Why I left my tech job to work on chronic pain

It took about 6 months for the brain zaps to start fading. Then another 6 months for me to start feeling capable of really doing my job well. I'm 18 months into "recovery" and I still think I have another 6 to 12 months before I feel like my old self again (so about 2 to 2.5 years in total).

Time is really the only solution. You can't just think your way through it. You have to left your body's rewards systems re-adapt and re-learn how to be a healthy, happy human.

That's my experience at least, that it's not healthy to be in environments like that for any length of time. In such a place, my regret is always not leaving sooner...

Apropos, I had chronic pain throughout this experience. I thought it was just aging, irreversible, and something that compounded my hopelessness. It's very surprising to be 10 years older now but feel 20 years younger. Books like "The Body Keeps the Score" or "Healing Back Pain" used to seem woo to me, but now I am convicted that health comes from within as much or more than it does from without.

I think there are a few reasons you see this in health/medical community.

1) just helping people understand a different view of the problem is often enough for one blog post. Stuffing new way to look at solution and new solution together can sometimes be a bit much.

2) we have to be cautious from a regulatory perspective about what we say, and sometimes in being too cautious don't give the people who REALLY want to understaned the processes enough to go on. For our company, I used to say things like "we can increase the synchronous firing of neurons which results in reduced 15^% drop in early night cortisol, and 14.5% increase in hrv....".

But prior to regulatory approvals, we can't point directly to neurological or physiological processes, which means we kinda end up talking around the solution a bit.

3) in marketing, they want to connect and build an audience, so they are dripping more information over time. One post gets feedback and interest from one group, then you do another, and another. It's about building the community and connecting with people, not just a "here's a problem, do the thing, thanks". If you are trying to build a business, you probably need to get in front of people 7-8 times, particularly if you're taking a new approach to a problem, to build trust and brand recognition.

It's not the best, but it is the way the world works.

Just woke up and this post's traction has surpassed my wildest imagination.

Similar to what pedalpete has said, I'm looking to release this in parts to ensure:

1. I am not overwhelming people and losing their interest

2. Quality remains as high as possible (I invested only a few hours into this last week as an experiment). I want this blog to be the most easily accessible, engaging + factual source for chronic pain sufferers. That requires sufficient time to nail (and it seems like I've struck a chord so far).

3. Get signals from readers week by week and tailor to the audience which is forming.

This will help me helpfully reach the most pain sufferers.

RE feel like you're being sold something. This series will cover what is needed to recover from chronic pain and be offered for free. I am looking to build a product eventually (why wouldn't I want help as many people as posssible while building a career which does good - I don't believe they're exclusive), but the information in this blog will remain free.

RE not calling out Pain reprocessing theory/therapy - I'll go through the post today and see if it makes sense to add this into #1 (or if it's better for #4). It's not something I consciously omitted when writting this post last week.

Thanks for the comment!

There isn't a "solution" - you're looking at a life-long mitigation and management strategy that will not be "brief".

The time commitment typically goes up as one ages. I could spend 40 hours a week on nutrition, exercise and relaxation if I was trying to optimize for chronic pain reduction.

But then nothing else would get done.

[0] Circadian rhythms and pain: https://www.sciencedirect.com/science/article/abs/pii/S01497...

[1] The disruptive relationship among circadian rhythms, pain, and opioids: https://www.frontiersin.org/journals/neuroscience/articles/1...

[2] Circadian rhythm disruption exacerbates pain behavior in male mice: https://www.sciencedirect.com/science/article/abs/pii/S03064...

I'll read this blog with love!

Thanks

Sometimes I wish there was a medHN

My wife has had two surgeries and each time she had a minor post surgery issue. One of them was an area that was tender to touch; another was chronic pain. Neither was mentioned as a possible side effect of the surgery by the surgeon. The main takeaway even if a bit extreme here is avoid all surgeries unless absolutely necessary.

Anecdotally, I had a phase where pretty much the same thing happened to me with the Achilles (+ calf/ankle) flare-ups I was having (during this part of my chronic journey). Eventually got through it by doing small walks around my home, then outside but keeping the frequency high each day (i.e. instead of 1 "long" walk, doing 3-4 short ones). I.e. Desensitisation / daily movement

This is a misinterpretation of these studies which is common throughout this thread.

The research isn’t showing that chronic pain is a psychological condition. It’s suggesting that some cases of nonspecific chronic pain that specifically do not match the symptoms of typical physically-rooted pain are psychological. The participants in this study were filtered for this criteria.

For some reason, people see this idea and lose the nuance, concluding that most or all chronic pain is actually psychological.

I think if someone matches the description used by the author of the substack for this HN entry (he describes his chronic pain as random and popping up all over his body) then pursuing the psychological explanation would be a very good idea.

However, it’s getting frustrating to see all of the reductionist claims that “chronic pain is psychological”.

This exercise fixed it for me. I was diagnosed with GERD last year, I already had it for 2-3 years before that, but it got worse last year. I got ppis for a couple of months and when I finished all of them it came back worse. Fortunately I found this article, and I started doing the exercise daily morning after I woke up(and still do it). I can now eat tomatoes, food with mint, spicy food etc etc :) I have shared my experience with others and it helped them too

Edit - Changed the link, had posted something else by mistake

Chronic reflux as a symptom is almost always initially treated by PPIs because the cause among white collar workers is assumed to be chronic stress[1]. Since doctors can't "treat stress" only its symptoms, they will just tell you to try and manage stressors in your life yourself. Maybe suggest counseling but in general they are limited in what they can do. What they can do, if you are persistent in the complaint, is to just run through all the other less likely causes of it.

I was lucky omeprazole worked for me the first time. I knew exactly what was stressing me out 24/7 and the acid reflux and frequent belching combined with the "pit in my stomach" feeling was all too common and connected around my main stressor. In my case, it started 8 months after accepting a role shift from engineering into management. I was cautiously excited initially, but it just soured very quickly. I would feel physical angst parking at work every morning trying to remind myself of all the web of political infighting "what our team is hiding from this other team", "who we can discuss what with", "how that other team is actively undermining us and their other downstream partners, but how we are circumventing that" how to 4d chess maneuver yourself in the most counterproductive ways possible. It was illuminating on where a lot of those special "business requirements" come from sometimes, but it just wasn't for me. Cutting that out was a massive relief

[1]: Stress and glucocorticoids have well documented effects on the digestive system. I recommend the "Why Zebras Don't Get Ulcers" book chapter on stress and the digestive system.

Oh definitely. Some doctors are physically incapable of uttering the words “I/We don’t know.” I know a few doctors, and have asked a couple of them about this. In private, they’re very frank about the limits of modern medicine. But in front of patients, they’re afraid any sign of uncertainty will lead to patients concluding that some other quackery is just as good as actual medicine. I can definitely understand their perspective, but it does sometimes make them come across as arrogant know-it-alls.

The diagnosis I got from my therapist is PTSD from my chikdhood due to the strong connection between stress and body.

The only thing I found that alleviates my symptoms short term is lots of Buddhist meditation (1-2 hours per day).

I wish you all the best and thank you so much for sharing.

Foods make it worse, but it’s rarely an issue if I’m in decent shape and not stressed.

-https://www.healthcentral.com/digestive-health/acid-reflux-e...

-https://www.refluxguard.com/the-acid-reflux-game-changer-sle...

And as you have said, avoid anything that increases stomach acid production (such as caffeine or even tea, along with spicy food).

You might also have success with Venter[1] (Sucralfate).

[1] https://www.medicinesfaq.com/brand/venter

> The most consequential problem with BKS is its promotion of a large number of treatments, outside of EMDR, that have limited to no evidence (e.g., massage, acupuncture, yoga, community theater, and neurofeedback), according to the latest treatment guidelines by the International Society for Traumatic Stress Studies (Frank et al., 2020), while simultaneously ignoring or criticizing PE and CPT, the two treatments with the highest quality evidence (Sakaluk et al., 2019).

https://web.archive.org/web/20250120164320/https://journals....

He almost certainly suffered minor brain damage during this episode, and later, after about a decade of taking anti-protonic medications for reflux, developed exactly the abnormally rapidly growing abdominal cancer that patients who take anti-protonics apparently develop at a higher rate than similar GERD patients who don't.

I don't mean to give medical advice. I can only describe what happened in my family (which has a heritable deformation in the esophagus, leading to severe GERD). Take it with a grain of salt (and an antacid) as what it is: an anecdote from some anonymous nonexpert on the internet.

Anyhow, good luck. I'm glad to know you're working actively on the problem, not ignoring it as my father did, and I hope you find some long-term relief and peace.

I agree, though this is a very difficult subject. Often, the people who would benefit the most from psychosomatic interventions are often the most resistant to accepting those explanations. Meanwhile, many of the physical chronic pain sufferers I know have desperately tried various mind-body programs (without success) because they will try anything that might help.

If people match the description of the author of this post and blog, where the pains are widespread, vague, and popping up around different parts of the body without explanation then you really should explore psychosomatic explanations like this author did.

However, I’m growing weary of the trend of people who fit this description starting newsletters they want you to subscribe to (like this one), writing apps they want you to download/buy, and making comments implying that they know better than doctors about chronic pain (while putting an obligatory “not a doctor” disclaimer juxtaposed to their comments complaining that doctors don’t know what they know). I think it’s great when people share their experience, but it’s getting tiresome to see it productized and generalized as a more universal explanation.

EDIT: Another trend in this space is to productize by building an audience (please subscribe to my Substack) and then introduce the monetization plan later: A subscription app, an e-book, a partnership with some product. It’s possible this person organically decided to quit their job, sell their house, and focus on writing a no strings attached Substack blog series to share information. However, I’ve seen this play out across enough health influencers that I recommend everyone stay cautious about people who claim to hold some information that will change your life but they need you to subscribe first. Be careful.

Very much agree it's critical to get an accurate assessment, ideally from a doctor who understands pain science to rule out a structural cause. In saying this, I recognise many practitioners are not fully across this so I'm hoping this series will help increase awareness.

This first blog is meant as a quick intro to the series - blog post #2 will break down the different categories of chronic pain (i.e. broadly including tissue, nerve damage and pain due to brain plasticity - what the series is primarily focused on).

Sounds like an interesting medical mystery.

Thanks!

In stressful periods, it's likely not stress crushing the immune system, it's the indirect relationship that stress causes bad quality sleep and low amount of sleep, that in turn crushes the immune system.

If, even if under stress, you manage to work out a system/habit that allows you to get proper sleep, you'd likely be ok.

He may need his tonsils out. I got mine out in my 30s. It was 3 painful weeks to recover but my quality of life is a lot higher.

To me that's the real question. I think either option is defensible, depending on what one values in life. I've known certain people who pulled 80 hour work weeks for years only to give away double-digit percentages of their salaries to charity, because that was what was important to them, and I don't think they were wrong for doing that, just making choices at a margin I would find intolerable far earlier.

> by selling the "the cure" on a newsletter basis and using organic growth to make more money.

I am not selling anything, the information from what is happening -> to how to recover (if it is relevant to you) is and will be freely available on this substack. It is not paywalled and I'm not intending for it to be.

Additionally where are you quoting "the cure" from? I will be sharing information for people to use to self assess if it applies to them. Recovery from chronic pain is rarely simple as your quote implies - instead it requires daily concentrated effort.

> his solution is not backed by extensive medical studies.

Please read this study from 2021: https://jamanetwork.com/journals/jamapsychiatry/fullarticle/... https://pubmed.ncbi.nlm.nih.gov/34586357/

> He could just write a document laying it all out, and letting people download it, easier for everyone.

Readers are more than welcome to download an offline copy from their browser if they'd prefer to consume it that way.

> (and try to get some researchers do the chekcing).

This is a valid point and I'll see how I can integrate it into future pieces, even if it's just collaborating with (legitimate) researchers. Thanks.

Something to understand is until yesterday no one knew I was in this space. Me DM'ing a researcher and asking them to vet my writing would likely have at best resulted in them letting me know they're busy. That likely isn't the case anymore.

> This is damn close to snakeoil.

Happy to discuss this in more depth. I don't see which part is comparable to snakeoil.

Thanks for sharing. I am walking down this path as well. In my experience I can tell I'm deeply out of alignment and it wreaks havoc on the body. My soul says to X but my mind says do Y, it's safer, maintains a stable status quo, income, and relationships, etc., even though it's slowly killing me.

My comment is off topic but I have to chime in: while I'm sad to hear of your bad luck, this is YOUR experience, and it is not universal.

At 54, I got my highest paying job ever in tech after being walked out of a "marquee-name" company after 24 years. This was three years ago. There is a tremendous need for senior engineers in smaller companies. The main reason is that all the A+ engineers (clearly I am not one!) have retired from decades of fat equity compensation, and those of us at the B+ level (or me who financially screwed up) are actually now a rare commodity.

So hang in there, greyhairs are still valuable to smaller companies.

My own impression is that the software industry is one of the industries where experience and qualifications are completely divorced.

So from my perspective one is really always back at square 0 when looking for jobs - including the need to prove oneself and stay humble.

On the second, I've mentioned it elsewhere in this thread (on a different comment) that it's critical to determine if a structural cause is at play (i.e. tissue/nerve damage or something else causing inflammation). It is unfortunate however that many doctors are not familiar with modern pain science so I'm hoping spreading awareness via patients (and some practitioners) will change this.

In the next few blog posts this very thing will be discussed (i.e. exploring when it's likely something is mind related vs the body [though I will focus primarily on the former in this series] - as you're 100% correct sometimes it's the body and sometimes it's the mind, and sometimes it's both!).

The pulp in the teeth are quite sensitive and can inflame easily, and that inflamation has nowhere to go (being bound by the hard sides of your teeth and jaw), which can lead to constant pain. I once had a routine filling that took about 3 months to stop aching and I had to take ibuprofen every day during that time to be able to focus. Per the dentist, constant aching pain = it's slowly healing, leave it alone. Sharp intense pain = pulp is dying, need root canal. Granted, this is pain the mouth and not in the head like you described.

If it's been a while and it's still bothering you, I'd definitely consider having it removed too. It would suck to remove it and still have the headaches, but at that point you can start looking at other causes.

In reality , nothing more than grifters. I wouldn’t be surprised if there’s a book or "masterclass" pitch at the end of this series.

Those stupid pain face charts you see at hospitals, physician offices. Purdue marketing, nothing else.

Everybody is shitty here. This is what happens when a market has loose regulations.

I can't comment on the conflict of interest as I do not know the practitioners personally, but from additional/supplementary research in this space as well as the massive amount of people this work has appearerd to help recover (look at reviews/discussion for books like the 'The Way Out') - it does seem to be having a big impact.

I'm aiming to link supplementary research in follow-on articles (e.g. the relation b/w pain and injury where nociplastic pain is present, the impact of psychological factors on pain etc) to paint a comprehensive (yet digestible) picture.

100%, medication plays a great role in providing comfort and support but it can be ineffective (and often harmful) if relied on solely for recovery from (neuroplastic) chronic pain.

> There's no business case for solving chronic pain

It seems some parties may be incentive aligned (e.g. insurers in Australia) - though I'm still navigating this space to find an approach which makes solving the root cause viable. Keen for your thoughts.

> 1.

Sorry to hear about your friend. This is often referred to as a structural diagnosis - i.e. where a knowledgable/proficient doctor has diagnosed there is legitimate tissue (nociceptive) or nerve (neuropathic) damage.

> 2.

Yep! This is what the series will be targeting, data points to a substantial percentage of chronic pain sufferers solely (or partially in comorbidities) being impacted by psychological disorder (otherwise known as neuroplastic pain / TMS / and a few other names!). There are a lot of causes and factors which have been shown in research to date, but largely it's adverse childhood experience, stress, personality traits, and more.

Will check out that vid!

> 3.

Related to this, there is an exercise called somatic tracking which has helped many people (including myself) - during it people often notice pain shifting throughout your body. This was a big turning point for me seeing how my mind behaves in real time. https://www.youtube.com/watch?v=Lw1D_UvzIDA

THC amongst its most minimal side effects increases my pain, not decreases it.

I would suggest everyone try everything that is open to them, but cannabis is not a miracle cure for every ailment.