This weekend I went on a two-day camping trip which afforded me the opportunity to imagine the environment in which our species evolved. And to do a bunch of bitching and whining about all the minor discomforts I experienced in that environment. And that led me to some speculations about whether the extremely comfortable nature of our modern life is capable of disregulating a pain system that was designed to work in a far different world.
The modern world is soft
Our ancestors evolved in an environment without soft beds, couches, pillows, chairs, floors, and roofs. Their world was composed solely of hard jagged things, dirt and pathogens, and scratchy stuff. When they were sleeping, sitting, standing or walking, they would have been in constant contact with objects that are hard and rough, and often cold, hot, wet, dirty or infested with bugs. This makes a startling contrast with our modern world, which is highly engineered to ensure that every object we touch is soft and smooth.
And this difference became very noticeable to me after a day or two of camping, even though I brought sunscreen, bug spray, clothes from REI, a sleeping bag, pillows and an inflatable bed. So I was not exactly roughing it, but my experience was still far rougher than my modern life. I had bug bites, I was covered with a layer of sweat and dirt, I had scratches from branches while hiking. I know, its heartbreaking, but I made it through.
As I was summoning the inner strength to perservere, it occurred to me that this constant low grade non-injurious irritation to the skin is actually the natural condition for humans. Which made me wonder whether the complete absence of this stimulus in the modern world can somehow dysregulate the pain system. Part of what gave me this idea was a seemingly related idea called the hygiene hypothesis.
The modern world is sterile
The hygiene hypothesis essentially asks whether the unnaturally clean lifestyles of the modern world are causing problems with our immune systems, which were designed to work in a world full of constant exposure to pathogens.
The immune system is basically an army of cells designed to kill invaders. In order to function optimally it needs proper training at a young age in the form of exposure to invaders. If it is denied this practice, it will lack essential skills, such as knowing what to attack when and how much. And perhaps if the army has nothing to do because there are no invading armies to fight, it gets restless and overreacts to the presence of minor irritants, which causes allergies. Or maybe it just gets confused and starts attacking the body, causing autoimmune disease. This is a rough sketch of some very complex ideas, but the logic is simple – the immune system is a complex system which evolved in the presence of constant exposure to pathogens, and therefore removal of this key input into the system can be expected to change its behavior in some way.
The hygiene hypothesis appears to be gaining more and more scientific support, including epidemiological data which shows various allergic and autoimmune diseases are far more common in sterile environments than more natural environments which involve far more exposure to pathogens.
The comfort hypothesis
So if the hygiene hypothesis can explain the modern rise in allergies, autoimmune disease, and the fact that my daughter cannot take peanuts to school, can the “comfort hypothesis” explain the prevalence of chronic pain in our society?
There is some similarity in logic between the two ideas. The pain alarm system is part of the immune system. It evolved in a situation in which one of the major players, the skin, was constantly receiving minor amounts of nociceptive input. We know that nociceptive or other sensory input in one area of the body will affect pain levels in other parts of the body. And counterirritation is a technique for pain relief that involves using an externally applied substance, such as capsaicin, to causes irritation and mild inflammation of the skin, for the purpose of relieving pain in other areas, such as muscles or joints.
Is it possible that a radical reduction in the amount of this peripheral low level nociceptive input to the skin can somehow cause disregulation of the pain alarm system, perhaps causing it to focus excess attention inappropriately in other areas? Perhaps this is a contributing factor (not the sole factor of course) in conditions such as allodynia, complex regional pain syndrome or fibromyalgia. Or perhaps it is involved in other more common forms of chronic pain such as low back pain or joint pain.
I don’t know the answers to these questions and I do not have any real practical recommendations on the basis of my speculations. Except that it’s probably a good idea to “rough” it from time to time so as not to become too “soft.” Our perceptions are in many ways relative. Food tastes better when you fast for a while. And my bed feels a lot softer after a camping trip.
What do you think about these ideas? Have you heard someone else propose them in a different form? Let me know in the comments.
Thanks Todd, The nervous system and the immune system being one system is really interesting stuff. A couple of great papers recently been posted on SomaSimple you might want to read
Thanks Dave. Do you have a link?
see below
http://www.somasimple.com/forums/showthread.php?t=13474
or this
http://www.somasimple.com/forums/showthread.php?t=13475&highlight=immune+system
I often try to think how it must have been for the ancients, and would like to add some more for your hike
1/ Go without food for a while
2/ get cold
3/ scatched skin, bruising, neetle stings.
4/ run from bear.
sure there is more ?
Stephen,
I would add lots of sex with various members of your tribe during the considerable downtime (to enhance social bonding and co-operation). But alas, our culture has stripped that one away too.
I wonder if this means that construction workers who experience a bit of roughing it have a lower incidence of pain as a population?
Good thoughts. It would be interesting to see what chronic pain looks like in indigenous populations. Of course, there are many factors there that could have just as much impact as the comfort level – cultural factors come to mind.
I often think about the same thing Todd… I get so uncomfortable in the woods and I have allergies myself.
But I wonder how long it would take to simply adapt to a “new normal”. Weekend trips are likely not very representative. I wonder how things would be if you went on a camping trip that lasted months.
Tony,
Yes it would be very good to know that. I am very interested in the idea of diseases of civilization and have always wondered whether back pain is one of them. I have looked into this a little and I think James Steele has as well. My recollection is that data is hard to come by, and very hard to interpret, but that it appears that aboriginal people suffer chronic pain as well.
I think we tend to complicate things. If most of your time is spent battling fatigue, cold, heat,hunger, etc, the twinge in your elbow is not the limiting factor. To do these things on a regular basis can be useful for keeping a general perspective and makes a good view point for contemplating the nature of pain,suffering, and the subjective experience.
This is a really interesting idea, and it brings to mind the softness I see in so many ‘hardcore’ athletes who cringe at the thought of hauling wood.
I grew up camping and hiking, and actually feel more relaxed, comfortable, and at ease in the wilderness. Bug bites don’t bother me, constant cold and dampness don’t seem to get to me, and dirt or poor superficial hygiene is fun. In civilization, these things do bother me, but as soon as I’m on trail, my mindset shifts and I toughen up.
I think, as you say, the softness of modern life makes us more susceptible to pain. Trying to convince people to rough it, though, is always met with resistance because growing into being tougher is an uncomfortable process. It’s like getting a tooth pulled: you know it’ll be better on the other side, but the acute pain of the operation itself is enough deterrent and you’d rather just put up with low-grade pain all the time than go through with it and be free of the chronic pain afterwards.
Just yesterday I was reading this other site about something very similar, a concept the author calls Hormetism, or “the application of progressive, intermittent stress to overcome challenges and grow stronger physically, mentally and emotionally”: http://gettingstronger.org/
I woke up thinking about how every modern convenience comes at a cost. The internet memorizes things for us, so we no longer have people memorizing epic poems. Cars provide locomotion so pedestrianism (walking long distances) is no longer a sport, let alone a past time. I’ve recently begun taking cold showers, or rather going from cold to hot and back at the end of my showers, in an effort to become more acclimated to variation in temperature. There is some scientific evidence that this might help prevent or aid in the treatment of anxiety and depression even.
With all the comforts and conveniences of our world, we must consciously choose discomfort and inconvenience if we are to adapt to stressors.
Hi Duff,
That is a great site, Becker is a smart guy. And your points are well taken. But I think what I am getting at here is a little different than hormesis though. My idea is not so much that constant irritation to the skin makes you tougher, it is that it distracts the CNS from putting too much attention on other areas, like maybe joints, muscles, etc.
Thanks for everything you do here, between you and Paul Ingraham my low back pain is about 5% of what it was a week ago. With regards to the comfort issue, I work as an offshore fisherman, and for the last ten years or so I’ve been aboard an old beast of a scow, built in the 60′s when the design was all function and little regard for comfort. Benches are bare plywood with nothing but a coat of paint to cushion your tush, bunks are small and narrow, you have to climb a ladder and run across the deck to get to the ‘water closet’ (which is seriously big enough to back into and sit with your knees nearly touching the door), etc. I experienced the usual pains of hard work – you don’t throw around 80,000lbs. of shrimp in 3 days without muscle fatigue – but never once did I experience the kind of back pain I’ve been dealing with since I spent six weeks aboard a newly remodeled, supposedly ‘comfortable’ boat this fall. Granted, comfort aboard an 80 foot fishing boat depends more on intelligent use of space than cushy rooms and padded benches, and the boat I was on was not intelligently designed, but I’ll take the hard life over the soft life any day!
Carolyn,
That is just great to hear. Congrats on your progress and thanks very much for sharing your story. Very interesting about the comfort! I am very glad to have been of some help.
May I ask what in particular about my site or Paul’s has helped you with back pain? Have you implemented some particular strategy? Or is it just the info itself? Just curious!
The most powerful impact came simply from education. This was my first time dealing with this kind of pain and I had all the usual fears (‘will I ever be able to fish again?’ being a major one), and my pain was reduced before I tried a single practical suggestion, just by reading around a bit. I should mention that I’m also an MA in philosophy and a bit of a science nut so I find the neurology of pain (etc.) fascinating in its own right, which makes it easy to spend a lot of time poking around here. I’ve been playing around with a bunch of different strategies – Paul’s sweet spots were a big one to get the pain back down to the minor twitch it was before I foolishly decided to try and exercise it out – and with the pain under control I’ve been focussing more on your side of things: exploring movement options, paying attention to what I’m up to, and just slowing down in general. The hardest thing to wrap my head around was the ‘pain breeds pain’ thing; once I realized what I was doing to myself with all the poking and prodding and twisting and stretching, I went out and bought a back brace as a kind of placebo… I didn’t expect any miracles of pain relief just from the brace itself, but I used it as a way to remind me how to move (and how not to) for a few days, and to bring a sense of stillness and protection to the suffering area. After wearing it for less than 24 hours, I thoughtlessly leapt up off the couch in my old way without an ounce of pain – a movement I haven’t been able to make smoothly and unthinkingly for weeks! I’m not cured by any stretch, being out and about in the cold is still a bit of an ordeal, but that moment was the turning point, when my brain finally started to believe that maybe there wasn’t so much wrong with me after all.
Thanks again and Merry Christmas!
Thanks so much for sharing your story, very interesting and great to hear! Would you mind if I used some of your quotes in a post?
Not at all, fill yer boots.