Tim Ferriss Back Pain - My Thoughts On How He Can Heal For Good
As a longtime follower of Tim Ferriss’ work, I’ve soaked up countless insights from his books, podcasts, and experiments.
Tim’s humble curiosity and hunger to learn from experts have always struck a chord with me.
This post is my take on managing back pain, inspired by Tim’s journey, particularly his conversation with physical therapy legend Shirley Sahrmann.
First off, huge shoutout to Tim for being open and transparent about his struggles with back pain.
It’s refreshing to see someone with such influence talk about real-world issues so candidly, and it’s what motivated me to throw my hat in the ring.
So, Tim, if you happen to stumble across this blog, thanks for all the lessons over the years.
In the spirit of Susan Cain’s approach to "telling the truths people don’t talk about," this blog aims to dive into the complexities of persistent pain.
And yep, I know—once you bring up anything that isn’t pain = tissue damage, it’s easy to hit the wall of “so it’s all in my head then?”
Trust me, I’ve been there, and I get it.
This blog is not about taking anything away from the realness of pain.
Instead, it’s about shedding light on new ways of understanding it.
Hopefully, this might help you—maybe even Tim—see the bigger picture and start seeing genuine progress on your healing journey.
Ground Zero: Biological Factors Matter
Before we get into the weeds, let’s be clear: biological factors like red flags, general health issues, inflammatory arthritis, or digestive issues can play a role in back pain.
If Tim were my patient, I’d want to rule out any serious conditions first (rare but important!). Once that’s done, we can move on and look at the bigger picture with a bit more clarity.
The Biomechanical Rabbit Hole
Over the years Tim has spoken a lot about his battle with back pain.
A recent podcast episode with Shirley Sahrmann was really enlightening as the discussion was 100% focused on the potential biomechanical sources of Tim’s back pain and I can’t (respectfully) help but feel that this conversation got stuck in the 80s—a time when biomechanics dominated the physical therapy scene.
I couldn’t help but think if Shirley had simply asked Tim, “So how long have you been dealing with this pain?”, it would have opened a new conversation at a deeper level about the struggle and how Tim has tried just about everything under the sun to heal his back pain.
But in the case Shirley was the next ‘EXPERT’ (in a long line) and she was trying to solve Tim’s back pain from within the same biomedical paradigm with her own interpretation.
Don't get me wrong, biomechanics matter, but when we focus too much on structural “faults” (like posture, joint alignment or muscle imbalances), we risk creating fragility.
The nocebo effect—where we think our bodies are broken—can be a sneaky byproduct of this approach.
Tim’s struggle to find clarity reminds me of the story of, The Blind Men and the Elephant with all the ‘expert’s giving their limited view opinions.
In Tim's case, relying solely on biomechanics for persistent back pain can become a slippery slope.
There’s this unspoken belief that if you stretch, strengthen, or massage just the right spot, the pain will vanish.
But for persistent pain, the body’s way more complex than a squeaky wheel that needs grease.
Tim’s Journey: David vs. Goliath
Listening to Tim’s saga of conflicting diagnoses felt like watching someone go through the stages of grief.
Denial, frustration, and ultimately, acceptance.
He’s doing battle with a seemingly unbeatable Goliath—persistent pain—and like David, you don’t win by just swinging harder.
You win with a smarter strategy.
Sure, Tim’s massage tool obsession with his Quadratus Lumborum (QL) might give short-term relief, but it's like winning the battle and losing the war.
While this tool might offer short-term benefits, it risks creating a cycle of temporary improvement followed by long-term discomfort due to the inflammatory response it can trigger around the tendon-bone junction (presents around 24 hours after compression loads on the tendon/bone interface with things like heavy pressure massage and stretching).
This cycle of "winning the battle but losing the war" is a common trap in managing persistent pain.
Persistent pain isn’t solved by chasing symptoms.
It’s not just bout ‘beating’ the pain with brute force or finding the magic pill (or foam roller).
Core Strength: The Pilates Paradox (and Why It’s Not Always About More Strength)
One thing that stood out to me was Tim’s focus on core strengthening as the answer to his back pain.
And honestly, he's far from alone—many people believe that if they could just strengthen their core, everything would fall back into place.
The problem is, more strength isn’t always the answer.
Focusing too much on core exercises like Pilates can actually create muscle imbalances and tension, particularly in areas like the paraspinal muscles. This tension can exacerbate pain rather than alleviate it.
Enter Neuroscientist Bud Craig’s Homeostatic Model—a much-needed update to how we think about pain.
Unlike the biomechanical model that tends to zero in on tissue damage or faulty movement as the cause of pain, Craig's model introduces a more nuanced understanding of persistent pain—one that ties into the body’s homeostasis, or balance, system.
Homeostasis is your body's constant effort to maintain internal balance—think temperature regulation, hydration, blood pressure, blood glucose and inflammation etc.
Pain is part of this system; it’s not just a signal that something is broken or needs fixing.
It’s more like your body’s smoke alarm, warning you of potential threats to balance, not necessarily actual structural damage.
When you experience persistent pain, your body is often trying to communicate homeostatic imbalance rather than injury.
And this is crucial to understand, especially for those stuck in the cycle of flare-ups and frustration.
Pain Flare-Ups: Not a Sign of Failure, but a Sign of Dysregulation
When someone with persistent pain, like Tim, goes through a flare-up, the common assumption is, “Oh no, I’ve made it worse” or “There’s more damage happening.”
But that’s the old, outdated way of looking at pain.
What Bud Craig’s model offers is a fresh perspective that can calm that spiraling thought process of fear and self-blame.
Instead of assuming that a flare-up means further injury, the homeostatic model suggests the body is simply going through a temporary state of dysregulation.
Think of it like this: when your core temperature rises during a fever, your body isn’t falling apart—it’s simply responding to a threat (like an infection).
Similarly, a pain flare-up isn’t necessarily a sign that you’ve wrecked your back again.
It could mean your body is out of balance—maybe stress, poor sleep, or even overdoing an exercise—but not damaged.
Your body is amplifying the pain signal as part of a broader system that’s trying to protect you.
Fear and the Amplification of Suffering
Here’s where things get sticky: when we believe that pain = damage, flare-ups lead us down the rabbit hole of fear, rumination, and catastrophizing.
“Did I hurt myself again?”
“What if this pain never goes away?”
This amplifies the suffering experience, making the pain feel more intense and more threatening than it actually is.
Bud Craig’s model helps break this vicious cycle by giving us a better explanation for why pain flares up without needing to default to the assumption that “something broke.”
Instead of seeing the flare-up as a personal failure or as more physical damage, we can see it as part of the body’s attempt to maintain or regain balance.
This shift in understanding takes away some of the fear that exacerbates the pain experience.
Moving Forward with a New Framework
Understanding that pain is part of a broader system working to protect and balance the body allows for a more empowered approach to healing.
Rather than frantically searching for the next quick fix or perfect core exercise, we can start looking at pain through the lens of homeostasis.
By addressing the underlying factors—whether it’s stress, inflammation, or even emotional states—we can help our bodies regain balance and move towards long-term relief.
It also helps us make peace with the idea that flare-ups will happen, but they don’t have to trigger panic.
They aren’t necessarily signs of worsening injury; they’re opportunities to reflect on what might be tipping your body out of balance.
Did you push too hard in your workout? Did you miss out on sleep or skip meals? Were you sitting in poor posture for hours?
Understanding these factors can not only help you manage flare-ups more effectively but also prevent them in the future.
So, next time the pain kicks up, remember: it’s not necessarily a failure or proof of more damage. It's your body signaling a need for balance, not another round of strengthening exercises.
Learn more about Bud Craig’s pain model here
The Mental Game: “Is This the New Normal?”
Tim’s candidness about fearing a life of chronic pain was raw and relatable.
When he said, “Fuck, is this the new normal?” I felt that.
Chronic pain is not just a physical battle—it’s a mental one too.
Fear of the unknown, fear of making it worse, and the mental load of trying so hard to fix yourself… it’s draining.
And unfortunately, obsessing over pain and searching for solutions can become part of the problem.
Here’s the paradox: the harder we try to "get rid" of the pain, the more we signal danger to our bodies.
And like Tim’s experience with OCD, preoccupation can amplify that pain, turning it into an even bigger monster.
John Sarno & Alan Gordon: Healing Beyond the Physical
Tim mentioned John Sarno and his theory that unresolved emotions, like anger, play a role in chronic pain.
While Sarno’s views can be extreme, there’s truth in recognizing the emotional and psychological layers of pain.
Similarly, Alan Gordon’s work on how fear can amplify pain is powerful. Gordon’s approach of somatic tracking—a bit like tuning a guitar—helps people reinterpret their pain sensations.
Instead of fighting the body, it teaches us to feel the pain differently and reduce its grip.
Alan Gordon’s Research: Pain Reprocessing Therapy and the Power of Somatic Tracking
When it comes to chronic pain, especially persistent back pain like Tim Ferriss has experienced, it’s easy to get caught in a never-ending loop of fear and frustration.
The brain interprets pain as a sign that something is wrong—a threat.
This response kicks off a cascade of reactions that can amplify the pain and make it stick around long after any original injury or damage has healed. Enter Alan Gordon and his game-changing work on Pain Reprocessing Therapy (PRT).
PRT is based on the understanding that chronic pain often stems from neural pathways in the brain rather than ongoing tissue damage.
In other words, persistent pain isn't always the result of something physically wrong in the body but can be caused by the brain mistakenly treating normal bodily homeostatic signals as if they were dangerous.
By helping patients retrain their brains to view these signals as safe, rather than threatening, PRT has shown impressive results in reducing chronic pain.
A key technique in this therapy is something called somatic tracking—a simple yet powerful method that can fundamentally shift how we interpret and respond to pain.
The Pain-Fear Cycle: Why the Brain Amplifies Pain
Before diving into somatic tracking, it’s important to understand the vicious cycle that so many people with chronic pain, like Tim, get caught in.
Pain is a danger signal sent by the body to alert us of potential danger, but when we experience that pain over and over—without an obvious injury or problem—it can trigger fear.
That fear, in turn, tells the brain, “Hey, this pain must be something serious. We should pay more attention to it.”
The brain, acting like an overly cautious guard dog, starts to amplify the homeostatic signals, increasing the sensitivity of the nervous system to even minor homeostatic imbalances.
This pain-fear-pain cycle can quickly spiral, making the pain feel worse and more overwhelming.
It’s easy to see why this can lead to frustration, rumination, and a constant search for a fix.
But the more we search, the more hyper-focused we become on the pain, sending the brain even stronger signals that something is wrong.
It's like trying to get rid of a fly by swatting at it repeatedly—you just end up making it more agitated.
Reframing Pain as Safety: The Role of Somatic Tracking
Somatic tracking, one of the key techniques in Alan Gordon’s PRT, is a method for breaking this cycle.
At its core, somatic tracking helps people observe their pain sensations with a sense of safety and curiosity rather than fear and dread.
By doing so, it reprograms the brain to interpret these sensations as non-threatening.
Here’s how it works: instead of panicking or becoming hyper-focused when you feel a twinge of pain, somatic tracking invites you to tune into the sensation with a more relaxed, neutral, even curious mindset.
You acknowledge the sensation without judgment or fear.
Rather than thinking, "Oh no, my back is flaring up again, something must be wrong," you tell yourself, "This is just a sensation. My body is safe, and this pain doesn’t mean there’s damage."
This simple reframing helps shift the brain’s interpretation of the pain signal from danger to safety.
And once the brain realizes that these signals aren’t a threat, it begins to quiet the alarm system, dialing down the intensity of the pain.
Why Somatic Tracking Works: Rewiring the Brain’s Response
Somatic tracking taps into the concept of neuroplasticity, which is the brain’s ability to rewire itself.
Chronic pain often exists not because of ongoing injury, but because the brain has developed pathways that keep firing pain signals.
By using somatic tracking, you are essentially reprogramming those pathways.
Over time, the more you practice somatic tracking, the more the brain starts to believe, “Hey, maybe this pain isn’t as dangerous as we thought.”
The neural circuits responsible for amplifying pain begin to weaken, and the pain starts to subside. It’s not a quick fix—rewiring takes time—but for many, it’s a long-term solution that helps reduce the intensity and frequency of pain without invasive treatments or medications.
How to Practice Somatic Tracking
Somatic tracking is surprisingly simple, but it does take practice. Here’s a basic step-by-step approach:
Acknowledge the Pain: When you feel pain, instead of immediately reacting with fear or frustration, pause and recognize the sensation. Name it: “I’m feeling some tension in my lower back.”
Reframe the Sensation: Remind yourself that this sensation isn’t a sign of damage or danger. It’s just your body sending signals, and your brain has been interpreting these signals in a heightened way. Say to yourself, “This is just a sensation. It’s uncomfortable, but it’s not dangerous.”
Tune Into It with Curiosity: Instead of avoiding the sensation or trying to push it away, gently focus on it with curiosity. Notice how the sensation changes—does it stay the same, or does it shift? How intense is it, and where exactly is it located? By approaching it with curiosity, you’re telling your brain that it doesn’t need to go on high alert.
Pair It with Relaxation: As you observe the pain, take slow, deep breaths. This helps reinforce the message that you are safe and that there is no need for your body to react with fear or stress. This combination of observation and relaxation is key to retraining your brain’s response to pain.
Stay Present: Try not to judge the pain or think about what it means for the future. Avoid the catastrophizing thoughts that might creep in. Stay focused on the present moment and the sensation in your body, reminding yourself that it’s just that—a sensation.
Somatic Tracking in Action: A Real Example
Imagine Tim, mid-back flare-up, frustrated and worried that he’s done something to make his pain worse.
Instead of rushing to stretch, foam roll, or reach for a quick fix, he tries somatic tracking.
He acknowledges the pain but doesn’t catastrophize it. He breathes slowly, focuses on the sensation, and instead of seeing it as a sign that he’s damaged something, he tells himself, “This pain doesn’t mean harm. It’s just my body being a bit too cautious.”
Over time, with repeated practice, Tim’s brain begins to dial down the pain alarm.
The brain stops treating normal sensations as dangerous, and flare-ups become less intense and less frequent.
From Threat to Safety: Why Somatic Tracking is a Game Changer
Somatic tracking is such a powerful tool because it directly addresses the fear-pain loop that keeps chronic pain alive.
By teaching the brain to feel safe in the presence of pain, it reduces the fear and stress that amplify suffering. Instead of reacting to every flare-up with panic and trying to "fix" it, somatic tracking allows you to sit with the sensation, knowing it will pass.
For people like Tim—and anyone dealing with persistent pain—this shift from threat to safety can be life-changing.
It’s not about ignoring the pain or pretending it’s not there, but about learning to respond to it in a way that doesn’t fuel the fire.
By reframing pain as a harmless sensation, the body can start to heal, and the brain can stop overreacting to every twinge.
So, if you find yourself stuck in the cycle of fear and pain, give somatic tracking a try. It’s a simple, accessible way to turn down the volume on your pain and take back control.
Embracing the Bigger Picture: Mushrooms, Fasting, and Holistic Healing
In a recent podcast, Tim talked about his journey to South America, involving mushrooms, water fasting, and emotional release as part of his healing.
And look, as wild as it sounds, this mulit-dimensional approach highlights something important: persistent pain is about the whole person, not just the muscles or joints.
Emotional, psychological, and even lifestyle factors play a huge role.
We can’t just laser-focus on the physical stuff and hope for lasting relief.
Here are three inspiring messages from guests on Tim Ferriss' podcast:
Jerry Seinfeld: Embracing Self-Reliance and the Illusion of the Expert
Jerry Seinfeld dropped a gem during his appearance on the podcast: “The fact that you’ve even signed up for this class is a very bad sign for what you’re trying to do. The fact that you think anyone can help you or there’s anything you need to learn, you have gone off on a bad track because no one knows anything about any of this.”
While blunt, Jerry’s message resonates in the context of persistent pain management.
His point challenges the illusion that external "experts" hold the key to solving your problems.
In the world of pain management, this idea can be incredibly freeing.
Instead of relying on external fixes or gurus, Jerry’s insight encourages people to become their own experts—learning about their own bodies, pain patterns, and what strategies truly work for them.
This advice is particularly empowering for anyone dealing with persistent pain.
It reminds you that while external knowledge can guide you, the ultimate power to heal and understand your body comes from within.
Jane McGonigal: Urgent Optimism for Pain Flare-Ups
Jane McGonigal’s concept of urgent optimism is a game-changer for managing persistent pain. She emphasizes the importance of preparing for and accepting the inevitability of setbacks or flare-ups, but with a proactive mindset.
In McGonigal's words, this isn't about being pessimistic; it’s about being realistic and taking control of the situation.
Expecting a pain flare-up to occur—and having a game plan in place for when it does—removes the element of surprise and reduces the fear associated with it.
Her message encourages us to adopt a stance of readiness and action, shifting the narrative from one of helplessness to empowerment.
McGonigal’s urgent optimism highlights that, despite pain flare-ups, you have the tools to influence the outcome positively.
You can prepare, adapt, and respond in ways that lessen both the frequency and severity of these episodes.
Naval Ravikant: Strength in Struggle
Naval Ravikant brings a powerful perspective to the table with his statement:
“You are strong only where you were broken.”
This quote speaks to the heart of resilience and growth through adversity.
For those dealing with persistent pain, it’s a reminder that every setback, every struggle, and every moment of pain is not just an obstacle but an opportunity to develop strength and deeper understanding.
Naval’s message reframes pain as not just something to overcome, but something that shapes you into a stronger, more resilient version of yourself.
It encourages you to see pain not as an enemy, but as a teacher guiding you towards greater self-awareness and genuine healing.
Conclusion: What Would It Look Like If It Were Easy?
If managing persistent back pain were easy, it would look like a simple, balanced approach that avoids overcomplicating the healing process.
It wouldn’t involve chasing quick fixes or getting stuck in cycles of fear and over-correction.
Instead, you’d focus on gentle movement, healthy breathing, and mindful strategies like somatic tracking to reframe your relationship with pain.
The goal is to create a holistic lifestyle that balances physical, emotional, and mental health—where back pain is managed in a sustainable way, without obsessing over perfect techniques or endless fixes.
This approach fosters resilience, allowing you to trust your body and reduce the constant rumination that can come with chronic pain.
In short, the path to managing back pain would be easy if it integrated relaxation, awareness, and gentle care—turning pain from a battle into a process of balance and healing.
Wrapping Up
Tim’s journey with back pain mirrors what so many of us go through.
It’s messy, it’s frustrating, and it’s certainly not fixed by stretching your way out of it.
The key takeaway?
Persistent pain is a multi-dimensional challenge that demands a multi-dimensional approach.
You don’t just need more strength—you need a strategy.
And sometimes, the best strategy is zooming out and rethinking what you’ve been doing all along.
Got thoughts?
Drop a comment below—good, bad, or ugly, I’m all ears.
Cheers, Dan O'Grady Adelaide, Australia