The Hidden Cause Behind Your Pain

Episode #374

For some time now, I’ve suffered from something called Piriformis Syndrome. It’s a fancy term for hip pain. You might be familiar with sciatica – pinching of the sciatic nerve. Piriformis Syndrome mimics the symptoms, meaning you get some pretty terrible hip pain.

This is caused by a very tight muscle in the hip. I don’t want to get too deep into physiology here – this isn’t a kinesiology or physiotherapy podcast. But there’s a lesson here worth sharing.

For a while, I was trying to address this issue by treating the symptom. In other words, stretching. You stretch the tight muscle, it releases the tension on the nerve, and your pain goes away – temporarily. But eventually, it comes back. Hence the term “syndrome.” It reoccurs. And so you find yourself stretching your hips every day.

However, recently, I learned something: if I activate my glutes properly during exercise, my Piriformis Syndrome goes away.

Here’s what’s happening. When my glutes aren’t activated – yes, I know you love when I talk about my glutes – that little muscle, the piriformis, has to take up the slack. It becomes tight, compresses the nerve, and causes pain.

For months, years, I struggled with this. I was treating the symptom, but I wasn’t addressing the cause.

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The Stoic Connection

This got me thinking about Stoicism.

You may find yourself struggling with certain emotions or having poor reactions to things – anger, for example. You can treat the symptom. Meditation, anger management techniques, deep breathing. Marcus Aurelius had a long list of anger management tools, and using them isn’t a bad thing.

But as a Stoic, you must dig deeper. You must ask: what is the underlying cause here?

Imagine your friend is driving, and someone on the street calls them an idiot. They get upset. If they’ve never heard of Stoicism, they equate “someone called me an idiot” with “I am now angry.” That’s it. Cause and effect.

However, as a practicing Stoic, you’d look at your friend and say: it’s actually your opinion of them calling you an idiot that is making you angry. It’s not the fact that they called you an idiot. If you don’t value their opinion, what they said holds no weight. Or perhaps they’re right – maybe you were an idiot in that moment. And if it’s true, why be offended?

Someone without Stoic training gets angry and may treat the symptom – journaling, deep breathing, relaxing. The Stoic digs deeper. They ask: What is this actually about?

They realize the cause is their opinion about being called an idiot – that it’s a “bad thing.” When you unpack that, you begin to understand it doesn’t have to be.

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Treating Both Symptoms and Causes

Now, I want to make something clear. Stoics can still treat symptoms.

If you’re having anger issues, do your deep breathing. Go to therapy. Treat the symptom. But treat the symptom while also treating the underlying cause.

Sometimes emotions are too overwhelming to talk or think your way out of them immediately. For example, a teenage boy with raging testosterone might struggle with anger. The anger is the symptom. The cause is hormonal. And his prefrontal cortex isn’t fully developed until around 25, meaning his executive function isn’t fully online. That’s why we give teenagers some leeway.

But even for him, treating the symptom – going to the gym, exercising, boxing – helps prevent destructive outcomes while he matures and gains better control.

So why treat symptoms at all?

Because while addressing the cause guarantees long-term improvement, treating the symptoms ensures things don’t get out of control in the meantime.

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Back to My Hip

It would be foolish for me never to stretch my piriformis while figuring out the cause. I’d remain in constant pain. So yes, treat the symptom. But what sets you free is finding and addressing the truth behind it.

In my case, it wasn’t obvious that a tight hip muscle was caused by inactive glutes during heavy squats. Likewise, it isn’t obvious to most people that your judgments are up to you, that you don’t have to get angry when someone calls you an idiot, that your opinions shape your reality.

These are deep truths of human philosophy. You can choose to change your opinion. You can choose not to be bothered by things – though it may take time to fix the cause.

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Bringing It Home

Whatever pain you’re experiencing – physical, existential, spiritual – it’s not necessarily bad to treat the symptoms. If you’re upset with life, maybe you do something that makes you happy in the short term. But that’s not the ultimate answer.

The ultimate answer is to find the cause of your suffering. Maybe your judgments are poor. Maybe you’re valuing the wrong things. Maybe you’re not distinguishing what’s up to you and what isn’t.

Treat the symptoms. But don’t use them as a crutch. While treating them, search for the underlying cause. Work on both simultaneously – days, weeks, months, years.

And maybe one day, you’ll find that the cause is resolved.

And the symptoms go away.

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