Thanks for writing this! It’s good to see more sceptical approach. Do you have
any more recommendations for reading on the subject?
Not really, sorry. Wacky old Sarno did the job for me, so I didn’t look further.
Then I took what rational argument I could find and put it in the above article.
However, for the people who think that the human body is easily broken, I’ll
repeat one recommendation from above: Through the
Valley
by Col. William Reeder.
EDIT: Another recommendation: When I have sports-related issues, I treat them with recommendations from Becoming a Supple Leopard by Kelly Starrett. And when this doesn’t fix it, I call one of the PTs at what used to be MobilityWOD. Apparently they’ve changed their branding to ‘The Ready State’.
I’ve had RSI for five years now. I read Sarno, tried the Curable app, and tried
on the hypothesis that my pain was psychosomatic. For my case, the benefit I’ve
got from a more psychosomatic approach is to try to form fewer negative
associations with the pain. I used to view the pain as an indication that my
body was broken and that I was ruined. Now I still have the pain, but I have
much less of that secondary psychological reaction to the pain, and that’s
greatly improved my life.
I’ve heard a similar story from a friend with chronic fatigue. Good for you!
[…]
In my estimation, this article and other arguments that RSI is psychosomatic
move too quickly from (true) evidence that chronic pain is a weird and
mysterious to the claim that it must be psychosomatic.
I’m not saying that all RSI is psychosomatic. Sorry for not being clear. I just
know that my case was psychosomatic, so I assume that it’s psychosomatic for a
certain unknown percentage of wrist pain sufferers.
My reasoning is this: I had severe wrist pain. And the physical remedies I tried
didn’t work. I read a book that gave me a few ideas and “thought remedies” and
the pain went away. And it’s been staying away for years, no matter how much I
type. (As I mentioned in the article, I get occasional slight, which pains I
attribute to stress and which go away quickly.) As the psychological change led
to a physical change, I conclude that I’ve had psychosomatic pain. And since
it’s unlikely that only I had it this way, I conclude that there must be other
sufferers of psychosomatic wrist pain.
The pain being ‘weird’ is not required for my argument. There is one paragraph
mentioning ‘strange’ pain, but that’s just one of my handwavy diagnostic
criteria, not an antecedent.
I worry that saying that
RSI is psychosomatic feels like it explains the condition, but really doesn’t
explain it very well. I like that in your post you make some predictions based
on your hypothesis.
I’m not aware of any satisfying explanation. I just know that changing my mind
somehow cured my pain, so I call it ‘psychosomatic’.
Actually I make another prediction in the comments: ‘If stress causes wrist pain
and people stress out, because they think that typing is bad for them, wrist
pain should be “contagious”. Take an office full of workers who are doing fine.
Then one starts having wrist pain for whatever reason, finds online warnings
about RSI, tells their colleagues, they get worried about their work being
harmful for them, and some of them also start having wrist pain.’
It would be informative to make a study of the EA and rationality communities
and see if we find a contagion pattern. I thought about doing it myself, but my
intuitions are stuck in the ‘RSI is psychosomatic’ camp. So I would just be
seeing evidence the way I want to see it.
My impression is that the hypothesis of myofascial trigger points has better
evidence and does a better job of explaining cases of RSI, and many people who
argue that RSI is largely psychosomatic are not aware of the theory of
myofascial trigger points.
This might be the explanation for the physical cases. I have skimmed the page on
trigger points. And what you write about the foam roller and the lacrosse ball
sounds like what I’m doing when I’ve messed up some body part with poor
weightlifting form. This works well, even though I wouldn’t explain the
weightlifting pains with trigger points.
Another thing I’d like to warn against is trusting the ‘pleasurable feeling of
pain’. Doing this, I once (or twice?) seriously messed up the muscles under my
shoulder blade and later aggravated my elbow joint. All healed, though.
I should note that I’m probably biased against the hypothesis that RSI is
largely psychosomatic. This is because it feels like the hypothesis trivializes
my condition. Of course, I think this bias is silly, but I think I do still have
it.
Trivializes it how? I wouldn’t consider psychosomatic issues trivial at all. In
fact, it’s terrible that a mostly reasonable person like me can be kicked into a
vicious circle of stress and pain by well-reputed and well-intended information
from family, friends or the web. This is why I want to change the communication
around wrist pain: help the people with purely physical pain, but don’t make it
worse for those with a penchant for psychosomatic issues.
I also wonder if this bias could explain why I haven’t got benefit from a
psychosomatic approach to my RSI. I do certainly seem to meet the psychological
profile of people who are susceptible to psychosomatic pain I’ve heard described
in books and media such as Sarno’s.
I guess I’m the opposite. Sarno’s arguments somehow made it into my brain to a
degree sufficient to get rid of the pain. And being ‘magically’ cured this way
has reinforced the psychosomatic hypothesis to a point where a “PSYCHOSOMATIC”
neon sign pops up in my head whenever I hear about a mysterious, unexplained
condition. Which in turn shuts down the mechanisms that originally caused the
pain.
Of course, when I write about this, I try to shield my eyes from the neon sign
and concentrate on established facts.
Just for fun (and not for argument, please), here’s a little rave from the
troupe that’s providing the electricity for the neon sign:
Overuse injury from typing on a keyboard? Maybe. It is an awkward movement. But
it appears absurd to me that using a mouse would lead to overuse injuries. Come
on! We open and close our hands all day long, and flex our fingers with much
greater force than is required for a click. And think of all the repetitive
(handcraft) activities that people had to do in the past! Typing on mechanical
typewriters, playing musical instruments, copying books by hand, grinding grain
with a stone, knitting, sewing, spinning, weaving baskets and cloth, weeding,
picking berries, making arrows, ropes and fishing nets, planing, sawing,
cutting, hacking, thatching, carving, filing…
Heck, if typing was so bad for you, shouldn’t half the secretaries of the
mechanical typewriter era have fallen out of the workforce within three years?
I’ve written this post with my recommendations for treatment here. I have a
section on the psychological component to RSI, but I don’t discuss the
hypothesis that RSI could be more or less entirely psychosomatic.
I saw that section and I’m happy that it’s there. Thank you!
Not really, sorry. Wacky old Sarno did the job for me, so I didn’t look further. Then I took what rational argument I could find and put it in the above article. However, for the people who think that the human body is easily broken, I’ll repeat one recommendation from above: Through the Valley by Col. William Reeder.
EDIT: Another recommendation: When I have sports-related issues, I treat them with recommendations from Becoming a Supple Leopard by Kelly Starrett. And when this doesn’t fix it, I call one of the PTs at what used to be MobilityWOD. Apparently they’ve changed their branding to ‘The Ready State’.
I’ve heard a similar story from a friend with chronic fatigue. Good for you!
I’m not saying that all RSI is psychosomatic. Sorry for not being clear. I just know that my case was psychosomatic, so I assume that it’s psychosomatic for a certain unknown percentage of wrist pain sufferers.
My reasoning is this: I had severe wrist pain. And the physical remedies I tried didn’t work. I read a book that gave me a few ideas and “thought remedies” and the pain went away. And it’s been staying away for years, no matter how much I type. (As I mentioned in the article, I get occasional slight, which pains I attribute to stress and which go away quickly.) As the psychological change led to a physical change, I conclude that I’ve had psychosomatic pain. And since it’s unlikely that only I had it this way, I conclude that there must be other sufferers of psychosomatic wrist pain.
The pain being ‘weird’ is not required for my argument. There is one paragraph mentioning ‘strange’ pain, but that’s just one of my handwavy diagnostic criteria, not an antecedent.
I’m not aware of any satisfying explanation. I just know that changing my mind somehow cured my pain, so I call it ‘psychosomatic’.
Actually I make another prediction in the comments: ‘If stress causes wrist pain and people stress out, because they think that typing is bad for them, wrist pain should be “contagious”. Take an office full of workers who are doing fine. Then one starts having wrist pain for whatever reason, finds online warnings about RSI, tells their colleagues, they get worried about their work being harmful for them, and some of them also start having wrist pain.’
It would be informative to make a study of the EA and rationality communities and see if we find a contagion pattern. I thought about doing it myself, but my intuitions are stuck in the ‘RSI is psychosomatic’ camp. So I would just be seeing evidence the way I want to see it.
This might be the explanation for the physical cases. I have skimmed the page on trigger points. And what you write about the foam roller and the lacrosse ball sounds like what I’m doing when I’ve messed up some body part with poor weightlifting form. This works well, even though I wouldn’t explain the weightlifting pains with trigger points.
Another thing I’d like to warn against is trusting the ‘pleasurable feeling of pain’. Doing this, I once (or twice?) seriously messed up the muscles under my shoulder blade and later aggravated my elbow joint. All healed, though.
Trivializes it how? I wouldn’t consider psychosomatic issues trivial at all. In fact, it’s terrible that a mostly reasonable person like me can be kicked into a vicious circle of stress and pain by well-reputed and well-intended information from family, friends or the web. This is why I want to change the communication around wrist pain: help the people with purely physical pain, but don’t make it worse for those with a penchant for psychosomatic issues.
I guess I’m the opposite. Sarno’s arguments somehow made it into my brain to a degree sufficient to get rid of the pain. And being ‘magically’ cured this way has reinforced the psychosomatic hypothesis to a point where a “PSYCHOSOMATIC” neon sign pops up in my head whenever I hear about a mysterious, unexplained condition. Which in turn shuts down the mechanisms that originally caused the pain.
Of course, when I write about this, I try to shield my eyes from the neon sign and concentrate on established facts.
Just for fun (and not for argument, please), here’s a little rave from the troupe that’s providing the electricity for the neon sign:
Overuse injury from typing on a keyboard? Maybe. It is an awkward movement. But it appears absurd to me that using a mouse would lead to overuse injuries. Come on! We open and close our hands all day long, and flex our fingers with much greater force than is required for a click. And think of all the repetitive (handcraft) activities that people had to do in the past! Typing on mechanical typewriters, playing musical instruments, copying books by hand, grinding grain with a stone, knitting, sewing, spinning, weaving baskets and cloth, weeding, picking berries, making arrows, ropes and fishing nets, planing, sawing, cutting, hacking, thatching, carving, filing…
Heck, if typing was so bad for you, shouldn’t half the secretaries of the mechanical typewriter era have fallen out of the workforce within three years?
I saw that section and I’m happy that it’s there. Thank you!