Perceptual Inference in Chronic Pain: An Investigation into the Economy of Action Hypothesis

OBJECTIVE: The experience of chronic pain critically alters one's ability to interact with their environment. One fundamental issue that has received little attention however, is whether chronic pain disrupts how one perceives their environment in the first place. The Economy of Action hypothesis purports that the environment is spatially scaled according to the ability of the observer. Under this hypothesis it has been proposed that the perception of the world is different between those with and without chronic pain. Such a possibility has profound implications for the investigation and treatment of pain. The present investigation looked to test the application of this hypothesis to a heterogeneous chronic pain population.

METHODS: Chronic pain sufferers (36; 27F) and matched pain-free controls were recruited. Each participant was required to judge the distance to a series of target cones, to which they were to subsequently walk. In addition, at each distance, participants used numerical rating scales to indicate their perceived effort and perceived pain associated with the distance presented.

RESULTS: Our findings do not support the Economy of Action hypothesis: there were no significant differences in distance estimates between the chronic pain group and pain-free controls (F(1,60)=0.927; P=0.340). In addition, we found no predictive relationship in the chronic pain group between anticipated pain and estimated distance (F(1,154)=0.122, P=0.727), nor anticipated effort=1.171, P=0.281) and estimated distance (F(1,154)=1.171, P=0.281).

DISCUSSION: The application of the Economy of Action hypothesis and the notion of spatial perceptual scaling as a means to assess and treat the experience of chronic pain are unfounded.