⚠️ I am not a medical professional. ⚠️

Summary

I dealt with chronic pain in my lower arms (aka repetitive strain injury; RSI) from early 2020 until late 2024. During the first year, my pain ramped up to unbearable (can’t do dishes or hold a full teacup), after that it was usually mild to medium-heavy depending on hand use. I am now pain-free and have been for about 1.5 years. This post is about how I got there.

Symptoms:

  • tennis elbow-like pain
  • pain on back of hand
  • pain on side of wrist (when using touchpad)
  • numb/cold/tingling fingers
  • sudden and intense involuntary neck muscle contractions

Failed therapies:

  • microbreaks
  • vertical mice
  • stopping computer use completely
  • numerous physiotherapy sessions (e.g. Mulligan Mobilization with Movement)
  • dry needling
  • hand therapy (squeezing putty etc)
  • “ergonomic” evaluation of my desk setup
  • painkillers

Somewhat successful:

  • Talon1 (but it slowed me down a lot which was frustrating; skill issue, some may say)
  • big trackball2
  • low-profile keyboard3
  • psychotherapy (accept and commit; not pain-focused, but may have helped for pain anyway)
  • mindfulness (body scan)

Solution ✅: “unlearning” my pain.

Not like the other pains

By chatting to other people suffering from RSI, I learned about tmswiki.org and books like The Way Out and The Mindbody Prescription. I have not read The Way Out but I thought The Mindbody Prescription was absolutely terribly written4. These resources are all about a “different type of pain”, and whatever you want to call it (TMS, nociplastic pain, central sensitization etc): it is important to know that it exists and it is not like other pain. Most treatments are for the other two main types of pain (nociceptive and neuropathic) so they are unlikely to fix nociplastic pain. They didn’t for me (see “failed therapies”).

Turning points

As a somewhat last resort I started treatment at an interdisciplinary pain therapy center (with a physician, psychologist and a pain physio guy). At some point just before my intake there, during a particularly depressed/medium-painful afternoon my brain decided “fuck it, I want to play Anno 1800, I don’t care if it hurts”. That was one of two turning points that got me pain-free. I played for hours and kind of forgot about the pain and everything else (even if I felt it afterwards). But I also felt guilty, because at this point (Aug or Sep 2024) I was collecting unemployment benefits; I can grind Anno 1800 but I can’t do actual work on a computer?

That leads me to turning point two, which is my therapist’s enthusiasm when I told him about this. I was told there was no need to feel guilty, and being pain-free during my Anno sessions was the first step to being pain-free all the time. “Keep playing for two hours per day and come back in two weeks”. Okay then, doctor’s orders (I played for more than two hours per day). I was also told to further educate myself a bit on the topic (this book is excellent, but sadly only available in Dutch).

Reprocessing

Playing Anno was fun, but the actual therapeutic aspect was that I was “reprocessing” my brain, effectively unlearning to feel pain. I saw progress in my pain, and didn’t feel guilty anymore either, because this was going to help me get to work again. The gaming-only didn’t last forever (month or two), after which I was ordered to also do some non-gaming computer work (in my case: finding a topic for my master’s thesis). This was to see if I would still be pain-free if I wasn’t so hyperfocused on my computer activity, and it went pretty well (although finding a topic took a while).

The whole therapy process took about 5 months, but I was already pain-free for most of that time. I started around September 2024 and formally my therapy ended in early 2025. I call it “therapy” here, but there was no “traditional” therapy going on; just me reading the book, telling my therapist that I can play Anno without pain, and him telling me “you’re doing good work, don’t feel guilty and keep playing”. I know in countries like the US, that “therapy” would have cost an arm and leg. My point being, you can do this on your own, but if possible I recommend you do it under supervision.

I’ve since completed my master’s degree with no physical pain whatsoever. I got a terrible throat infection5 shortly before the final deadline, and had to compress 2.5 weeks of writing into one. I was probably typing for 70+ hours that week, with no pain. Just a year before, that was unfathomable.

What Type Of Pain Are You? Take The Short Quiz!

If you have:

  • not had any traditional pain therapy stuff work (physio etc)
  • no visible damage or inflammation
  • no clear cause of the pain
  • had symptoms for >6mo
  • had random pain-free stints without a clear explanation

you may have nociplastic pain.

So what should you do?

My cautionary advice: find something you can completely and utterly hyperfocus on (for me: Anno 1800), while doing the thing that would normally cause you pain (for me: using mouse and keyboard). Your brain may just forget to make you feel pain.

Obviously there is the risk of making your pain worse if it doesn’t work. But with nociplastic pain, fearing your pain only reinforces your brain’s resolve to feel pain. Education on this topic is important. I recommend the aforementioned book for Dutch speakers, and highly recommend this website too: https://www.debugyourpain.org/docs/main_posts/understand/debugging_rsi/. And once again, I recommend you do this under supervision.

I should note unlearning pain obviously requires “learning” it first. I think you can also “re-learn” it. By really remembering my pain and focusing on feeling my hands (and writing about it), I can feel it a bit again. But I am stronger. It can fuck off, lol.

Closing thoughts

My story may sound like this was easy (“just play some games bro”), but going through pain every day for well over 4 years with no hope of it getting better (or any therapies working) is anything but. I consider becoming pain-free one of the greatest achievements of my life.

  1. talonvoice.com ↩

  2. Kensington Expert. For the biggest ballers. ↩

  3. Apple Magic Keyboard. Yes, it requires turning your hands inward. Yes, I also tried split ergo keyboards. ↩

  4. This is mainly a critique of the writing style. I know many people have used this book to become pain-free. Some stories here: one, two, three. A key part of Sarno’s theory is that pain is caused by repressed emotions. I don’t believe that was the cause of my pain. YMMV. ↩

  5. Man, that sucked WAY more than I thought it would. ↩