The Cause of What I Feel Is What I Do: How I Eliminate Pain
By Bryan Caplan
Over the last twenty years, I have experienced a litany of chronic pain: back pain, neck pain, foot pain, knee pain, forearm pain, and tailbone pain. I also experienced bizarre chronic tingling on my scalp. The good news is that I have managed to virtually eliminate every one of these problems.
Perhaps these ills would have gone away on their own, but all my experience says the opposite: Without conscious action, each of these problems would have lingered, compounded, and probably intensified. Fortunately, I have developed a system that works wonders for me. Hopefully it will work for you to, if you ever share my plight.
So how have I overcome my litany of pain problems? Let me start with what never works for me.
1. Doctors. I have talked to a wide variety of M.D.s about a wide variety of my problems. They have been beyond useless. Most offer nothing better than a name for my symptoms. (“Mr. Caplan, you have plantar fasciitis.” “Latin, how helpful.”) Some have given me prescription pills that are chemically equivalent to two non-prescription pills. Some have given me injections that numb the affected area, then leave me no better off than before. Often, they lecture me about unrelated issues just to fill the time. When people ask me if I’ve “considered surgery,” I am astounded by their naivete. If Robin Hanson hadn’t made me a medical skeptic, my first-hand experience would have.
2. Exercise. Every time I’ve tried exercising a painful part of my body, I felt my problem getting worse. Lifting stuff made my forearm pain worse. Leaning over made my back pain worse. Running made my foot pain worse. The slogan says, “No pain, no gain.” For me, however, the right slogan is: “Pain begets pain.” Enduring physical pain simply leads to even more pain in the future.
Then what does work?
1. Obsessively examine behavior. Without exception, I’ve discovered that the cause of my pain is behavioral. In slogan form: The cause of what I feel is what I do. Sadly, the details of what causes what are far from obvious; otherwise, all my pain would be extremely short-lived. The best fundamental pain remedy, therefore, to obsessively search for any behavior that plausibly aggravates your pain. Then test your ideas by mindfully ceasing suspicious activity.
For example, when I had horrible tailbone pain, I naturally suspected that I was sitting the wrong way. So I tried chairs with a wide variety of back angles, until I discovered that a straight 90-degree angle was least painful for me.
Similarly, when my right forearm started hurting a year ago, I eventually notice that shaking hands horribly aggravated my pain. So I stopped shaking until the pain was a distant memory.
2. Orthotics, orthotics, orthotics. Doctors provide expensive verbiage. Your local pharmacy, in contrast, provides cheap salvation. After multiple doctors failed to alleviate my foot pain, I went to the pharmacy and bought every foot product they sold. Some turned out to be useless, but I quickly learned that a simple arch support provided marked pain reduction. This in turn led me to hunt for an even wider variety of arch supports. Ultimately I wound up crazy-gluing a women’s arch support on top of a men’s arch support – and my foot pain faded into nothingness. As far as I know, I am the world’s leading assembler of artisanal foot orthotics.
Another example: When I had tailbone pain, I naturally tried softer chairs. That helped slightly, but I soon resolved to buy and test a dozen different cushions. That, combined with a 90-degree chair, ultimately eliminated my tailbone pain.
3. Obsessively experiment. If you’re out of good behavioral ideas, try any idea that crosses your mind. You can usually tell in a minute or two if you’re aggravating your problem. When my back was in agony last September, I tried every sleeping posture, bed type, and pillow arrangement I could imagine. I expected almost every idea to fail, but kept trying. Finally I discovered that my back pain upon waking was minimal if I stacked two soft thick pillows horizontally under my abdomen, then placed a flat pillow vertically under my upper chest. After hitting on this inverted t-formation, I further experimented with a wide variety of pillows to enhance the pain-reducing effect.
4. Focus on proximate causes. Logically speaking, your “pain-inducing behavioral problem” could be a vitamin deficiency. In practice, however, reasoning from proximate causes is highly reliable: like causes like. The cause of foot pain is walking or standing the wrong way. The cause of tailbone pain is sitting the wrong way. The cause of forearm pain is grabbing and lifting the wrong way. My last episode of back pain was hard to diagnose, because I was initially in so much pain that all behaviors hurt. Once I made progress, however, I was able to discover that my back pain only amplified when I was sitting. This in turn led me to focus on different chairs, back cushions, and the like. Now I’m practically cured.
While this is only one man’s experience, my principles have repeatedly worked out of sample for me. When a new form of pain descends upon me, I open up my well-tested toolkit and get to work. Obviously my approach will not work for everyone, but I suspect it will work wonders for 80% of people who mindfully apply it. And even if chronic pain has never troubled you, one day it will. So take heed.
P.S. I got an MRI for my head tingling. As usual, the doctor found nothing and knew no way to help me. Fortunately, I eventually noticed that my head tingled much more whenever I was near a heat vent. So I drastically cut my use of artificial heat, dressed more warmly, and my tingling almost vanished.