Stardew Valley And How it Relieves My Chronic Pain

I experience chronic pain, and there's actually nothing particularly unique about that.

The CDC reports that roughly 20% of Americans reported chronic pain in 2019. Roughly 8% reported that their pain was so severe it impacted their ability to conduct a "normal" life - aka the life they want.

I am certainly in that 8%. I went from a career obsessed, high energy, perpetual motion machine to needing four spine surgeries over a 3 year period. Two of them were technically emergencies. I have been blessed with a reduction in pain, but recovery isn't instantaneous. The surgery isn't a health potion I can just chug and instantly regain all my health points. It's a long, brutal, and personal process - one that requires the patient themselves to engage in due to the ecosystem that chronic pain treatment lives in.

Treating chronic pain is tricky, especially as our understanding of pain is rapidly developing in neuroscience. Medical practitioners, in general, have not caught up systemically. As a result, quality of care varies greatly from practice to practice despite any good intentions. The ignorance gap is quite substantial. Entire companies have been formed to address this gap, such as Curable.

My own medical team was amazing, but when they tried to communicate the current understanding of chronic pain, the delivery fell short. I got a mutation of the old models and the new, and a lot of confusion. Half the time the reading materials they gave me seemed to contradict each other. I would show up to my pain management appointments progressively more confused. Was my back pain due to a physical problem? Was it in my head? Was anxiety causing me pain or pain causing me anxiety?

My biggest irritation was pain was preventing me from doing the things I enjoyed. I would ask the doctors over and over again how to get my pain managed enough I could do them again and move on with my life.

"Are you sure you actually enjoy those things?" They asked after a while.

"Of course," I replied, irritated.

"Well if you truly enjoyed it, that would override the pain. You would consider it worth a bit of discomfort."

This exchange sent me into a tailspin of sorts. I re-evaluated how I was communicating my frustration to them. I went off on a research journey, and these are my main takeaways.

Identify What Specific Things You Are Enjoying About the "Too Painful" Activity

The example I kept mentioning to doctors was knitting, crochet, and computer related tasks. Those are my neurotic passions. Before the surgeries I could engage in those activities for hours upon hours. Basic biological functions such as eating or using the bathroom were the biggest nuisance breaking my concentration. I assumed the appeal was cerebral only. I was wrong.

I have mentioned in previous articles how crochet puts my brain in a mindless meditation state. It was a state I was craving desperately to achieve in a predictable fashion. I wanted to rely less on painkillers and more on activities to achieve that state of mind. The goal was the state of mind itself but I didn't realize it at the time.

Crochet was also listed on the paperwork given to me by my pain management team. It was considered a low pain activity, but I couldn't manage it more than a few minutes. It engaged core muscles around my incisions to physically make the stitches. It seemed ridiculous to me. Who the hell thinks crochet is exercise?

"Well do it for as long as you can and then take a break. I think you are getting too hung up on not listening to your body. Find something else to do when pain interrupts the preferred activity as a break of sorts."

This was suggested the next appointment. I had shared that I was actually beginning to absorb some of their feedback in a different way.

I don't like putting down a task if I am enjoying it (who does?) but I take it to the extreme. I just end up thinking for hours or days unhappily about how I want to do The Thing. The idea of finding a "replacement activity" seemed impossible to stick to. I knew myself well enough that tricking myself to accept a replacement to anything wasn't going to be easy.

It then occurred to me that I need to sort out what specifically about that activity makes it meditative and soothing to me. Here is the list I came up with.

1. Repetition of the same pattern of motions or actions
2. Rewards for getting timing and sequence challenges optimized.
3. The ability to define my own success criteria.
4. A bit of variation for "spice."
5. The ability to correct mistakes.
6. The ability to change my mind what "success" or "done" is.

I suppose I should mention at this point I am also a musician. Repetition and pattern recognition is a huge theme for me in general. I crave activities that engage and reward this part of my brain. Being conscious of this trait directly assisted my ability to do self-care. It allowed me to identify shared things between tasks I can enjoy so I could then work out a better pain management strategy.

I wasn't necessarily craving to crochet, I was craving the feeling crochet gives me. I had also been craving playing my cello, but that was more of an obvious "physical" activity in comparison so it didn't even occur to me to complain about that. However, when I took the time to think about which part of my back I use to play the cello, I realized it's the same area that hurts my back to crochet. I was substituting wanting to play the cello with crochet and getting frustrated because I ended up not being able to do either long enough to get the mind space I was after.

The other activity on my list was using a computer. I had been unable to play video games or do my software engineering tasks comfortably for quite some time. Computer chairs became the bane of my existence. Standing desks were ok until my pain shifted again and didn't want to stand anymore either. If I needed more than 10 minutes to get anything done, I was perpetually bouncing in and out of my chair in response to pain. And before you laugh - this is a very common experience with sciatica patients. You simply cannot maintain a comfortable position long enough to get anything done.

But stopping is still not in my vocabulary. No amount of surgery is going to cut out my personality. I needed to find a middle ground.

"Well can you use a device that lets you just sit where it's comfortable and you can just move around constantly while you work on it? Does it have to involve a desk at all?"

I was already doing that with my smartphone (an invaluable device for people with mobility issues). It was my lifeline during my most painful periods. I had always loved handheld gaming systems, so perhaps I needed to figure out which handheld would best suit somebody that can't sit still.

I ended up purchasing a Nintendo Switch so that all the Steam games I couldn't play sitting or standing at a desk were available to me. I tried a few games and got similar frustrating results. I could only manage playing for about 10 minutes before my back would start hurting and I'd consider stopping just to scroll mindlessly through social media while I rode out the pain. When social media became too boring, I'd play my Switch some more. I'd shift around while playing but still couldn't manage much longer than a half hour at a time. Repeat, rinse, remain frustrated.

I was scrolling through my Instagram account and it was bursting with posts showing Stardew Valley playthroughs. A recent patch to the game had flooded my feed with people checking it out and posting enthusiastically about it. I practically threw my phone across the room at that point. I had forgotten to purchase that game and immediately downloaded it. It met all the points mentioned above about crochet and I was hopeful again.

Repetition of the same pattern of motions or actions

Crochet

• The ritual of planning a project, gathering materials, deciding what the end of the project looks like, etc.
• Choosing combinations of stitch patterns that are physically enjoyable to make with my hands.
• The physical act of creating each stitch the way it should be is enjoyable.

Stardew Valley

• The ritual of planning a farm, gathering materials, deciding what the farm's goal is.
• Choosing farm functions that are physically enjoyable to execute with my hands.
• The physical act of mining, farming, foraging in the game are enjoyable.

Rewards for getting timing and sequence challenges optimized

Crochet

• The project looks as desired.
• Satisfaction of tangible final product.

Stardew Valley

• The farm looks, operates, and produces like a dream because of game decisions/actions.
• In-game rewards and incentives.
• Satisfaction of good execution.

The ability to define my own success criteria

Crochet

• Choosing if I am following a pattern to the letter, if I am altering it, or if it's an original pattern in my head.
• I prefer to spend my time crocheting specific items. Blankets and sweaters don't interest me, and that's ok.

Stardew Valley

• Choosing what type of farmer I wanted to be - there really isn't a wrong way to play.
• I prefer spending the majority of my time in the mines or taking care of animals. I like the ritual of collecting all my artisanal goods when they are ready as well. I tend to play a miner that happens to have a farm.

A bit of variation for "spice"

Crochet

• Focus on something new if bored. Sick of hats despite loving to make hats? Make a cowl. Sick of cowls? Make a hat with cables. Sick of hats again? Make a cowl with cables. Sick of all of the above? Make fingerless gloves. Add beads to a project. Add color. Remove that, etc.
• Sick of crochet? Switch to knitting. They both use string.

Stardew Valley

• The "chaos" factor alone in the game keeps things interesting.
• Focus on another area of the game. Maybe finally level up fishing or some other skill I typically ignore. Progress relationships. Finish the community center.
• Start a new farm with a different starting map

The ability to correct mistakes

Crochet

• Frog it; try again.

Stardew Valley

• Try again in game
• Start from your last save
• Create a brand new farm

The ability to change my mind what "success" or "done" is.

Crochet

• Alter a pattern to suit my whims
• Decide the project can go in another direction
• Drop the project all together

Stardew Valley

• Change my mind at any time how I play the game for enjoyment
• Create separate save files if I want to explore options without losing anything

I have been playing Stardew Valley on the Switch now for several weeks and it's a successful "replacement activity." The difficult part remains accepting you need to transition to another activity to manage the pain.

I'm still a perpetual motion machine, but I am learning how to better balance the activities themselves and transition appropriately. I have already noticed the reduction in my frustration levels if I listen to my body when the transitions need to occur and commit to the transition before the pain escalates.

Summary

1. The physical sensation of playing the game is soothing in a nearly identical way crochet is.
2. The physical sensation of playing the game mimics the feeling I get from other soothing tasks that are more physically strenuous.
3. The transition from crochet to playing Stardew Valley allows me to maintain the state of mind I am after while accommodating my physical needs.
4. I use the game as a replacement for the more painful task during breaks.