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The Pain Puzzle

Pain is really . . .well, a pain, isn’t it?  Pain prevents us from doing the things we love to do and living the way we want to live.  

BODY shirtless male back with doc hand on shoulderIf you’ve ever dealt with a chronic injury, muscle tightness, or pain with movement (and I’m willing to bet at some point you have!), you understand how complex it can be to pinpoint why you have pain and the solution to make it go away. 

Even the most well-equipped and well-intentioned doctors and therapists are often stumped at how to completely “solve” your pain.  Studies show the diagnosis of arthritis or other structural issue doesn’t dictate where or how you feel pain . . . or even if you feel pain at all.  It’s frustrating to have pain and not know why, and worse when you think there might not be anything you can do to change how you feel.

What makes pain so tricky is its elusive nature:

Sometimes chronic muscle and joint pain and tightness occurs without having injured the area where you’re feeling the pain and tightness.  Why?

Some people who have structural damage to a muscle or joint (as shown by X-ray or MRI) have no pain in the damaged area . . . but others who have no structural damage in an area do experience pain.  Why?

People use many words to describe their muscle and joint discomfort: sharp, dull, tight, sore, searing, weak, glitchy, and many more.  Why do we choose to call some feelings “pain” and others as some other word?  Why (and how?) do pain and discomfort come in so many “flavors”?

Maybe you’ve experienced chronic pain or tightness in a certain area that gets exacerbated only “sometimes”, without knowing what you did to aggravate the area. Why is the cause of the pain so tough to pinpoint and predict?

Sometimes pain is accompanied by a sense of fear or concern, and sometimes pain could be described as simply “annoying”.  Why is there a sense of “danger” associated with some pain but not others?

How can we better understand pain to get a better handle on how to deal with it?  Let’s start taking a look at the source of the production of pain itself:  The Nervous System.

THE NERVOUS SYSTEM PRODUCES PAIN

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 conclusion made by the brain.1

woman holding neckPain isn’t a “thing” we can remove with surgery or solve by massaging or “rolling” tissues on the outside.  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. 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.1  Where you feel the sensation isn’t necessarily the source of the information that led to the pain.  No wonder dealing with pain is so tricky!

SUMMARY:

Pain is a conclusion produced by the brain.
The area where you feel pain isn’t always the source of why you feel pain.

THE BODY IS A SYSTEM

The human body is a miraculous vehicle, certainly greater than the sum of its parts.  It works as a system.  Part of its genius is in its sophisticated setup for communication within itself: the body is one continuous, interconnected system with the innate ability of every part to be aware of, and work with, the other parts to achieve the goal of operating efficiently. 2

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, among and between all the parts.

SUMMARY:

The body is a continuous, interconnected system with the innate ability of every part to be aware of, and work with, the other parts to achieve the goal of operating efficiently. 

THE NERVOUS SYSTEM - MUSCLE SYSTEM PARTNERSHIP

Your muscles are part of this dynamic, interconnected system as well.3   The ability of your body to move well is based on extensive collaboration between your nervous system (i.e. your brain, spinal cord, and trillions of nerves) and your muscles.  And that collaboration requires information . . . lots of continuous, high-quality information – from and about the muscles in every area of your body – communicated to the rest of the system.4

Movement can feel easy and flawless . . . movement can also feel tight, weak, and painful.  How your body feels while completing the task is a part of your brain’s subjective conclusion of how good your system’s “solution” was.   And the quality of any solution is only as good as the quality of information available to create the solution.  

SUMMARY:

The body is a system, creating internal solutions to movement based on the information the nervous system has available about your muscle system.

PAIN IS AN INFORMATION PROBLEM

Have you ever had pain in an area you know you haven’t specifically injured?  Why in the world would that part of you hurt when you move, if there’s nothing physically wrong with it?

Remember that pain is really a subjective conclusion of the brain, based upon the quality of information it has to solve a problem.  If you have pain in an area you know doesn’t have a structural problem, maybe what you have is an information problem.  

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 second kid whispers the message they think they heard into the ear of the third kid, 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 way.  Clear, well-communicated information between your nervous system and your muscle system produces a precise, efficient solution on the part of your brain, which produces high-quality movement and a high-quality sensation to match.  Your movement looks good and feels good.

Just as in the case of our friends and their game of Telephone, a set of garbled, low-quality information will produce a result much different than your body intended.  Your brain’s conclusion about this low-quality information will be poor in quality as well.  Maybe you notice a problem with how you move a part of your body . . and maybe it hurts when you move it a certain way.  Maybe the movement feels tight, weak, or unstable.

Have you ever watched a contestant on “Wheel of Fortune” attempt to solve the final puzzle for a trip to Hawaii? 

What happens when the contestant is presented with a complex puzzle to solve, with only a few letters available for the contestant to work with?  Our friend may attempt several erroneous solutions to the puzzle, and frustration ensues.  Eventually the buzzer goes off without the contestant producing the correct answer. 

Once the correct solution is revealed, Pat Sajak usually remarks, “If you’d only had a ‘P’ or maybe a ‘D’, you would’ve had it.”  Our forlorn friend didn’t have enough information to successfully solve the puzzle.  

This analogy holds true for the nervous system as well.  When it’s attempting to produce movement for your body with inadequate information about your muscle system, it will be very difficult to devise a proper solution!

SUMMARY:

The quality of any body movement is a reflection of the quality of information the nervous system has about how to best create a “solution” for that movement.

WHEN INFORMATION GOES WRONG

Now, let’s apply this information to our original questions about pain.  Why would you feel pain when you’re not injured?  Why would you feel pain in a certain body part during some movements but 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.  When there is inadequate or only low-quality information available to solve a problem, your movement and your sensation will suffer.

What do you think would happen in your body, if your nervous system didn’t have enough high-quality information to orchestrate an proper solution for an everyday task? 

Think about a repetitive movement or a position you typically do each day:  reaching up to grab items from a high cupboard, maintaining proper posture while sitting at your desk all day, leaning over the sink to wash dishes every evening, etc. Any movement or body position for which your nervous system lacks an optimal solution could start to cause you chronic muscle tightness, discomfort, or pain as your body struggles to pull off a mediocre solution with its limited set of capabilities. 

To illustrate this point, try raising one arm straight forward and over your head.  Now perform the same movement with the other arm.  Do you detect any difference in how this movement feels in one arm versus the other?  Barring any acute structural damage to your shoulder joint, any difference you perceive about the quality of your movement (e.g. muscle tightness, less range of motion, pain) can indicate a difference in the quality of the solution your system currently owns regarding that particular orchestration of movement.

SUMMARY:

Missing or poorly-communicated solutions for movement can result in chronic muscle tightness and pain.

SOLVING THE PUZZLE

Now, what if that Wheel-of-Fortune contestant was presented with the same puzzle, but this time they had more letters revealed so more information was available in their problem-solving arsenal?  Maybe that critical “P” was now 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 your system has about how to approach a task, the better quality the outcome will be.

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 the theories set out in this article to your advantage?  How do we add more “P”s and “D”s to our arsenal of solutions?  Can you change the quality of information in your system and actually change the way you’re feeling?  And where can your brain acquire the information it needs?  Let’s check it out in Part 2!

References:

  1. Ingraham, Paul.  “Pain is Weird”.  PainScience.com. PainScience.com.  27 February. 2020.   
  2. “Systems Engineering:  A Great Definition.”  Kitchensoap.com.  Kitchen Soap.  Web.  20 March. 2020.
  3. “Body Systems”.  Sciencelearn.org.  Science Learning Hub.  Web. 20 March. 2020.
  4. “The Nervous System”.  Mcb.berkeley.edu.  University of California, Berkeley.  Web.  March 20. 2020.

Jessica Cahen, MS, CMES, CHN is an Exercise Physiologist and Holistic Nutritionist.  Her company, Perfectionist Health LLC, offers Muscle Restoration and Medical Exercise services in Columbus, OH as well as holistic health & wellness coaching worldwide.  Read more about Jessica and Perfectionist Health LLC at www.perfectionisthealth.com.

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