614-442-8100 gtmack01@mac.com

Jessica Cahen, M.S., CMES, MSS, RTS

“Pain don’t hurt.” –Patrick Swayze’s character Dalton in “Road House”, while responding to the doctor about to stitch up his wounds after a bar fight who tells him that the stitches are going to hurt.

 

Pain is an elusive concept. 

  • Sometimes chronic pain or discomfort occurs in muscles and joints without having injured the area where they’re feeling the pain and discomfort.  Why?
  • Why do some people who have structural damage to a muscle or joint (as shown by MRI or other test) have no pain in the damaged area, but others who have no structural damage in an area do experience pain there?
  • People use many words to describe sensations in their body they don’t like:  pain, discomfort, tightness, soreness,
    glitches, weakness, and many more.  Why do we choose to describe a particular sensation as “pain” and another sensation as some other word?  Why are sensations so subjective?  Why (and how?) do sensations come in so many “flavors”?
  • Sometimes pain is fleeting:  it occurs only occasionally or only when the body is in certain positions or engaging in
    certain activities.  Why does the “pain” only occur under certain conditions?
  • Why is some pain accompanied by a sense of fear, and other pain could be described as simply “annoying”? 
    Why is there an emotional significance to some sensations but not others? 

This article will introduce a concept called Information Set Theory (posited by Greg Mack), which offers an explanation to each of these questions. Information Set Theory is a theory of pain that states the following: all physical sensation, including the choice to use the word Pain to describe it, is a conclusion of the brain based on the quality and quantity of information flowing within and throughout the body at any given moment.

 

PAIN IS AN INFORMATION PROBLEM

So what is it about pain that makes it so tricky?  The reason pain is such a mystery to us is that pain is a subjective conclusion made by the brain.  Pain isn’t a “thing” we can remove or fix.  Even though you might be able to point to your knee and say, “I feel pain here”, it doesn’t mean your knee is the reason for the pain. Weirdly, the pain is actually in your brain. The brain is presented with information from all the body’s parts, and your sensation is simply a part of the brain’s final conclusion about the total information present.  Where you feel the sensation isn’t necessarily the source of the information that led to the pain.

The human body is a miraculous vehicle, certainly greater than the sum of its parts.  Part of its genius is in its sophisticated setup for communication within itself: the body is one continuous, cohesive system with a built-in mechanism that allows for every part to be aware of, and work with, the other parts to achieve the goal of operating efficiently. The field of engineering refers to this as the “Systems Approach”

Your body is not simply a set of individual parts, welded, glued, and bolted together, with each operating blindly to the others. Your body grew together from its conception – as a system.  It is impossible to tease out one part from the next without disrupting another part in some way.  The bones grew as the muscles grew. The tendons grew as the ligaments grew. The blood vessels grew as the nerves grew. This inherently connects all of the body’s tissues creating a continuous information stream.

Your muscles are part of this interacting, interconnected, and interdependent system.  The operation and movement of your body is based on extensive collaboration. And that collaboration requires information . . . lots of continuous, high-quality information – from and about each of the body’s regions – communicated to the rest of the system.  Every body movement is a whole-body task that requires an internal, whole-body solution.  Brilliant!

When you decide you want or need your body to move (or purposely not move), a negotiation occurs between your nervous system and muscles about how these tasks will be completed; think of it as a “problem-solving session”.  The nervous system receives the information about the intention of your muscles to complete an action, the brain interprets the information and makes the most efficient conclusion it can about how to solve the “problem” based on the information and resources it has available.  How the body feels while completing the task is a product of how well your body “pulled off the task”, or how good your body’s “solution” was.

 

WHEN INFORMATION GOES WRONG

 Did you ever play the game “Telephone” as a kid?  A bunch of kids line up, and the first kid in line whispers a message to the second kid.  The message the second kid heard from the first kid’s whisper gets whispered to the next kid in line, and so on.  Each kid whispers their version of the message down the line, and the game ends when the last kid in line announces the message.  Usually, “Bananas are better than biscuits” ends up something more like “Bandanas are butter and lipsticks”.

 Communication within the nervous system works in a similar manner.  Clear, concise, well-communicated information between the muscle system and the nervous system produces a precise, efficient conclusion on the part of the brain, which produces high-quality movement and a high-quality sensation to match.  Just as in the case of our friends and their game of Telephone, a piece of garbled, low-quality communication— or even excessive, unnecessary information– will produce a result much different than the body intended.  The brain’s conclusion about this low-quality information will be poor in quality as well. 

Have you ever watched a contestant on “Wheel of Fortune” attempt to solve a puzzle for the grand prize?  What happens when the contestant is presented with a complex puzzle and only a few letters are available for the contestant
to work with to solve the puzzle?  They may attempt several erroneous solutions to the puzzle, frustration ensues, and
eventually the buzzer goes off and the contestant has lost the prize.  They didn’t have enough information to successfully solve the puzzle, or the quality of the information they had wasn’t good enough for the contestant to easily come up with the correct answer within the time limit to win the prize.

Now, what if that contestant was presented with the same puzzle to solve, but this time they had more letters revealed so more information was available in their problem-solving arsenal?  Maybe a critical “z” or “q” was at their disposal.  The
contestant now has the information they need to complete the task with ease . . . because the information set they possessed was robust and powerful.  Knowledge is power!

The same holds true for the nervous system.  The more knowledge it has about how to approach a task,  the better quality the outcome will be.

Now, let’s apply Information Set Theory to our original questions about pain.  Why would you feel pain when you’re not injured?  Why would you feel pain during some movements and not others?   Why does pain come in a dizzying array of
“flavors”?  Your body’s sensations are a conclusion about your body’s current information state.  Your body’s information set changes from moment to moment; your brain’s system of processing and interpreting information is ever adapting and ever evolving.  Your body’s ability to devise a high-quality solution to a problem will differ depending on the conditions of the situation, the capabilities of your muscle system under those conditions, and the information your nervous system has available.  If your system has enough useful information available to solve the problem with high quality, then you’ll move well and feel good.  If necessary information is missing, then the way your body moves and feels will suffer.

Enough with the theory already!  Can you actually use Information Set Theory to your advantage?  Can you change the
information in your system and actually change the way you’re feeling?  Where can your brain acquire the information it needs?  Let’s check it out in Part 2!

 

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