[HN Gopher] Body mapping study suggests chronic pain comes in ni...
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Body mapping study suggests chronic pain comes in nine distinct
types
Author : lnyan
Score : 161 points
Date : 2021-08-06 07:13 UTC (1 days ago)
(HTM) web link (www.sciencealert.com)
(TXT) w3m dump (www.sciencealert.com)
| martini333 wrote:
| Nothing about headache or migraine...
| mxd3 wrote:
| Yeah, it's odd to see that omitted, especially for headaches
| that are related to muscle and joint issues.
| tuatoru wrote:
| Or trigeminal nerve pain.
|
| https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Educat...
| syockit wrote:
| 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 wrote:
| This is probably due to their definition of chronic, as
| migraines and headaches are usually episodic.
| [deleted]
| binarymax wrote:
| 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.
| candyman wrote:
| 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.
| yosito wrote:
| Better title: study picks 9 categories and assigns chroinic pains
| to one of those categories, proving that data can be sorted into
| arbitrary categories.
| [deleted]
| chrisdhoover wrote:
| As I suffer from relentless chronic pain, I was hoping to read
| something insightful. What I saw might as well been on
| reddit/r/coolguides. Your post gave me a chuckle.
| DaveSapien wrote:
| Yes, this!
|
| I am by no means an expert, but I have spent time and
| experience enough with chronic pain to state that this rather
| one dimensional. Meaning their group although big was narrow in
| scope. For example, no chronic head pain? We have been working
| on a VR body mapping app(https://www.hatsumivr.com/), I'm the
| art lead on it. And you quickly find that there is an ocean if
| different experiences out there, and thats probably the biggest
| obstacle to helping people with chronic pain. Its is often
| treated (at the policy level) as one condition with a select
| few options for treatment. Studies with conclusion like this
| reinforce a reductionism in medical spaces and leave the people
| that don't fit into their pidgin holes out in the cold, alone,
| and in pain.
| refactor_master wrote:
| >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 wrote:
| "study suggests height comes in 9 distinct types!"
| snissn wrote:
| 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 :)
| dade_ wrote:
| 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.
| maxerickson wrote:
| Was CRPS mentioned as a possibility?
| dade_ wrote:
| No, and thank you for the suggestion. I've never heard of it,
| but I had more than half of the symptoms listed on the Mayo
| clinic website. It exactly describes my experience and also
| the words of my many baffled practitioners. It was a response
| completely out of line to any possible injury. Pure agony.
| Doesn't look like there are cut and dry answers, but I'll
| look into it further. Thanks again.
| void_mint wrote:
| > 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
|
| My left shoulder was mostly unusable after a subaccromial
| decompression surgery that was meant to make the shoulder less-
| unusable. Doctors told me to see PT, PT had me do the same
| waste-of-time banded pull aparts and subscap work. Imaging
| suggested there wasn't a structural problem and PT never really
| listened to anything I had to say. So, as do most, I stopped
| going.
|
| Eventually I got tired of being immobilized and I just started
| doing what I wanted to do. I lifted weights and just clenched
| my teeth during the periods of extreme pain during various
| movements. Lo and behold, the issue was mostly related to lots
| of muscles being very weak from the changes in movement
| patterns to accommodate the extreme pain. None of the PTs
| allowed me to do any movements other than rotator cuff band
| work. Bench pressing for 2 weeks had me largely out of pain.
|
| The state of doctors/phsyiotherapists/physical therapy is a
| joke. At this point I would consult a bullshit crossfit box
| owner before going to a doctor for movement deficiencies.
| dade_ wrote:
| My rotator cuff was also on the list of problems. We used the
| bands, but also a squash ball and rolled out the 4 muscles.
| Lie down on it with your arm pointing upward for the rear
| one. On your side under your arm pit for lower, between your
| pec and shoulder for the front and think of a bull with the
| ball between your shoulder and the wall.
|
| It is one of my favourites because shoulder pain is so
| annoying to reach, and all it took was a simple ball. Lots of
| sites on the Internet have better detail on the steps, but
| releasing tight muscles can work wonders.
| void_mint wrote:
| Are you my PT? My rotator cuff wasn't related to my
| problems, it's just the only thing PTs focus on when you
| come in with shoulder pain.
| elric wrote:
| 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.
| dade_ wrote:
| Ha! Exactly that, he has named all of his exercise with
| humorous names.
|
| Worst result is the referral to a podiatrist for expensive
| insoles that IMHO are snake oil. Huge waste of time and
| money. It turned out that the primary problem they were
| trying to fix was an issue with glute activation, nothing to
| do with the foot itself.
| nradov wrote:
| If something hurts then why should the default reaction be to
| see a doctor? It makes more sense to start with a trainer or
| physical therapist first. Then if you're not seeing
| improvement after a few weeks move up the continuum of care
| to a physician and investigate medical treatments. We can't
| fairly criticize doctors for not knowing absolutely
| everything about the human body.
| cmiles74 wrote:
| My personal experience has been that I need a referral from
| my primary physician before I can get physical therapy
| covered under my insurance. So far, when I express to my
| physician my interest in PT they are happy to provide the
| referral.
|
| That said, the idea that PT may be more effective than
| medication or surgery is kind of new to me. People may need
| to be informed that PT is a possible solution for a some
| pain, especially those a physician may find difficult to
| diagnose.
| Noumenon72 wrote:
| That's a good question. I had to learn this lesson through
| experience -- that doctors rarely solved anything, while
| self-study and exercise worked miracles. But I was 35
| before I really got beyond "Well, I went to the doctor,
| nothing else I can do."
| void_mint wrote:
| > If something hurts then why should the default reaction
| be to see a doctor?
|
| If something hurts the default is, and should be,
| consulting a primary care physician, who should then
| forward your issue to a specialist. PTs are less trained
| and less useful than MDs, so their scope should be more
| limited (and should only be consulted for appropriate
| ailments).
| Jtsummers wrote:
| An issue with PTs is that they don't (in the US) have the
| full diagnostic capability of an MD. Particularly when
| the issue centers around the neck and spine, going to an
| MD first and then getting a referral to PT is very
| important. At that point the PT can be informed of the
| actual physical issue and develop a proper course of
| treatment.
|
| Now, if an issue is chronic (like my shoulder problems),
| there's not much point in going to the MD except to get a
| "Yep, it's your shoulder again, still don't want opioids?
| Ok, here's the referral for 10-20 PT sessions so you can
| get it covered by BCBS."
| newbamboo wrote:
| Physical therapists are more helpful than doctors for many
| maybe most problems, in my experience, though the variation
| in quality may be greater. Part of this could be economics;
| pt's have more time. In the future I think having pt rather
| than doctors as primary point of contact for most patients
| will be shown to result in better outcomes. I susspect the
| reason this isn't already the way it works is mostly
| because of organized labor (the ama wouldn't have it) and
| liability.
| dade_ wrote:
| If I suspect I could have a broken bone, I always go to the
| GP first. Otherwise, I skip the doctor because it is always
| the same routine that ends in painkillers and a
| recommendation for a PT.
|
| Therein lies a major problem, PTs are so used to dealing
| with health plans capped at hundreds of dollars. People go
| to a PT expecting an instant solution which is impossible
| for complex problems. So the whole PT industry has turned
| into quick fixes in 2-3 sessions that have an immediate
| feel good result and hand out a piece of paper with a bunch
| of exercises no one does. It is just as well, without
| supervision and coaching, they are probably doing the
| exercise poorly resulting in minimal benefit.
| bishoprook2 wrote:
| >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.
| chewz wrote:
| > Concerning healthcare, you have to be your own project
| manager.
|
| +1 for that. 10 years ago I had misdiagnosed cancer for 3
| years despite seeing lots of doctors. The symptoms were
| there but none of the doctors connected the dots.
|
| Since that experience I am coming to the doctors prepared
| and with defined expectations. And I engage them in well
| defined Q&As which have defined goals.
|
| I am taking care of my 90 years old Mom now and I do the
| same - I read the medial literature and suggest to the
| doctors what results I am expecting. To my surprise most
| doctors are quite keen to co-operate.
|
| I have improved my Moms quality of life suggesting
| replacing sleeping pills for mild ant-anxiety pills, and
| getting anti-depressants that work well for osteoarthritis
| pain.
| BoxOfRain wrote:
| As someone with a rare neurological disorder that hadn't
| even been clinically recognised when I contracted it (it
| was seen as a weird subset of migraine in the few places
| it'd been studied systematically) this is fantastic advice.
| I also had the joy of being put on SSRIs only to find out
| they interact _horribly_ with my condition and there's many
| reports of this that doctors for the most part seem totally
| unaware of. I won't touch anything of the sort ever again
| as a result, I can only describe my experience as a bad
| trip that lasted around nine months.
| foepys wrote:
| 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.
| ziml77 wrote:
| That's how good doctors have done it as far back as I can
| remember. If the person you're seeing isn't involving you
| in the process and trying to get the whole picture, you
| should try a different doctor. You don't have to stick
| with a doctor just because they're the closest or the one
| you happened to choose first.
| arpa wrote:
| there are also ideas about patient empowerment (since
| last century). Medical community is not the most
| flexible, but we'll get there.
| theNJR wrote:
| How did you find your personal trainer?
|
| I have a chronic neck pinch, coming from a weak lower trap (I
| think), that I'd love to fix. I make it worse multiple times a
| year from lifting and have to take at least a week off the gym.
|
| I bet I am doing what you did with using the wrong muscle.
| dade_ wrote:
| I was stuck on my couch and fed up so I kept searching the
| web until I found someone that could help. He had an amazing
| website which is very unusual for small businesses. It
| described an experience of having our fitness achievements
| and habits disrupted by injury. The frustrations of
| traditional physio, but also the importance of integrating
| training to accelerate healing instead of avoiding the area.
| It resonated with me, I called him and learned more.
|
| The part I like the most is that I have a bunch of solutions
| for my problems. I don't need to call him, he taught me what
| I need to do.
| Tagbert wrote:
| I'd suggest starting with a physical therapist. They are
| trained to look at you whole body and how it moves and
| suggest exercises to address issues.
|
| A good trainer might have this kind of outlook and training
| but most don't.
| theNJR wrote:
| Arnold's best friend, Franco Columbo, was my body worker.
| He'd just look at me and know what I was doing wrong. He
| was so amazing. And sadly died way too young from a boating
| accident.
|
| I'll see if I can find a PT who can replicate.
| fidesomnes wrote:
| You would benefit from frequent and deep hip flexor stretching.
| Look at what they do in Thai massage and or kickboxing warm ups
| and you will how to develop the full range of motion for the
| hip. I am convinced most men under appreciate this to our own
| detriment. After I started doing deep stretching and functional
| exercise movements for awhile my back, neck, and hips would
| crack on their own and it really loosens up the whole body.
| meroes wrote:
| I've had a similar experience in Covid with muscle tightness.
| It's unbelievable how much our bodies compensate.
|
| It started with a muscle injury to my upper back. Well to heal
| it, unbeknownst to my conscious awareness, almost an entire
| half of my body tightened to allow that one area to heal. Like
| you said it's as if whole sections of my muscles were numb as
| well, and only after repeated stretching did I "activate" those
| dormant areas.
|
| And it took being in a very calm and relaxed state (not trivial
| to do with tightness and/or pain) to "sense" these areas and
| being stretching them out. Turns out I had to find stretches
| for all the way down to my big toe to the top of my head and
| everything in between.
|
| The lessons of body to mind are overflowing suffice to say.
| justicezyx wrote:
| That's when traditional medicine like traditional Chinese
| medicine come to be helpful. Although traditional Chinese
| medicine lacks preciseness and reasoning of the modern
| medicine, they possess a truly whole body methodology of
| treating ailment and diseases.
|
| It's under major criticism nowadays, although mostly for the
| wrong reasons. Because like so many once beloved and respected
| professions, they become the unfortunate prey of the capitalism
| frenzy and being used as the tool for profit.
|
| Practitioners now use the inherent fuzziness to hide their
| ignorance. Putting the ineffectiveness of their treatment on
| some seemingly plausible "theory" that was never proclaimed by
| their ancient predecessor.
|
| Even worse, the herbs used in traditional Chinese medicine are
| now toxicated by the industrial wastes grow into the soil.
| Merchants are now more than happy to adopt modern agriculture
| techniques to improve their quantity and cases nothing about
| the effectiveness.
|
| Alas, sadness is now upon the ones who truly see and feel the
| greatness of the traditional Chinese medicine.
| wpietri wrote:
| This definitely resonates for me.
|
| Like many developers, I grew up thinking of my body more as a
| tedious, irritating burden; the whole brain-in-a-jar/live-in-
| the-matrix thing seemed kinda appealing. So I was proud of how
| long I could spend coding or reading and ignoring my body. That
| gave me a lot of bad habits.
|
| Then I made a friend who's a yoga teacher. Out of curiosity I
| started attending some of her classes. In her yoga tradition,
| the root purpose of yoga is to free the mind for meditation.
| That really resonated for me. Instead of ignoring my body, I
| could work with it to do better at the things that mattered to
| me.
|
| In the years since, I've come to think of my previous
| relationship to my body as like somebody running a large
| software system with poor instrumentation and observability.
| Somebody who ignored monitoring alerts until there was
| downtime. In that framing, I could see it as obviously the
| wrong approach. That instead I needed to pay attention, take
| care of maintenance, debug problems, and generally to
| understand and improve the system over time. Especially as I
| get older, it really pays off. My only regret is not starting
| sooner.
| dade_ wrote:
| I was reading up on improving my rock climbing skills /
| movement, and a book about better movement was directly
| mentioned. Looking back, it was what started me down this
| journey. Being stuck on the couch in searing pain finally
| pushed me to make the investment of time and money.
|
| https://www.goodreads.com/book/show/22847203-a-guide-to-
| bett...
| m3kw9 wrote:
| 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 wrote:
| 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.
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