The Pain of Comfort

[Nick]

This week when a patient asked for my advice re: pillows and mattresses for what seemed like the billionth time in my career, I had to wonder how many of our aches and pains arise from cultural achievements that shield us from adversity so successfully. Are we made soft by the amenities of modern living? I mean how many of our predecessors, even in the recent past, much less our caveman forebears, required Tempurpedic mattresses to sleep through the night? How many suffer foot pain because our feet are arch supported with gel cushion heels? Can it be that our cultures contribute far more to our dis-ease than I've imagined?

I just finished the book Survival of the Sickest. The author discusses how many modern diseases conveyed some genetic advantage at the time of a particular mutation (eg. sickle cell anemia protects from malaria). It made me wonder about genetic factors contributing to sensitivity and any potential survival advantage they may impart or may have imparted. The book has made me a bit obsessed with evolutionary biology and I can't help but see how much of our culture is built around the denial of our heritage.

[Diane]

Excellent topic.
I've wondered the same thing about mattresses. We put such thick buffer zones between ourselves and experiencing our bodies against surfaces. Including our feet. I'm sure our brains are only half developed in their capacity to downregulate because of this careful avoidance/denial of sensory input from babyhood on.

I get those questions about mattesses too. My answer is usually "anything that gets you through the night, but the harder you can tolerate the better, so no waterbeds."

[nari]

I have thought for a long time that our relentless pursuit of ease and comfort will lead us into trouble and the decline of civilisation. We are just too soft and hedonistic.

Re mattresses: The posh latex mattresses are just as bad as waterbeds. I've known three folk in one year give up the latex and return to springbases, due to increased spinal pain. I am sure the pursuit of optimal comfort has altered our collective pain thresholds and tolerances. Each of us could spend two weeks in the bush/wilderness in a position of self-sufficiency in order to be aware of our perceptions and goals.

Mostly kidding, sort of. I think this is an important topic, with important cross-cultural differences - if I can find some.

Nari

[toddhargrove]

There was a good article in the New Yorker recently about the benefits of walking barefoot and the foolishness of trying to outengineer millions of years of evolution with "high tech" shoes. One of the interesting findings is that a cushioned heel leads to less not more shock absorption. http://nymag.com/health/features/46213/

[SMEGC]

I had a patient burn through close to $8000 worth of matresses and pillows last year and she ended up going back to sleeping on her old matress and using her old pillows.

I generally tell people to look at the label on their old matress and try to buy and identical or as close to it matress. That, or stick to a similar firmness in pillow and matress that your body is already used to.

[Randy Dixon]

I've had this in my save file for a while and finally have a place to put it:

http://bmj.bmjjournals.com/cgi/conte.../321/7276/1616

[nari]

Interesting observations, Randy. I wonder what the fellow sitting on his fully flexed knees does for venous circulation after 3-4 hours?
Squatting is easy, if done from an early age, and feels quite relaxing, as long as the heels are flat on the ground with full ankle dorsiflexion.
Oddly enough, I find the best sleeping position is the one adopted for lumbar manipulation, plus a pillow that is about 3 inches thick. Very comfortable.
I had also read some years ago that the more cushioned the shoe heel, the higher the risk of injury above the ankle. Not sure if this is still valid.

Part of the problem is that docs and PTs have advised the same 'remedy' for all people regardless of size, shape and nature of spinal pain; the 'one size fits all' recipe with regard to sitting straight, lying down, certain moulded pillows, standing tall and so on.


Nari

[marcel]

Hi,

My mother in law (Thai woman 70 yrs.) never complained of backpain. She's accustomed to sleeping on the ground only on a sleeping bag!
I've tried that too in Thailand and on some campingtrips in the past. Pretty easy and not that uncomfortable as it would seem.

Years ago there was a African runner : he ran marathons barefeet; in a pretty good time too.

[Diane]

Randy, that article is great. :clap2:
Thanks for posting it.
Think of all the wonderful passive neural gliding that must be happening in a body sleeping against an unforgiving surface. All of us need to learn to make friends with the floor more.

[Nick]

Thanks for the links Randy and Todd. Both great reads with very good points.

Some of these "natural" solutions to chronic pains seem to involve a degree of more acute discomfort. Have you ever had the experience of camping and trying to get to sleep with something sticking into your back only to wake up in the morning feeling as though you had the best sleep of your life?

I wonder how well people might adopt these kinds of solutions.

[Diane]

Todd, that shoe article rocks too. :thumbs_up
If people only had their unencumbered feet to walk on, they would soon learn to move differently, more like cats and less like people with hoofs. I look forward to being able to get some of these thin-soled shoes for everyday wear.