I had RSI for about a year and a half. By random luck, a stranger (actually, two of them) referred me to The Mindbody Prescription by John Sarno. This was September 1999. I had chronic arm pain, 24 hours a day, 7 days a week. I treated my arms like they were made of fragile glass, I didn’t type at all (I used voice recognition software to do most of my work). I saw myself in the book, but I was afraid — afraid that if I believed in Sarno’s theory I might get worse, might hurt my arms more, etc. Nonetheless, over the course of the next 4 months, I gradually became more and more convinced of his theory, enough to take a leap of faith around January 2000 by choosing to take a lot of classes rather than a few (i.e. coddling my hands). By May 2000 I was very confident and was not restricting my physical activity at all. I was typing, writing, opening doors, lifting weights, everything. I still had some pain. By September 2000, the pain was gone. I was working a full-time job as a programmer, in an extremely un-ergonomic workstation, and I was completely pain-free.
Whee! Forgive me, but it really is a wonderful thing.
What is Dr. Sarno’s theory?
I’m not going to go into all the detail here. It’s been explained elsewhere on the web, and besides, it is a *must* for you to read The Mind Body Prescription or Healing Back Pain if you haven’t already.
Here is my summary of what I think is most important in Dr. Sarno’s theory:
1. The mind and the body are linked. Classic example: the placebo effect — your mind thinks it’s gotten a pill that’s gonna fix your body, and what do you know, believing that leads to your body fixing itself.
2. Not only can the mind-body connection lead to your body healing itself (as with placebos), it can also lead to the body harming itself, or creating pain.
3. Now why would your body do this? In my experience, people with chronic RSIs are, deep down, not happy. There is something eating away at them inside that they haven’t addressed. The RSI is their mind-body’s attempt to fend off the emotional problem. Because when you have a full-fledged repetitive strain injury, it permeates every area of your life. Your work, your friends, your peace of mind, everything. You think about it all the time. Want a glass of water? Ooh, that hurts turning the spigot. Damn this RSI, I wonder if I will have this pain for my whole life! Many people can’t go 10 minutes without thinking about it. And there — THERE — is the driving force behind the RSI. It is so absorbing — SO absorbing, the only parallel I can think of is drug/alcohol/food addiction (i.e. eating disorder) — that you effectively don’t have to think about other things in your life. In some ways you are living like a zombie: going through the motions, but not really living. The RSI is the only real thing in your life, your constant companion, your constant curse.
That’s my take on it. Now, Sarno goes into extensive explanations about conscious and subconscious and yada yada. And I think that’s all well and good, and good for him for trying to get detailed about it, but to me the crux of the theory is simply that an RSI is a huge, extremely efficient distraction from everything else in your life. I didn’t realize it at first, myself — sure, it seemed like I was living my life! But as I gradually began to realize what life would be like without the RSI in it, it began to dawn on me what a huge void its absence would leave in my life — how for so long I had relied on it being a part of my life — and what a huge hole existed without it for me to fill. Happily I preferred to start filling it than to leave it filled by the RSI.
Now, not everybody has the same experience that I did. Most of the people who don’t identify with what I’m describing read the book and got better immediately, more or less by themselves! But I have met a number of people who had similar experiences to mine, who often require a little hand-holding in their recovery, and that is why I’m writing this webpage.
In case it’s not obvious, let me mention that I have no personal stake in advancing Sarno’s theory. I’m not getting any kickbacks, unless you count the pleasure of watching people recover from years of debilitating pain in the blink of an eye .
My suggestions for your recovery
1. Read the extensive number of success stories online
2. Begin to appreciate the extent to which your life revolves around your injury. Think about what this means.
Set aside some quiet time and imagine how you’d feel if you didn’t have this chronic pain. Go beyond “Yippee! I can type again!” and really try to imagine what your life would be like. Does it feel good? Bad? Uncertain? Would you feel safe? It’s easy to forget this when you’re dealing with a debilitating affliction, but there may be things you’d have to face if your arms weren’t a source of concern that you’re putting off right now, since your RSI is your main priority.
Try spending half an hour without dwelling on your chronic pain. Before you start pick a thought-topic that you can focus on every time thoughts about your RSI come up. For example: your sister’s upcoming wedding, taking your cat to the vet, a painting you like — nothing too stressful but something meaty enough to focus on. Don’t attempt to do anything too strenuous during the half hour (lifting weights, bicycling, typing if you restrict) but do do any basic task that you happen to come across, such as opening door knobs, lifting plates and books, etc. Rest assured that a half-hour of unrestricted casual activity will not cause any permanent damage to your arms, if you’re nervous about that. You can try this at home in your bedroom or anywhere else. Every time you notice yourself thinking a thought related to your RSI, shift your attention to the thought topic you chose before. Do your best to avoid thinking about your RSI for a half-hour straight. The point of this exercise isn’t to cure your problem of thinking about your RSI all the time or to get you doing physical activity — it’s for you to educate yourself about how often you think about your RSI. Try it and find out.
If you’re already convinced that Sarno’s diagnosis is right for you, then try extending the above activity: when it hurts, think about something else.
Do the mental exercises that Sarno describes in The Mindbody Prescription. Buy Dr. David Schechter’s book The Mindbody Companion and try the exercises in there.
3. Consider when and why it started.
In my case, RSI started as pain in my right hand, followed a week later by pain in my left hand. I then had this conversation with “Alice,” another girl in my Computer Science class who had gotten RSI shortly before me:
Alice: Has it spread to your elbows yet?
Alice: Oh man, that’s when it really sucks.
A week or two later my pain had spread to my elbows, where it stayed for the duration of my RSI. At the time I thought, “Wow, she really knew what she was talking about!” Now I look back and think she “spread” it to me by suggesting a place I could legitimately expect to have pain. What were people telling you about your kind of chronic pain before you had it?
What was going on in your life when your pain started? Did your RSI start around the time some other ailment went away, or at a time of emotional stress? Psychosomatic afflictions can switch places since the root cause is something emotional that needs to be avoided. Equivalent ailments could include muscle/nerve/pain problems in another part of the body, stomach problems, frequent headaches, an eating disorder, OCD, or obsessive anxiety. I’ve met people who had a knee injury which conveniently went away just as their arm pain was beginning.
4. Seek out some more hand-holding, if you want it.
Find a doctor in your area who specializes in Sarno’s theory of chronic pain. A starting point for finding a doctor is on the Tarpit website or on Dr. David Schechter’s website.
5. Get more information. Sometimes hearing it in a certain way really strikes a chord.
Read The Mindbody Prescription and Healing Back Pain. They’re different and both worth reading. The TMS website at Tarpit has a lot of info.
Nate McNamara recovered from RSI recently. Read his website for more suggestions for recovery.
Read the mind-body section of the Harvard RSI Action Group site and read the handout that we gave out at our information session. By the way, the rest of the Harvard RSI site is written from the perspective that RSI is a structural problem — just ignore it.
Read Dr. Schechter’s TMS website.
Dr. Sopher also has a TMS website.
Dr Sarno now has a website with a video for sale (I’ve never watched it).
6. Take what your structural doctors say with a grain of salt.
Doctors who treat via a strictly structural methodology may look high and low for a structural diagnosis when your only symptom is chronic pain. Do you have any significant structural abnormalities? (No, “micro-tears”, which are invisible, hint hint, scar tissue, and inflammation do not count.) How do you test in your physical therapy measurements such as grip strength — are you in the normal range? I came to realize that there was nothing measurably wrong with me and that my only symptom was pain. Note that if you do have a structural abnormality your pain can still be psychosomatic (Sarno observes that structural abnormalities are normal, common, and not necessarily at blame for pain). But many chronic RSI sufferers don’t even have significant structural abnormalities.
I once heard a wise quote along these lines: A multiplicity of treatments is a sign that the cause of an illness is not yet well understood.
Don’t get disheartened by loser doctors. This was the conversation that I had with the first doctor who treated my RSI, after he examined me:
Doctor: So, what do you want to do when you grow up?
Me: I don’t know yet.
Doctor: Do you think it might have to do with computers?
Me: Yeah, maybe…
Doctor: Well you better find something else! Because you’re not going to be able to do computer work. Your body’s not cut out for it.
…I should really pay him a visit…
7. Just remember, your body is a workhorse.
Just remember, especially if you’re still in your 20s, your body is a strong, healthy beast. Nothing should take a year or more to heal, especially nothing as mild as tendinitis and inflammation.