Some people don't seem to understand that their experiences aren't the same as other people's experiences, and the places they play aren't the same as the places other people play. Everyone has a different experience, and what works for some doesn't work for others.
I'd say your experience is the exception to the norm.
I've never played in Hawaii - but pretty much everywhere else, my experience is the typical. Yours is the exception to the rule.
We aren't all the same, we don't have the same challenges, the same viewpoint or the same situations or the same solutions for problems. There is nothing wrong with that.
Absolutely... and I can certainly understand playing/dealing with pain because I love gigging. But I have a hard time wrapping my head around paying to do it when doing it for free with less pain is always an option...
I also recall our previous guitar player who had severe psoriatic arthritis (and eventually had to quit because of it) - he couldn't carry crap any distance... and he still brought a backup, because the rest of the band carried his equipment for him, because we were a band and we help each other out.