How Priya, a San Francisco product manager, cured her chronic back pain after four years of being told she couldn't.
Four years at a desk. Eighteen thousand dollars on a Herman Miller Embody, Pilates, PT, specialists, and supplements. An MRI that said her back was normal for her age. Then she picked up a book at an airport.
Priya is a 32-year-old product manager in San Francisco. She had chronic back pain for four years. A Herman Miller Embody, six months of physical therapy, eight months of Pilates reformer, a personal trainer, a spine specialist, supplements, and about eighteen thousand dollars out of pocket, none of it worked. Then she picked up a book at an airport. Ten months later, she was pain-free. In the University of Colorado Boulder trial of Pain Reprocessing Therapy for chronic back pain, 66% of patients became pain-free or nearly so.
Ashar et al., 2022, JAMA PsychiatryFour years of ergonomic upgrades, physical therapy, and specialists who couldn't say what was wrong.
Priya was 28 in March 2021. She had just been promoted to Senior PM at a Series B fintech. Her first big launch was a B2B payments product the CEO had staked the Series B on. The eight weeks before go-live were the hardest of her career. Twelve-hour days. Weekend work. Blue Bottle cold brew and Chipotle bowls at her desk. Three weeks before launch, her lower back started to feel stiff. She assumed it was her chair.
She ordered a $1,400 Herman Miller Embody the next day. Put it on her credit card. Her back kept hurting. The night the launch went live, she was on a Zoom with the engineering team until 2 a.m. watching the deploy. When she closed her laptop and tried to stand up, her lower back seized. She sat back down for ten minutes before she could walk to the bathroom. She told herself she'd rest that weekend and it would be fine. That was four years ago.
What followed was a ladder of treatments a 32-year-old tech worker in San Francisco tries. A $350 standing desk converter that worked for two weeks. A company-provided ergonomic assessment with a printed report Priya followed to the letter. Six months of physical therapy, two sessions a week, $2,400 out of pocket. Weekly massage in the Mission at $120 a session. Pilates reformer at $45 a class, two times a week for eight months, about $2,900 total. Twelve acupuncture sessions at $110 each. Hot yoga, vinyasa, yin at CorePower, $180 a month for most of a year.
In October 2022 she paid $900 for an out-of-network MRI because she didn't want to wait three weeks for Kaiser. The radiologist's impression: mild L5-S1 disc desiccation, no herniation, no stenosis, findings non-specific and common. A $500 UCSF spine specialist looked at it two weeks later and told her her spine was basically normal for her age. Priya felt patronized. She paid the $500.
A personal trainer, twice a week for seven months, $150 a session. Six rounds of myofascial release at $175. A $600 functional medicine consult that ended in $280 a month of supplements for six months. A $450 sleep specialist. A Flexeril prescription she finally filled in late 2023, didn't help. CBD oil, tinctures, edibles, patches. Headspace, Calm, Insight Timer for ten days each.
Total out of pocket across four years: about eighteen thousand dollars. Not counting insurance premiums, time at appointments, or the fitness tracker she'd bought partly to track sleep and partly because she thought maybe the data would explain her pain.
"I'm a PM. I solve problems for a living," she says. "My own back was the one problem I couldn't solve. I kept a Notion database. Four hundred and eighty-six entries over three years. Date, pain level, trigger theory, treatment that day. I thought if I just collected enough data, I'd find the pattern. The pattern was always there. I just couldn't see it, because I couldn't fix stress with a product."
Pilates Studio SF · Statement
12 / 15 / 2022 · Client: P. Menon
Eighteen thousand dollars to fix a back that was never broken.Priya, Year 4
The book she picked up at an airport Hudson News.
Priya was in New York in August 2024 for a work conference. Her flight home was delayed two hours. She was in JFK at 10 p.m. with a sore back and nothing to do, browsing the Hudson News bookstore. She passed the self-help section like she always did. Then she stopped.
She'd heard Dr. Alan Gordon interviewed on the Ezra Klein podcast a few months earlier and had meant to check out his book. She picked up The Way Out. Bought it. Opened it on the plane. She was forty thousand feet over Kansas when the first real shift landed.
Three things hit her during the first chapter. Her pain's behavior wasn't consistent with a structural problem. Pain that moved, varied with stress, got worse in predictable situations and better in others. She'd always assumed that meant a multi-factor problem. Gordon framed the inconsistency itself as the diagnosis.
Her MRI was normal. Gordon cited the research that disc desiccation shows up on most adults' scans regardless of whether they hurt. Priya looked up the Brinjikji study on her phone at altitude. Thirty-seven percent of pain-free 20-year-olds have disc degeneration. Fifty-two percent of pain-free 40-year-olds. The findings on her MRI were common in people who felt fine.
Her personality fit the profile exactly. Eldest immigrant-family daughter. Career-driven. Compulsively responsible. Always saying yes to more. Treating her own needs as lower priority than the team's or the family's. She'd been this person since she was eight.
Then one sentence from the book stopped her. "You can't optimize your way out of a problem your nervous system is creating." She'd spent four years and eighteen thousand dollars optimizing her back. The optimizing was part of the problem.
On the rest of the flight she opened her Notion database and filtered pain level against her calendar. Quarterly business reviews. Performance reviews. A bad Slack conversation with her CPO. Her mother's cancer scare waiting period in 2022. Four years of data. The correlation was not subtle. It had been there the whole time.
Functional
Her MRI showed only mild L5-S1 disc desiccation. Her UCSF specialist called her spine basically normal for her age. No injury, no fall, no lifting event. She'd tried PT, yoga, Pilates, personal training, and myofascial release. A structural problem fixed by movement should respond to at least one of them. Hers didn't.
Strong matchInconsistent
Pain moved. Low back, upper back, glutes, sometimes radiating down her right leg. Worst before a quarterly review. Best on vacation. Back to baseline within a day of returning. Monday mornings were usually a 6. Saturday mornings were usually fine.
Strong matchTriggered
Flared before every quarterly business review. Four years, sixteen reviews, sixteen flares. Flared the day after a tense Slack with her CPO. Flared during her mother's cancer scare. Dropped to a 2 on day one of a Mexico vacation in 2023. Back to a 6 on the flight home before she'd moved her body differently.
Strong matchWhat recovery actually looked like.
It was not a straight line down. At month two her pain spiked worse than it had been in two years, the week she had to present to the board. She was sure the whole framework was wrong. It wasn't.
Told Arjun. Started The Way Out workbook. Ten minutes of somatic tracking in the morning before opening her laptop. Felt awkward. Kept the Notion database but stopped tracking potential causes and just tracked the sensation. Her PM brain wanted milestones. The book said to let go of the agenda. She found that annoying and did it anyway.
Noticed the pain dropping on mornings when she did somatic tracking before checking Slack. Pain came back when she opened Slack. She literally ran this experiment for a week, same routine, different sequence. The data said Slack was a pain trigger. She couldn't unsee it.
Q4 business review week. Priya had to present to the board. The week before, her pain escalated to levels she hadn't felt in two years, now radiating into her right calf. She almost booked another MRI. Texted her therapist at 11 p.m. asking if she was crazy. Therapist replied: this is what a nervous system protest looks like. Present the deck. Let it hurt. Don't make it mean anything.
Canceled the weekly massage. Canceled the personal trainer. Canceled the Pilates reformer package. Kept therapy. Started working out at a regular gym like a regular person. Carried her own 15-pound laptop bag up a hill to work without stopping for the first time in three years.
Trip to Kerala with Arjun to visit family. Sat on a 16-hour flight without pacing the aisle. Helped her mother move furniture in the family home. Climbed the stairs to her grandmother's old apartment. Sat on the floor at a family gathering for three hours. Told her mother what had worked. Her mother put her hand on Priya's back and left it there for a long time.
At a team offsite in Tahoe. Ten-hour workdays, intense whiteboard sessions, late dinners, the kind of week that used to wreck her. On the second day she noticed her back wasn't a thing. Just a back. The noticing itself was unremarkable. That's what made it remarkable. On the flight home she wrote in her journal: I'm a person who has a back, not a person who has back pain.
The three things that changed everything.
She stopped optimizing her body.
For four years Priya had been treating her back like a product to ship. Herman Miller chair, iteration 1. Standing desk, iteration 2. PT protocol version 1. PT protocol version 2. Yoga A/B test. Pilates. Supplements stack. Sleep optimization. Every iteration created new data. Every failure created a new theory. The problem compounded.
In week four she canceled the weekly massage, the personal trainer, the Pilates reformer, the supplements, the myofascial release. Four standing wellness appointments canceled in one week. She'd been paying almost eight hundred dollars a month to fix a problem that was fixing itself now that she was finally looking at it right.
The optimizing itself was a form of hypervigilance. Every appointment, every purchase, every protocol told her brain, this place is a problem that needs solving. When she stopped the interventions, her brain stopped treating the area as a problem. The body listens to what you do, not what you say.
She stopped outsourcing her body to experts .
Before, whenever her back hurt, she'd book an appointment. PT. Massage. Myofascial. Personal trainer. Functional medicine. Each expert had a theory. Priya collected theories the way you'd collect vendor pitches. If one didn't work, she'd schedule the next.
After, when her back hurt, she'd do nothing. Pay attention. Not book anything. Not call anyone. Not buy anything. Feel the sensation without sending it somewhere to be treated. Most of the time it faded in minutes or hours. The few times it didn't, she waited it out.
Outsourcing her body had told her body it needed expert intervention to function. Trusting her body to be its own regulator told it that it was competent. Her body got the message.
Drop the reflex to outsource the sensation and the pain loses its volume.
She stopped performing wellness on top of illness.
Before, she said I'm fine the way other people say hello. She posted yoga photos. She talked about her wellness practice in standup small talk. She did not tell her mother, her brother, her manager, or even her therapist that she was in daily pain. She made the pain invisible on purpose because admitting it felt like failure.
After, she told Arjun. She told her therapist. She told her brother, who it turned out had already noticed. She told her mother. She told her manager that she was managing a health thing and needed to protect some time. No over-explaining, no apology. The truth, out loud, and then on with the day.
The performance was exhausting. The performance was its own source of stress. When she stopped lying, something that had been tight for a decade relaxed. The back was downstream of the tightness.
Back in her own body.
Priya has been pain-free for nine months. Not flare-free. Pain-free.
She sits at her desk eight hours a day. No standing desk converter. No special chair. A regular office chair at the office, a regular dining chair at home. She ran her first 10K in September 2025. Not a fast time. She finished it. She went camping in Yosemite in October 2025 with Arjun, an 8-mile day hike with two thousand feet of elevation, slept on a sleeping pad on the ground, woke up fine.
She took a 14-hour flight to Singapore for a work conference in November 2025. Coach. No back brace, no special pillow. Walked the whole Changi Airport after landing because she wanted to see the Jewel waterfall. She and Arjun started trying for a baby in early 2026.
She still gets a flare maybe once every six to eight weeks, usually around quarterly review weeks, sometimes during her period, occasionally after a tense call with her mother. She notices. She doesn't change her plans. She doesn't buy anything. She doesn't book anyone. She doesn't tell herself a story about it. Usually gone within a day or two.
She sold the Herman Miller Embody on Facebook Marketplace for $600 in early 2025. Used the money to buy her mother a new sari. That one she doesn't regret.
"The pain going away wasn't the biggest thing," she says. "The biggest thing was getting back the version of me who can sit on a floor with my cousin's kids, say yes to a work trip without calculating whether I'll survive the flight, admit I'm not fine when I'm not fine. That woman had gotten smaller every year for four years. Getting her back was what this was actually about. The back was just the messenger."
Does Priya's story sound familiar?
If your back pain started in your late twenties or thirties with no injury, if your MRI came back mild or normal, if you've tried every ergonomic fix and every wellness protocol and the pain follows your quarterly schedule instead of your lifting schedule, there's a good chance your pain follows the same pattern Priya's did.
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