[HN Gopher] Programming with chronic pain
       ___________________________________________________________________
        
       Programming with chronic pain
        
       Author : thomasvogelaar
       Score  : 80 points
       Date   : 2025-02-17 23:43 UTC (23 hours ago)
        
 (HTM) web link (thomasvogelaar.me)
 (TXT) w3m dump (thomasvogelaar.me)
        
       | shakna wrote:
       | Random chronic pain sufferer here. Fibromyalgia hit me in
       | puberty, and I now have a couple hundred symptoms that
       | sporadically change, day to day.
       | 
       | The aircon is a fun one. Outside of 16-18C (60-65F), the pain
       | flares, and continues to flare. Mostly the referred pain and
       | tendonitis. That reduces when under a fan or aircon - except the
       | tendonitis. So I often end up wearing a jumper, and working under
       | aircon. The two together confuses a lot of passerby.
       | 
       | And just to add - I sometimes use STT when my hands are worse, or
       | TTS when the nerves in my eyes malfunction. And I gotta say...
       | The accessibility controls on most IDEs is utterly crap.
       | 
       | If you have a hambuger menu? I might get read "triple bar" or
       | "trigram for heaven". That ain't useful. If the UI absolutely has
       | to use unicode symbols instead of text... Please give an alt
       | text. Please.
        
       | samename wrote:
       | I had chronic pain in my neck for a couple of years. It started
       | in the pandemic, so the usual guesses were it had something to do
       | with working remote - which meant sitting down more, potentially
       | ergonomic issues, less socializing, etc. After seeing several
       | doctors, doing all the tests like MRI and CT scans, trying
       | physical therapy and many other conventional and non conventional
       | treatments, the key for me was seeing a pain psychologist. As
       | mentioned in this article, a lot of pain takes place in the mind.
       | Even though we feel it in our bodies, it's our brain telling us
       | that it's a problem. After a few months of therapy, the pain was
       | no longer a major facet of my life. After 6 months I felt totally
       | cured and myself again. The US medical system can be a maze and
       | easily spiral for chronic pain sufferers. I suspect this is an
       | area where we are still learning
        
       | willtemperley wrote:
       | I'm a bit surprised you didn't mention inflammation management.
       | The western diet almost entirely consists of inflammatory foods -
       | refrigerated dough, packaged snacks, burgers etc.
       | 
       | Whilst my tennis elbow is probably caused by poor ergononics and
       | not warming up properly before exercising, I'm finding tiger milk
       | mushroom, a known anti-inflammatory [1] is helping a great deal.
       | 
       | [1] https://www.nature.com/articles/s41598-021-91256-6
        
         | thomasvogelaar wrote:
         | In my case I didn't find much impact from diet and any blood
         | tests I did showed no signs of inflammation. Though as I
         | mentioned closer to the end of the post, I think generally
         | focussing on your health (and I'd include diet in this) is
         | always good. Most things might not have an impact but something
         | often will.
        
       | EVa5I7bHFq9mnYK wrote:
       | What about drugs? nsaids help, but not advisable for long term. I
       | take gabapentin for longer term relief.
        
       | nakedneuron wrote:
       | Hi Thomas, sorry to hear. I'm no doctor but I've had my own share
       | of bad-ergonomic-induced pain so I feel entitled to add my view.
       | 
       | Also I write this to everybody suffering from this kind of pain.
       | It's the raging epidemic of our time.
       | 
       | This all sounds too familiar for fascia as the source of pain.
       | Fascia pain is often described as "nasty". MRT doesn't show
       | problems is also indicative of fascia.
       | 
       | I may say that I saw your profile pic on LI and immediately
       | noticed your hanging shoulders. Slight head-forward-posture also
       | doesn't surprise if I may say so and if I'm not mistaken.
       | 
       | My advice would be, leave the stretching behind. Theraband is an
       | insult for every young healthy individual. I sorted out my
       | problems by training upper limbs with weights (start with 1.5kg
       | dumbbells), resistance band and also the occasional fascia roll
       | aka foam roller.
       | 
       | Let me suggest some reading to get into the matter.
       | 
       | Beginner level: Fascial Fitness, Schleip Expert level: Anatomy
       | Trains, Myers
       | 
       | Also: Built From Broken, Hogan
       | 
       | With kind permission, from that book:
       | 
       |  _Because posture is what you do most of the time, it is often at
       | the root of joint pain, muscle imbalances, and injuries. On top
       | of that, it tends to worsen with age. If you don't address
       | posture, you'll be continually slapping Band-Aids on the problems
       | caused by it. It's a game you simply can't win. But you can't
       | just fix posture by consciously holding yourself differently. It
       | takes structural changes to musculature [...]. It requires a
       | combination of training your body to maintain better posture and
       | consciously working to hold yourself in better positions. [...].
       | While exercising, you train muscles and movements that improve
       | dynamic posture, and you see a little progress from week to week.
       | It's a painstakingly slow process, but it works. And it's worth
       | it._
       | 
       | Same source: _It isn't the mountain ahead that wears you out -
       | it's the grain of sand in your shoe._
       | 
       | Good news is that you will get better soon if you start
       | exercising regularly. Bit of a downer is, that it will take about
       | the same amount of time to revert to "pristine" posture as it
       | "took" you to imprint your current posture into your fascia.
       | 
       | Pain from the 50th repetition of a weight lift has far better
       | quality to it than chronic pain.
        
       | CobaltFire wrote:
       | Chronic pain sufferer due to a career where I got beaten up and
       | broken (military) and autoimmune conditions.
       | 
       | Counterintuitively, and for me, being more active helps. If I
       | take a few days off because I'm lazy or tired I invariably get
       | stiff and my pain ratchets up. Stretching twice a day is a huge
       | help; I won't say how long as you have to come up with a routine
       | that works for you. A massage every couple of months can help as
       | well, as I often have spots getting bunched up that are pulling
       | other things out of alignment.
       | 
       | As for treating it, I use non-THC CBD oil, Ibuprofen, and
       | gabapentin when it gets really bad. My doc is currently
       | discussing TNFi's with me for my AI stuff; we shall see if I
       | pursue that.
        
         | everybodyknows wrote:
         | I have similar. Try a steam bath. Beware of ibuprofen -- can
         | damage intestines.
        
       | apitman wrote:
       | Forearms for me. Best advice I can give for young guns is start
       | preventative breaks/stretches/exercises now. I saw it coming and
       | pushed myself over the edge anyway. I've gotten to a pretty good
       | place with a kinesis keyboard (the cheaper split one ) and some
       | custom foot pedals for Ctrl/Alt/Shift, but have never been the
       | same as before.
       | 
       | Also, lift weights. Squats/deadlifts/bench press. Hasn't helped
       | my arms much but been a game changer for back and neck pain.
        
         | LouisSayers wrote:
         | Have you tried a rice bucket?
         | 
         | I had some upper forearm pain (likely from pullups, but perhaps
         | coding as well) for around 6 months last year, and after a long
         | break from pullups and trying the rice bucket it seems that the
         | pain has subsided.
         | 
         | Could be worth a try anyway!
         | 
         | https://www.reddit.com/r/kettlebell/comments/1759tyo/elbow_t...
        
       | Rhapso wrote:
       | Ironically, chronic pain drove me the other direction.
       | 
       | Programming gave me "I forgot I have a body" levels of engagement
       | with a problem. It was a way to actually find relief from pain.
       | My addiction to programming was very useful in my development.
       | 
       | I was lucky in so many ways. My pain wasn't caused by the
       | kinematics of my body, instead it was a heart condition, cancer,
       | Celiac and Crohn's and I have managed to cure a nontrivial part
       | of it over the years (heart surgery, diet change,
       | immunosuppressants).
       | 
       | Ultimately i do not recommend the "cause yourself so much pain
       | you seek refuge in flow state and become an expert" method. It
       | results in a lot of maladaptive behaviors, damaged relationships
       | and needing a lot of therapy (but also the money to pay for the
       | therapy).
        
       | byyoung3 wrote:
       | Read John sarnos book and you will recover. It might not be quick
       | but you can. Don't give up. Also look into Harvard RSI action
        
       | thenerdhead wrote:
       | I'd keep eyes on the immune system. We are already rethinking
       | migraines and inflammation based on findings from COVID-19.
       | 
       | https://www.nature.com/articles/d41586-025-00456-x
       | 
       | Did this happen after a known infection of some sort? Does it run
       | in your family? These questions may be important to know the
       | answers to until science gets more tests over the counter as they
       | are fairly close already.
        
       | Just_Josh wrote:
       | I've had similar symptoms since college, and they continually
       | worsened for a long time while I ignored them. After a few years
       | of trying different solutions and doctors, I've found a
       | satisfactory set of treatments.
       | 
       | The only Orthopaedic doctor with impactful advice happened to
       | have a daughter with the same issue. Loose ligaments required
       | stabilizer muscles to work overtime. Her solution: supported
       | strength training exercises to build up the larger muscles so
       | they can compensate. For the next 6 months, I worked out 5 times
       | a week, and the symptoms practically disappeared. I was able to
       | work 8 hours at my computer with very little strain - compared to
       | just 30 minutes at the start. The symptoms returned about a month
       | after falling out of the routine.
       | 
       | Other treatments that helped:
       | 
       | Ergonomics - I use the Logitech ergonomic keyboard and vertical
       | mouse. These have been great. I avoid using the mouse as much as
       | possible, and use keyboard shortcuts + vimium browser extension
       | to navigate.
       | 
       | Compression Gloves - Just like the author, I also found that long
       | sleeves help somewhat. But not nearly as much as the cheap,
       | fingerless compression gloves I get off Amazon. Between these and
       | the ergonomic peripherals, my symptoms are generally under
       | control, so I struggle to find motivation to continue my
       | workouts.
       | 
       | Relaxing Muscles - When using a phone or game remote, support
       | your wrist (and perhaps elbow) on a pillow. Avoid tightening your
       | muscles - this is tricky when playing intense games. Stop doom
       | scrolling.
       | 
       | YMMV, I am not a doctor, these subjects are complicated and
       | actively researched
        
       | hollywood_court wrote:
       | I suffered from chronic neck and shoulder pain for years. I had a
       | cervical fusion surgery. I had a labral repair surgery. Neither
       | improved my symptoms at all.
       | 
       | I slept maybe 3-4 hours per night for ~7 years.
       | 
       | Then one day I saw someone on Hacker News mention Dr. Sarno's
       | book, and it changed my life.
       | 
       | I convinced myself that the pain was all in my mind. I'm still
       | not 100% symptom free, but I now have far more good days than I
       | do bad days.
       | 
       | I read all of his books and I try to re-read the first one at
       | least once per year.
       | 
       | It become convenient for me to blame my problems on my chronic
       | pain. I fixed all of that by simply changing the way I thought
       | about the pain.
       | 
       | Now, whenever I feel the pain flaring up, I just make myself
       | focus on my breathing rather than focusing on the pain. And then
       | I simply forget about the pain.
        
         | davzie wrote:
         | Exactly the same as me except more general health anxiety
         | symptoms that turned into real painful symptoms. I learnt about
         | Dr Sarno from Dan's channel on YouTube Pain Free You. So glad
         | you found similar!
        
           | notfed wrote:
           | At the risk of discounting a genuine anecdote, I feel
           | inclined to point out that the grandparent and parent post
           | exactly model a very trendy type of spam that I've noticed
           | appearing in YouTube comment sections at an ever-growing
           | rate; especially in self-help and financial-advice areas.
           | 
           | I guess it's impossible to prove whether someone's anecdote
           | is genuine or not. I'd at least suggest people try visiting a
           | YouTube financial advice video, read the comments, and you'll
           | see this pattern like every ten comments.
        
             | code_biologist wrote:
             | Thank you for mentioning financial advice. It's so
             | difficult to find someone trustworthy, but recently I
             | connected with Helene Gulbrandsen-Frafjord. She was able to
             | help me invest my inheritance and my investments are up 70%
             | over the past year!!
             | 
             | (Just to be clear, this post is a joke and a parody of
             | exactly the types of comments notfed is talking about. This
             | type of bot engagement is a cancer on social media.
             | 
             | To be vaguely helpful, here's an NYTimes article reviewing
             | Sarno's ideas:
             | https://www.nytimes.com/2021/11/09/well/mind/john-sarno-
             | chro...
             | 
             | Archive.is non-paywalled link: https://archive.is/VrIiN )
        
             | hollywood_court wrote:
             | Uh, I wrote my post myself. I am not affiliated with Sarno
             | or his books at all. His books actually offer no kind of
             | treatment method. Their main message is simply that pain
             | originates in the mind and focusing on it only makes it
             | worse.
             | 
             | Edit: I'm pretty sure this is the post that first taught me
             | about Sarno. Just based on my comment like history.
             | 
             | https://news.ycombinator.com/item?id=32495146#32541341
        
         | ericmcer wrote:
         | Does he talk about exercising while in pain at all? This has
         | been something that really worked for me after tearing my
         | achilles. After 8 months it still felt irritated 24/7 and I was
         | terrified of re-injury, but ramping up the intensity of my
         | ankle/calf exercises started to make it better. The harder
         | exercises were probably having a minimal impact on strength,
         | but they were having a huge effect on convincing my brain that
         | the area was fine and it could drop its obsession with it.
        
           | hollywood_court wrote:
           | He doesn't specifically mention exercising IIRC. Although I
           | found that lifting is another tool I can use to distract
           | myself from the pain.
           | 
           | He does encourage patients to stop any and all forms of
           | physical therapy. I had already stopped PT by the time I read
           | his first book. But I do remember thinking that the PT was
           | making it worse.
           | 
           | All of the stretching and specific exercises were only
           | causing me to focus on the pain even more which lead to even
           | more pain.
        
       | jasongill wrote:
       | If anyone is suffering from chronic pain that is referred pain
       | from the neck and shoulders, are you sleeping on a memory foam
       | mattress?
       | 
       | I "upgraded" to a Casper mattress in 2019 and it took 5 years of
       | debilitating referred pain and headaches, and attempted
       | resolutions including a 12-level spinal fusion, to realize that
       | the mattress was the cause.
       | 
       | Switched back to a more traditional spring mattress and the pain
       | faded within about 3 weeks.
       | 
       | Easily the worst and most trying experience of my life which will
       | have lasting effects on the remainder of my life - never in a
       | million years would I have expected that the mattress was the
       | cause.
        
         | mayhaffs wrote:
         | I bought a Purple mattress because I thought it would fix my
         | back and neck pain and it has only made it worse. I will also
         | be going back to a more traditional spring mattress soon.
        
         | srik wrote:
         | I'd also recommend sleeping on the floor with a couple sheets
         | and pillows. Sounds like it should be uncomfortable, and it is
         | for a bit, but after a while your body just adapts with
         | postures that do wonders for spinal relaxation and relief from
         | some back/neck pains. IANAD.
        
       | nevertoolate wrote:
       | I also have loose joints, had chronic back pain for years with
       | periodic inflammation episodes. I also had quite a bad period
       | with a herniated disk in my lumbar spine. I spend significant
       | amount of my time with physical exercise. Training with a
       | personal trainer and practicing yoga with a mentor - I'm training
       | for yoga instructor exam also (Iyengar) The good news is that you
       | most likely can cure yourself. On the other hand you have to
       | realize, that you won't be the same person you were before the
       | pain. Pain is (usually) your friend, will keep you on your way.
        
       | kayo_20211030 wrote:
       | I love the ads between the content and the comments; and after
       | them too, just in case you missed the first impress.
        
         | thomasvogelaar wrote:
         | Wait what ads? I've never run ads. Wonder if disqus is jamming
         | something in there.
         | 
         | Can you send me a screenshot or something?
         | 
         | Edit: Damn looks like it is Disqus, I'm going to remove that.
         | I've got no interest in running ads.
        
           | kayo_20211030 wrote:
           | Nice. I liked the piece. It seemed inconsistent with the ads.
           | Can't trust anyone these days :-)
        
       | John23832 wrote:
       | Chronic pain suffer here. All major joints , but specifically
       | neck and back bother me most. Diet for me is key. I'm gluten free
       | and low sugar at this point. I've also started to ween caffeine
       | (sadly).
        
       | locusofself wrote:
       | I'm 40 have had desk job since 18.
       | 
       | I've had back pain forever, but the thing that has been really
       | bad the last few years is "migraine" or tension headache that
       | feels like it's coming from my neck.
       | 
       | The more I concentrate on my work, the worst I have it in the
       | afternoon. This means I can rarely work a full 8 hour day without
       | a nasty, nauseating neck migraine episode.
       | 
       | The only thing I have found that has helped a lot is quitting
       | caffeine. I switched to decaf, which does not taste as good and
       | only gives me a mild placebo boost each morning. I really miss my
       | coffee, but it's not worth the headaches.
        
       | Funes- wrote:
       | Word of advice, as someone who's had lots, and I mean _lots_ , of
       | injuries: past the initial cooling down of the injured part of
       | your body, rest is not going to heal shit, most probably.
       | Stretching and working out the area will. I've recovered from
       | injuries some people would've had surgeries on, by taking this
       | principle into practice. Look up isolation exercises if you can't
       | seem to figure them out on your own, but _work_ that part of your
       | body exhaustively.
       | 
       | Oh, and since the author of the blog post mentions "tennis
       | elbow": I healed mine doing unilateral triceps extensions with a
       | kettlebell. I naturally felt that it was the most straightforward
       | and efficient exercise, just by messing around with the weights.
       | It took around two weeks to heal completely, and I had it _bad_
       | on both elbows (judo practice and pull-ups with bad form will do
       | that, yeah).
        
         | linkregister wrote:
         | Some nuance: the _right_ kind of stretching and working out
         | will heal the injury. The optimal way to do this is to work
         | with a physical or occupational therapist to develop the right
         | set of exercises for the issue. Adherence to the exercise plan
         | is essential to recovery. I have learned this the hard way as a
         | procrastinator.
         | 
         | Indeed, rest alone will most likely result in a chronic issue
         | that one can live with. But these injuries can be remedied even
         | years later with the right physical therapy-- it is rarely too
         | late to make a change.
         | 
         | Example: nerve damage requires some unintuitive solutions that
         | are difficult to isolate on YouTube or other resources (due to
         | high volumes of quackery).
        
         | bluefirebrand wrote:
         | > past the initial cooling down of the injured part of your
         | body, rest is not going to heal shit
         | 
         | Rest is not for "healing" it is to avoid re-injuring something
         | already weakened by an injury
         | 
         | This is potentially very reckless advice
        
       | ArlenBales wrote:
       | I've lived with chronic pain for the last 10 years. Hip,
       | shoulders, lumbar. Have tried just about everything, including
       | minimally invasive surgery. 100s of appointments, over 6 MRIs.
       | 
       | Eventually I came to the conclusion that chronic pain isn't
       | curable. It's our nerves rewiring themselves to constantly send
       | pain, even when no problem exists.
       | 
       | This also gave me peace though. Until I tried everything, I
       | thought my body was breaking down. I'm a very physically active
       | person, who has tried to be proactively healthy their whole life.
       | 
       | Knowing the pain isn't organ or muscle related, but is just
       | fucked up nerves, is consolation. It's not preventing me from
       | doing anything. I still have full range of motion and mobility,
       | it just hurts, but it can't stop me from doing the things I want
       | to do.
       | 
       | So I continue to be active. I have a very high pain tolerance as
       | a result, but I can cope with the pain better than years ago.
       | Last year I hiked the whole 2,600+ miles Pacific Crest Trail
       | despite the pain. Strangely enough, my pain actually mostly
       | disappeared on the trail, but returned after I got home. I think
       | the sudden change of daily habits and sleep conditions may have
       | thrown my nervous system in for a loop.
        
       | Vox_Leone wrote:
       | I had a physical therapy session this morning for a neck-
       | shoulder-arm issue that's been bothering me. After years of
       | working at the keyboard, my musculoskeletal system finally gave
       | way. This is a common problem for people who use keyboards
       | extensively, including musicians--so it's something many of us,
       | especially frequent users of this site, can relate to. It's often
       | classified as an occupational injury.
       | 
       | The good news is that with better posture, some equipment
       | adjustments, and a new, slightly less comfortable chair, I've
       | seen significant improvement and am feeling much better. So, I'm
       | optimistic that you'll be on the road to recovery as well.
       | Wishing you the best of luck!
        
       | guynewton wrote:
       | I've been dealing with chronic pain as well but with my pelvic
       | floor/pudendal nerve. It started in May last year when I was
       | sitting at work when I suddenly felt a strong tingling sensation
       | to go to the bathroom and since then it has developed into a
       | whole array of different symptoms. One of them being leg numbness
       | which affects mostly my left leg. I went to a PT and she told me
       | it could be from sitting too long as well as a lack of exercise
       | and being sedentary. Some symptoms have improved with stretching
       | but I am afraid of going to the gym because doing leg exercises
       | and sometimes spending too much time on the treadmill can cause
       | big flare ups for me. My sleep has also been affected and I wake
       | up even if I do not feel any pain or discomfort.
       | 
       | I am taking more standing breaks now, and I use the gym at my
       | office during lunch time to get some steps in on the treadmill, I
       | also stretch everyday and I feel like it has been helping me heal
       | but it is frustrating that I am not 100% recovered yet.
        
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