Information Medicine
What if chronic pain was mainly bad information?
Wait a minute, you might be thinking. Why would someone who spends a significant chunk of his professional time doing hands-on manual therapy to help resolve pain think that’s possible (or want to tell people that)?
Well, what I’ve discovered over the 14 years (and counting) I’ve been in practice is that chronic pain is mainly an information issue. That’s been the main driver behind the ongoing transformation of my practice over the years.
That’s right. It’s not a structural issue, nor an injury issue. It’s an information issue.
So let’s talk about that information issue and how you can solve it.
I recently finished reading “The Way Out” by Alan Gordon, the founder of the Pain Reprocessing Therapy Center. In it, the author describes what’s he calls “neuroplastic” pain.
The idea behind neuroplastic pain is that structural abnormalities in the body are often incidental, and not the cause of pain. Instead, we’ve effectively “learned” to be in pain chronically.
That’s not to say “it’s all in your head,” you’re doing something wrong, or that it’s your fault in any way. That type of mindset is a relic.
Studies have shown that the areas of the brain signaling pain for people with back injury, for example, shift from standard pain-processing regions after one year to “regions associated with memory, learning, and emotion among those who had developed chronic pain.”
According to the back pain study Gordon’s group published (more on that below), in approximately 85% of chronic back pain (CBP) cases, “definitive peripheral causes of CBP cannot be identified, and central nervous system processes are thought to maintain pain.”
And here’s a mind-blower, check this table out. According to Gordon’s group, the prevalence of structural anomalies in populations with zero pain symptoms is quite remarkable (table per the Pain Reprocessing Therapy Center’s introductory training).
What this all means is that for a vast majority of chronic pain cases, there’s no damage and no injury that’s causing the pain. There may be concurrent structural issues, but there’s very little evidence that suggests a causal link.
If you’ve had an injury and developed chronic pain, you most likely fully healed after a couple months. Your muscles, bones, ligaments, tendons, connective tissues, and fascia are just fine. Nothing’s broken.
It’s an information issue.
In what became known as the “Boulder Back Pain Study,” the thesis was that chronic pain is “a brain-generated false alarm.” Essentially, we get used to the pain signal, it messes with our sense of bodily safety, and that becomes a habit. It’s not simply a “pain” or “body” challenge, it’s a mind-body challenge.
Their study followed a cohort of participants over a 4-week period, receiving a mix of:
Mindfulness-based self-study (very similar to elements of Hakomi)
Cognitive reframing and evidence gathering
Positive psychology techniques (gratitude practices, essentially)
The results were stunning.
Fully 73% of those that participated in this treatment protocol reported being pain-free or nearly pain-free after one month. One year later, half of the population was still pain-free or nearly pain-free.
Amazing.
Pretty simple sounding protocol, right? In a nutshell, change your relationship with your pain, learn to see it as less threatening, and create a more positive mindset. Give your System newer and better information (hence, “information medicine”), and voila! You’ve locked in on a high-probability solution for solving it entirely.
Want to nerd out on this stuff a bit more? I absolutely recommend you click on that link above to read the research (or, if you prefer a breezier read, check out Gordon’s book). And check out this outstanding podcast interview with Dr. Rachel Zoffness, pain psychologist and professor at Stanford and UCSF School of Medicine.
OK, let’s be clear about something here. Just because this is “information medicine” doesn’t mean it’s as simple as just knowing what’s going on. You need to learn ways to embody something new, to become it.
So, what else is needed, and what may be missing from the protocol in this study?
First, a better awareness around how you’re using your body. And second, a deeper understanding of why you’re doing what you’re doing.
In other words, understanding the core mental-physical-emotional-spiritual reasons driving your behavior and the ways you use your body in the first place. From there, you can build newer and better options using that awareness so you don’t need to do that stuff anymore.
THAT’s powerful work. In my practice we’re not only helping you reframe your relationship with your pain (like in the back pain study), we’re also giving you new options for what to do, and helping you build awareness around why you do it in the first place. With that awareness and skillfulness in place, you won’t fall back into your old, habitual ways of being that got you there in the first place.
Those pieces, grounded in the guided self-exploration elements of my practice, are what create the great outcomes my clients experience.
And since it’s an information issue, I don’t need to be in the same room as you to help you solve it. It can all be done virtually.
When we’re in pain, we very often feel the need for and want the helping hands of a professional, whether that’s a Rolfer, a physical therapist, a surgeon, or another type of helper. Sometimes it can feel like that someone is the gateway to our health and freedom from pain, and that the things that they do to us are what heal us.
Now, it is true that there are often physical components to our pain. But the important thing to understand from this article is that any remaining physical drivers of pain are just one piece of a very complex psycho-emotional stew of information that creates our pain. True healing from chronic pain is an inside job. You have to change the way you organize and make meaning around that information.
The helping hands a professional provides can be viewed as information that your System is taking in too. Which means, with the right guidance and inner work, those helping hands can be located elsewhere.
Check out this quick video I made way back in 2020 discussing this very idea.
This is my work. Has been for years. Helping clients solve their mind-body challenges (including chronic pain) using leading edge mindfulness- and somatic psychology-based methods. Oftentimes remotely.
Interested?
If you live in Austin, or anywhere else in the world, connect with me today and let’s find out if working together is a good fit to help you solve your mind-body challenge.