Tackling the chronic pain epidemic

Roughly 1 in 5 adults in the United States, approximately 50 million people, suffer from chronic pain. Nearly 35% of those individuals experience high-impact pain which severely restricts their daily activities and quality of life. The estimated cost to service this condition is $600B+ per year — more than the annual cost of cancer, heart disease, and diabetes combined. Meanwhile, yearly treatment outcomes remain woefully low with resolution in less than 10% of patients. The industry and population size continues to grow, yet that's all. There's clearly something broken!

I first learned these incredulous statistics after experiencing unexplained chronic back pain for the first time after healing from a minor calf strain in November 2022. I jumped through all the typical hoops seeking answers: primary care, chiropractor, pain specialists, MRI's, physical therapy, pain injections and more. No matter what I did, the pain persisted. Until I discovered the work of Dr. John Sarno, a rehabilitation physician at NYU and author of Healing Back Pain. He shattered industry expectations with pain resolution in more than 80% of clinic patients.

Dr. Sarno proposed that the majority of chronic back pain, and other persistent symptoms, were a often a result of unconscious emotional stress. Repressed emotions, especially anger, divert attention from emotional conflict by creating physical symptoms. A perfect storm in a healthcare system built on the notion that pain always has an anatomical basis. Consistently dismissed by mainstream critics, modern neuroscience research has largely proven his concepts to be true: pain is not always a signal of injury, the brain can create real physical symptoms and emotions and past trauma can fuel chronic pain. Thanks to Dr. Sarno and other mind-body practitioners, I'm pain-free after embracing and tackling the true origins of my pain. I explored how to leverage technology so others can experience the same result.

From personal experience, I have a very intimate understanding of the needs and challenges individuals with chronic pain face. I'm still only one subject. I wanted to speak to others of varying backgrounds to get a clear sense on what would help them in their journey. The space I found those individuals was an online forum called The Mindbody Syndrome. It was typically one of the first places people landed after they'd exhausted all traditional medical resources, just as it was for me. Their position of vulnerability ensured an openness that was effective to engage with and conceptualize what an AI chat bot for pain might look like.

In order to create a comfortable environment, I approached all conversations with natural dialoguse dominated by education and encouragement. My goal wasn't to sell a potential vision, but instead peek into their inner brains. An effective angle was naturally weaving in questions to my correspondence like, "What do you feel is missing from your journey?" and "How do you want to be supported in navigating this world?". The insights that trickled in gave clarity on what was truly at the core of their struggles and how they're thinking about navigating it.

• Desperation: They've done everything by the book, accruing a laundry list of specialists each with their own treatment protocol. Yet, nothing has worked. These individuals aren't lazy or weak, they're exhausted and bewildered. The question driving them crazy is, "Why is nothing fixing this?". This is where a framework for thinking about the pain comes into play.
• Skepticism: It's likely they stumbled onto Sarno, TMS or neuroplasticity concepts online. Maybe they viewed reviews of his book with stories of people cured just by reading. All of it sounds too simple and too different from everything they're familiar with. These individuals need patient, credible education that builds a case for psychosomatic pain over time.
• Isolation: Somewhere along the way, they started wondering if they're permanently broken. It's likely a doctor gave up and passed them onto the next specialist. Surely they'd have found a fix by now. The surface area of trust gets smaller. A friendly AI partner that compassionately explains the neuroscience behind it can reframe doubt into a promising doorway.

Ultimately, chronic pain is undoubtedly an incredibly challenging issue to solve due to it's individualized complexity. Unlike a disease with a shared culprit, every case is unique. People of all size, age and background may experience it at some point in their lives. Although, Sarno identified specific attributes that commonly make someone more prone to experiencing psychosomatic pain.

The distinctive character of those most effective is defined by responsibility and high-sterss. They're commonly labeled in society as: high-achieving, perfectionist, people-pleaser, hard on themselves, too responsible and/or always happy. The same vulnerability that makes people good can also be responsible for creating a pressure cooker like emotional environment. I saw this unfortunate paradox play out consistently in my conversations where individuals described their lives and experience as "environments of chaos" with deep rooted expectations of elite performance. Whether a mother of four adult kids or a CEO of a large company, the expectation of a happy face at all times was a prevalent burden.

Beyond a specific personality profile, the most substantial commonality was lived experience. Hardships and trauma scale linearly with adults that have had more opportunity to experience life and maturation during different stages of aging. Divorce, death of a parent, accelerated work promotions — all outcomes that can create lasting emotional and spiritual wounds. If not processed properly, the possibility of developing neuroplastic pain persists. Almost everyone I interacted with had a traumatic life experience that altered the trajectory of their life, whether they knew it or not. It likely happened in the last 5 years, but for some it stretched as far back as childhood. As a result, the majority of potential users were midlife (45-65 years old) where the height of life's challenges and changes typically occur.