9 ms·

Body mapping study suggests chronic pain comes in nine distinct types

172 points by lnyan 5y ago

deleted 5y ago
[deleted]
dade_ 5y ago
At the time Covid lockdown started, my entire foot had become inflamed, and I couldn’t walk on it. It’s happened before, doctors, physiotherapists and immune specialists couldn’t find a disease or condition to blame it on. They could only offer pain killers and anti-inflammatory meds. It passed, as it has before. One thought was overuse, or some reinjury from the past. I happened to find a personal trainer that was educated by osteopaths and the last year with him has been shocking. In my mind, I didn’t have any pain issues, though some areas were stiff, getting things from lower cabinets was becoming a chore, and the end of the day at work the back of my head and neck would get stiff. A cocktail or beer could solve the latter. It has been over a year of discoveries. It turns out, muscles all over my body were very tight, for whatever reason, many major movements were no longer using the major muscle, but instead the brain had recruited minor muscles for the movement - perhaps a compensation for a past injury. I’ve learned that I have psoas muscles, and how to use them (though that journey continues) and that pinching feeling in my hip no longer happens when I am sitting. I was already aware that so many things happen in our bodies that we aren’t conscious of, but the depth of it now astounds me. First, I did have pain and problems, but I had somehow shut off awareness. Second, all of those problems were being still having the effect of making me feel tired and worn down. Third, all of these compensatory movements that the brain does all by itself were probably great for simple survival because they allow us to keep going even though the best way to move is lost. Thing is, the brain doesn’t seem to have an automatic ‘service restoration to primary’. We have to do it consciously, intentionally, and with practice. Pain is in the mind. There can be pain where there is no physical problem, and there can be no pain where there is a serious problem, but there can also be pain because we have lost awareness of our body and so pain manifests all over the place. There is an idea that the mind and body are separate, this is wrong and the idea needs to be burned with fire. Until then, people will continue fighting with these phantoms. We can group pain together, slice it apart, but I think that in many cases there isn’t much more to learn from pain, except that in many cases it is a symptom of a body trying to communicate to a mind that stopped paying attention.
- elric 5y ago
  It's fascinating, isn't it? It's also frustrating. You see a doctor because something hurts, they look at the something -- often in isolation -- and if they can't figure it out, you're pretty much on your own. I had constant foot pain in one foot for nearly a year. Doctors told me to rest. I walk a lot, and walking less wasn't really an option. Saw an osteopath, with more than a healthy dose of skepticism. They gave me exercises which were both baffling and ridiculous, which basically taught me how to use my big toes, then graduated to strengthening those muscles. At some point during this process, the pain went away, and it hasn't come back. Why couldn't my doctor identify this apparent muscle weakness in my foot? I don't know. But I'm glad the osteopath did.
  - bishoprook2 5y ago
    >You see a doctor because something hurts, they look at the something -- often in isolation -- and if they can't figure it out, you're pretty much on your own. A quick Old Man(tm) rant. Concerning healthcare, you have to be your own project manager. They're a lot better at curing things they can see (ie. surgery), GPs have crude tools for analysis and mostly serve as gatekeepers to specialists and pharmacists. Also, GPs work mostly from flow charts and you are just one of 1000 patients they see that year. Communications between hospital departments, independent contractors like specialists or ER personnel, GPs, etc. are poor. Continuously audit procedures and drug regimes. Sci-Hub is your friend but don't overestimate the value of studies.
    - foepys 5y ago
      I was told recently that there is already change happening. Medical students are being told that they need to work with the patient, not on them. Nobody knows their symptoms and illness better than the patient themselves. A doctor looks at them for 5 minutes, the patient lives with them so not including the patient in the diagnostic process is like working with a blindfold on.
      - arpa 5y ago
yosito 5y ago
Better title: study picks 9 categories and assigns chroinic pains to one of those categories, proving that data can be sorted into arbitrary categories.
- refactor_master 5y ago
  >The agglomeration method that we adopt is Ward’s method, which aims to min- imize the total within-cluster variance. At each step in Ward’s method, the algorithm finds two clusters that will result in minimum increase in total within-cluster variance after fusing. The number of clusters was narrowed by cluster size and similarity to 9 total groups through review of dendrograms and heat maps by non-clinician investigators (A.G. and N.A.). 1. Pick an algorithm. 2. Get a number of clusters. Preferably below 10, because otherwise it gets too messy for publication. 3. Justify algorithm based on its first paragraph on Wikipedia.
  - IshKebab 5y ago
    "study suggests height comes in 9 distinct types!"
    - snissn 5y ago
      i like your spin on it to height. albiet pain likely has a multidimensional graph to cluster onto, height having one dimension makes the whole idea of clustering it silly :)
  - specialist 5y ago
    I'm much more enthusiastic. (see other comment) More over, picking new categories is a great application of "big data". Real example: Imagine catalog for fashion retailer. Time to add color picker & filter. No agreement on color names, how many shades of gray, etc. So one of our big data gurus figures it out. Gather dozens of palettes. Social cognition style guessing game. Slice & dice our product catalog 100s of ways to get best fit. Result was a thing of beauty. Truly novel. The analysis worthy of a PhD.
- deleted 5y ago
martini333 5y ago
Nothing about headache or migraine...
- mxd3 5y ago
  Yeah, it's odd to see that omitted, especially for headaches that are related to muscle and joint issues.
- syockit 5y ago
  Was about to comment the same. I had a severe headache this week, the second headache episode for this year. It's not chronic so it's off-topic, but I was wondering if the reason headaches are not catalogued here is because pain management clinics don't handle them.
- arpa 5y ago
  This is probably due to their definition of chronic, as migraines and headaches are usually episodic.
- tuatoru 5y ago
  Or trigeminal nerve pain. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Trigeminal-Neuralgia-Fact-Sheet https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Educat...
binarymax 5y ago
For anyone suffering from Type A or Type C, I urge you to check if you have LSTV (Lumbosacral Transitional Vertebrae). It is estimated to effect 12% of the population. This diagnosis (only 6 months ago) got me out of a spiral of pain. Knowing it was not a disc or other soft tissue gave me the confidence to stretch and exercise appropriately and I’m now mostly pain free. I expect in another 6 months I won’t notice it at all. If you see a chiro then ask for imaging (X-rays are typically covered by insurance after 6 visits with your doctor). This diagnosis literally changed my life, and I wish I’d had it sooner.
m3kw9 5y ago
Had shooting pain on my thighs and thought it was sciatic nerve issue but turns out I needed to stretch my it bands and ligaments and it went away. I mean it could still be sciatic nerve issue but at least I didn’t need pain killers or anything to fix it. I find a lot of pain we have could be due to muscle overuse, misuse, underuse causing tightness. Everything seem to link and if you relief a kink in a different area, it could solve a pain in another area.
- slfnflctd 5y ago
  Weightlifting can also be a huge help in this area-- among other things, it forces you to stretch less used muscle groups. You should be prepared to care for yourself on off days, but decent nutrition and massages every so often are more affordable than you think.
candyman 5y ago
I think our healthcare system (in the US) is very poor at helping people figure something out. If you know and it's clear the system is great at fixing it. I had all kinds of knee pain and saw every ortho I could. Knees were fine. It wasn't until I visited an osteopath in France (by coincidence) that he was able to diagnose it just by feel - it was my hip. After having it replaced I was good as new. I have friends having similar chronic pain problems and they have been to medical centers all over, had tons of tests and yet there is no real diagnosis. Each doctor looks at it from their own point of view - nope, no cancer - nope, no MS, etc.

172 points by lnyan 5y ago

deleted 5y ago

[deleted]

At the time Covid lockdown started, my entire foot had become inflamed, and I couldn’t walk on it. It’s happened before, doctors, physiotherapists and immune specialists couldn’t find a disease or condition to blame it on. They could only offer pain killers and anti-inflammatory meds. It passed, as it has before. One thought was overuse, or some reinjury from the past. I happened to find a personal trainer that was educated by osteopaths and the last year with him has been shocking. In my mind, I didn’t have any pain issues, though some areas were stiff, getting things from lower cabinets was becoming a chore, and the end of the day at work the back of my head and neck would get stiff. A cocktail or beer could solve the latter. It has been over a year of discoveries. It turns out, muscles all over my body were very tight, for whatever reason, many major movements were no longer using the major muscle, but instead the brain had recruited minor muscles for the movement - perhaps a compensation for a past injury. I’ve learned that I have psoas muscles, and how to use them (though that journey continues) and that pinching feeling in my hip no longer happens when I am sitting. I was already aware that so many things happen in our bodies that we aren’t conscious of, but the depth of it now astounds me. First, I did have pain and problems, but I had somehow shut off awareness. Second, all of those problems were being still having the effect of making me feel tired and worn down. Third, all of these compensatory movements that the brain does all by itself were probably great for simple survival because they allow us to keep going even though the best way to move is lost. Thing is, the brain doesn’t seem to have an automatic ‘service restoration to primary’. We have to do it consciously, intentionally, and with practice. Pain is in the mind. There can be pain where there is no physical problem, and there can be no pain where there is a serious problem, but there can also be pain because we have lost awareness of our body and so pain manifests all over the place. There is an idea that the mind and body are separate, this is wrong and the idea needs to be burned with fire. Until then, people will continue fighting with these phantoms. We can group pain together, slice it apart, but I think that in many cases there isn’t much more to learn from pain, except that in many cases it is a symptom of a body trying to communicate to a mind that stopped paying attention.

elric 5y ago
It's fascinating, isn't it? It's also frustrating. You see a doctor because something hurts, they look at the something -- often in isolation -- and if they can't figure it out, you're pretty much on your own. I had constant foot pain in one foot for nearly a year. Doctors told me to rest. I walk a lot, and walking less wasn't really an option. Saw an osteopath, with more than a healthy dose of skepticism. They gave me exercises which were both baffling and ridiculous, which basically taught me how to use my big toes, then graduated to strengthening those muscles. At some point during this process, the pain went away, and it hasn't come back. Why couldn't my doctor identify this apparent muscle weakness in my foot? I don't know. But I'm glad the osteopath did.
- bishoprook2 5y ago
  >You see a doctor because something hurts, they look at the something -- often in isolation -- and if they can't figure it out, you're pretty much on your own. A quick Old Man(tm) rant. Concerning healthcare, you have to be your own project manager. They're a lot better at curing things they can see (ie. surgery), GPs have crude tools for analysis and mostly serve as gatekeepers to specialists and pharmacists. Also, GPs work mostly from flow charts and you are just one of 1000 patients they see that year. Communications between hospital departments, independent contractors like specialists or ER personnel, GPs, etc. are poor. Continuously audit procedures and drug regimes. Sci-Hub is your friend but don't overestimate the value of studies.
  - foepys 5y ago
    I was told recently that there is already change happening. Medical students are being told that they need to work with the patient, not on them. Nobody knows their symptoms and illness better than the patient themselves. A doctor looks at them for 5 minutes, the patient lives with them so not including the patient in the diagnostic process is like working with a blindfold on.
    - arpa 5y ago

yosito 5y ago

Better title: study picks 9 categories and assigns chroinic pains to one of those categories, proving that data can be sorted into arbitrary categories.

refactor_master 5y ago
>The agglomeration method that we adopt is Ward’s method, which aims to min- imize the total within-cluster variance. At each step in Ward’s method, the algorithm finds two clusters that will result in minimum increase in total within-cluster variance after fusing. The number of clusters was narrowed by cluster size and similarity to 9 total groups through review of dendrograms and heat maps by non-clinician investigators (A.G. and N.A.). 1. Pick an algorithm. 2. Get a number of clusters. Preferably below 10, because otherwise it gets too messy for publication. 3. Justify algorithm based on its first paragraph on Wikipedia.
- IshKebab 5y ago
  "study suggests height comes in 9 distinct types!"
  - snissn 5y ago
    i like your spin on it to height. albiet pain likely has a multidimensional graph to cluster onto, height having one dimension makes the whole idea of clustering it silly :)
- specialist 5y ago
  I'm much more enthusiastic. (see other comment) More over, picking new categories is a great application of "big data". Real example: Imagine catalog for fashion retailer. Time to add color picker & filter. No agreement on color names, how many shades of gray, etc. So one of our big data gurus figures it out. Gather dozens of palettes. Social cognition style guessing game. Slice & dice our product catalog 100s of ways to get best fit. Result was a thing of beauty. Truly novel. The analysis worthy of a PhD.
deleted 5y ago

martini333 5y ago

Nothing about headache or migraine...

mxd3 5y ago
Yeah, it's odd to see that omitted, especially for headaches that are related to muscle and joint issues.
syockit 5y ago
Was about to comment the same. I had a severe headache this week, the second headache episode for this year. It's not chronic so it's off-topic, but I was wondering if the reason headaches are not catalogued here is because pain management clinics don't handle them.
arpa 5y ago
This is probably due to their definition of chronic, as migraines and headaches are usually episodic.
tuatoru 5y ago
Or trigeminal nerve pain. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Trigeminal-Neuralgia-Fact-Sheet https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Educat...

binarymax 5y ago

For anyone suffering from Type A or Type C, I urge you to check if you have LSTV (Lumbosacral Transitional Vertebrae). It is estimated to effect 12% of the population. This diagnosis (only 6 months ago) got me out of a spiral of pain. Knowing it was not a disc or other soft tissue gave me the confidence to stretch and exercise appropriately and I’m now mostly pain free. I expect in another 6 months I won’t notice it at all. If you see a chiro then ask for imaging (X-rays are typically covered by insurance after 6 visits with your doctor). This diagnosis literally changed my life, and I wish I’d had it sooner.

m3kw9 5y ago

Had shooting pain on my thighs and thought it was sciatic nerve issue but turns out I needed to stretch my it bands and ligaments and it went away. I mean it could still be sciatic nerve issue but at least I didn’t need pain killers or anything to fix it. I find a lot of pain we have could be due to muscle overuse, misuse, underuse causing tightness. Everything seem to link and if you relief a kink in a different area, it could solve a pain in another area.

slfnflctd 5y ago
Weightlifting can also be a huge help in this area-- among other things, it forces you to stretch less used muscle groups. You should be prepared to care for yourself on off days, but decent nutrition and massages every so often are more affordable than you think.

candyman 5y ago

I think our healthcare system (in the US) is very poor at helping people figure something out. If you know and it's clear the system is great at fixing it. I had all kinds of knee pain and saw every ortho I could. Knees were fine. It wasn't until I visited an osteopath in France (by coincidence) that he was able to diagnose it just by feel - it was my hip. After having it replaced I was good as new. I have friends having similar chronic pain problems and they have been to medical centers all over, had tons of tests and yet there is no real diagnosis. Each doctor looks at it from their own point of view - nope, no cancer - nope, no MS, etc.