An infinite loop is a sequence of instructions in a computer program which loops endlessly, this can be due to the sequence having no terminating endpoint, or that the sequence of commands never gets met, or another command that causes the loop to start over. Most often, the “infinite loop” term is used when the circuit is unintended and is a program bug or error. 

An infinite loop is typical a common error among beginner code writers, but an infinite loop can be created by more experienced programmers as well. The loop phenomenon can be difficult to analyze and can be quite cunning. Another place you also can be caught in an infinite loop, is in support structures like phone tech support or when you call the insurance company.

 An infinite loop will keep running because the condition (or target goal) that should end the sequence is never meet. Infinite loop will typical first end when the computer freezes because the loop takes up all available processor time, and the computer user is forced to restart the PC.

 A much similar infinite loop or situation can be described and explained as happening in the health care system. In this situation, a person with non-specific low back pain, will engage in problem-solving behavior, that they think will solve and “fix” their back-pain-problem. 

But because this problem-solving behavior is framed within a biomedical and biomechanical framework, the problem is typical still unsolved, their pain being non-specific, as most back pain is. Typical between 80-95% of low back pain is non-specific (1,2,3).

Like a rat trapped in a maze

It is like the person with low back pain has been placed (by the health care system) in a labyrinth with no exit. But the person with pain does not know this and will continue to engage in biomedical framed problem-solving behavior, trying to find the exit. This has been called the “perseverance loop of pain”.

The patient will go from one therapist to another, but if all the therapist is also using a biomedical problem-solving approach, the problem will remain unresolved. The patient will then try another therapist in the hope that that therapist will be the one that will solve the problem.

Like with the computer program, the infinite loop will run (in this case) until the patient does not have any more time, energy, or money. 

The health care system can often act as an infinity loop, where all the health care providers try to solve and “fix” the person’s pain. However, in this case, they all actively are a part of the health care “infinity loop”, contributing to the perseverance loop of pain.

An similar situation that can explain is the infinity loop phenomena in another way is when your car breaks down and won’t start. You will then most likely also engage in problem-solving behavior. In that, you will take your car to a mechanic in the belief that he will solve and “fix” your car problem.

 If the mechanic does not manage to fix the problem, you will likely find another mechanic that claims he knows when the problem is, and that he can fix it. If the loop continues and the problem is not fixed, many people will at some point, get another car if the car continues to break down. However, this is not really an option when you have pain.

 Sadly the above scenario is more realistic of what the people with pain feel like than it should be. Up to 89% of people with low back pain, discuss persistent pain as due to the “body being like a broken machine”, and indicated that they learned these beliefs from health professionals (4).

So one potential first step rectifying this and helping a person with pain out of the infinity loop. Is to try to help them reconceptualize pain as an “multidimensional experience produced by multiple influences” (5).

 

 

 References:

 1. Waddell G. Subgroups within “nonspecific” low back pain. J Rheumatol. 2005 Mar;32(3):395-6.  

 2. Della Mora LS, Perruccio AV, Badley EM, Rampersaud YR. Differences among primary care patients with different mechanical patterns of low back pain: a cross-sectional investigation. BMJ Open. 2016 Dec 7;6(12):e013060. 

 3. Saragiotto BT, Maher CG, Moseley AM, Yamato TP, Koes BW, Sun X, Hancock MJ. A systematic review reveals that the credibility of subgroup claims in low back pain trials was low. J Clin Epidemiol. 2016 Nov;79:3-9. Epub 2016 Jun 10.

 4. Setchell J, Costa N, Ferreira M, Makovey J, Nielsen M, Hodges PW. Individuals’ explanations for their persistent or recurrent low back pain: a cross-sectional survey. BMC Musculoskelet Disord. 2017 Nov 17;18(1):466. 

 5. Melzack R, Katz J. Pain. Wiley Interdiscip Rev Cogn Sci. 2013 Jan;4(1):1-15. doi: 10.1002/wcs.1201. Epub 2012 Oct 4.