The Curable app
Curable is a pain psychology app. I used it for a year and I want to give my feedback on it, because I know a lot of people with endometriosis are curious about it.
From their website: “The Curable app provides evidence-based chronic pain lessons in your pocket. It uses a combination of pain science education and research-backed techniques to address pain from every angle.”
I liked it and recommend it, but I also know that there are people who don’t like it and that’s ok too. Not everything is for everyone – it helped me in a time of my life when I needed it. I used the app for a full year, and decided not to renew after that because I felt like I had internalized the lessons after practicing them daily and didn’t need the app’s support anymore. Plus, I got out of chronic pain about 8 months into using the app. During that same year, I also treated suspected SIBO with 5 rounds of anti-microbials, so I don’t know whether it was Curable or the SIBO treatment or the combo that helped me, but my pain disappeared. It’s been 2 years since then and I’m still pain free.
I came across Curable post excision, once I no longer had my excruciating pain flares. I did still have full body fibromyalgia pain and IC bladder pain, although these had lessened since excision. What I was dealing with then was MCAS symptoms and I thought that finding safety in my body could help them. I suspected that I had a wound up nervous system and was in a constant state of hypervigilence and fight-or-flight that was exacerbating my symptoms. I was drawn to Curable because the science made sense to me. Additionally, I also knew that when I was in my early twenties, I had been in an ongoing state of subconscious anxiety and tension due to trauma, and I had significantly calmed my nervous system through meditation. This helped lessen my bladder and bowel urgency/frequency, which at that time were having a detrimental impact on my life. So I already had an experience where finding more safety in my body improved disabling symptoms.
What I liked
The lessons are short, like 5-20 min, so they were easy to carve out time for a few times a week. Soon I found myself doing them daily because they became something I could turn toward during moments of high symptoms. There’s a panic button for when your symptoms spike, and I would push the panic button and feel like I had instant support. This helped me to breathe deeply and remain calmer during a flare instead of spiraling. I turned to its guided visualizations during nights of insomnia, anxiety attacks, racing heart, etc.
The pain science was interesting, and there was a focus on getting you out of heightened alert. Even though I wasn’t using it for pain specifically, I found the info on how perfectionism, repressed emotions, and anything that makes you subconsciously feel like you are in danger to be very helpful. I had a lot of self exploration which helped me get out of my constant fight-or-flight. For several years, I’ve been doing activities to wind down and relax my overactive nervous system, to try and get into a state of relaxation and out of hypervigilance. Activities like yoga, qigong, meditation, and painting to get into a flow state have really helped my mental health as well as some of my bladder/bowel symptoms . But for me, it wasn’t until I did guided meditations, journaling, and other exercises specifically aimed toward chronic pain (and in a broader sense, calming the nervous system) that I saw a real breakthrough in getting out of fight-or-flight.
What I learned in the app has stayed with me because I now understand what kinds of thoughts and tendencies subconsciously trigger fight-or-flight in me, as well as my window of tolerance and how to bring feelings of safety back to myself when I’m triggered. Even if being triggered doesn’t lead to pain or symptoms, it certainly makes my experience with life situations more uncomfortable and anxiety.
What I didn’t like
I didn’t use the app for endometriosis pain or even my pain in general, but of course each lesson also made me think about it.
It’s really important to know the app is aimed more toward people who have central sensitization or mind-body pain – basically pain in people who have no structural damage causing their pain. Rather they have a sensitization of their system or misfiring of the brain (learned pain pathways) that’s causing their pain. A message throughout the app – and among the practitioners I follow doing various types of somatic tracking/ pain reprocessing therapy – is that you need to (once you get checked out by a doctor) trust that your pain is not from any physical source. This helps with pain reprocessing because when you believe your pain has a structural cause, it can keep the brain in high alert. Since pain is a danger signal, fear can keep you trapped in pain, especially if you believe you will never heal your pain because your body is damaged in some way.
Those of us with endometriosis know that it can be dangerous to accept that our pain is not from any physical source – that’s what doctors told us for years as they dismissed us when all tests were normal. This is one of the main reasons why it takes an average of 8+ years to diagnosis, because doctors don’t recognize the symptoms of a very real disease. It’s also true that due to racism, sexism, ableism, classism, and more systems of oppression, depending on our identities, it can lead to outright dismissal and denial of care that we deserve and need. Someone with less marginalized identities may actually get diagnosed and treated while the same doctors actively ignore us.
So I want to encourage endometriosis patients using this app to keep looking for expert care and causes for your pain. Many patients with endometriosis have multiple contributing factors to their pain, such as the lesions themselves, pelvic floor dysfunction, and adenomyosis. No amount of pain reprocessing or downregulating your central nervous system can take the place of a surgery for a kinked bowel or separating organs that have fused together. Whenever I heard the message that the pain was not caused by a structural source, I reminded myself that endometriosis does cause structural damage and this app is being used by people in a different pain situation than I am. Meanwhile, I’m using it because I may or may not have central sensitization/ learned pain pathways as one of my puzzle pieces.
I also stopped listening to their podcast after several episodes because those healing stories were not relevant to my situation.
In conclusion
If you are going to use the app, have an understanding of why endometriosis can cause pain. For many people with endometriosis, there are multiple puzzle pieces to their chronic pain. I used the app hopeful it could help me: either with my pain, MCAS symptoms, or just calming my fear response around my symptoms. My goal was to better understand the mind-body connection with my pain and have a better emotional experience during my flares. And if it ended up reducing my actual pain/symptoms, then cool. And if it didn’t, that was okay too.
On Curable’s website, they say that “the best results will come from using the program at least 2-3 times per week for the first couple of weeks.”
It also says “You may see results related to the improvement of your quality of life shortly after you start using the app. For lasting pain relief, it varies. We have seen people find total relief within a month, and we’ve seen others get 10% better every month for many months. In general, though, from a survey of Curable users shows that about 70% experience some degree of relief from their physical symptoms after 30 days of continued use.”
If you are using the app and it isn’t helping to diminish your symptoms, this might not be the puzzle piece you need right now. Maybe this puzzle piece will help more after you treat structural causes to your pain (such as doing excision or PFT). Or maybe the app won’t help your physical pain but will teach you tools to cope better during a pain flare and have a better pain experience.
It’s hard to emotionally invest in another healing modality when we’ve likely been trying different activities/lifestyle practices/apps etc ever since we got sick. I was drawn to Curable and I bought it during Black Friday sales so I paid less than $50 for a full year. So for me it felt like a low risk, low maintenance habit I could easily commit to a few times a week. However, like I said, it’s not for everyone, so I encourage you to look at their website and Instagram and see if it sounds helpful to you.