. In my mind, he is inaccurately explaining something which isn't true but corresponds to _some_ true phenomenon. I've wanted to write this up for a while, but while I'm relatively convinced that I have a better explanation for RSI than most doctors, I don't really understand how "the solution" works (nor for how many people it does). I also realize that it sounds exceptionally hokey, which fuels my reticence. We'll see how it goes over here... ask me anything.