Pain is a really complicated business. That’s what makes pain science so fascinating!
We know very clearly that there is more to back pain than what is happening in your back. There is more to neck pain than what is going on in your neck. There is more to headache than what is going on in your head. There is more to knee pain….. you get the idea.
So what else comes into it? One important factor is context or the environment. Another is expectation. What do I mean by that? I think this amazing study should help to clarify it!
In 1998, a pain science study was published by Bayer and co. in the highly-regarded journal Pain, in which they studied the effects of environmental factors and earlier experiences with pain.
The experiment
They took a bunch of willing (I hope) subjects and divided them into two groups:
The first group had the pleasure of experiencing pain by ice water and pressure, then connected to a ‘sham stimulator’.
The second group did it the other way around – they got the ‘sham stimulator’ first, then the ice water and pressure pain.
The results
The first group, who experienced the ice water and pressure pain first, had a significant increase in their reported pain as the sham stimulator was increased, but not the second group. In the first group, as the dial went up, their pain went up after they had experienced ‘real’ pain.
The second group (the sham stimulator first) had a significantly shorter time of enduring the cold water and the pressure pain compared to the first group. In the second group, doing the sham stimulator part seemed to affect their ability to cope with the cold water and pressure pain.
So what exactly was the ‘sham stimulator’?
This is the cool bit. The ‘sham stimulator’ was kind of like a salon hairdryer with a box attached to it and dials. So it looked important, but it did absolutely nothing!
The subjects were told to expect a headache from it. So in that first group, as the dial was turned up in full view of the subject, the pain they reported increased significantly too! Even though it was not capable of doing anything!
The other cool bit is that the two groups did not differ in the number of subjects that reported pain, or the average maximal pain that they felt.
What do the results tell you about pain science?
I’m glad you asked. The context and the environment has a big effect on pain. You can get pain if you are expected to feel it and you see a dial go up from 0 to 10.
It also showed that having that experience (despite being a sham) can influence later pain behaviours like tolerance to pressure and cold.
The take home messages
- Low back pain is more than just about your back. Neck pain is more than just about your neck. Headache pain is more than just about your head (or whatever source is blamed for it).
- A salon hairdryer can give you a headache if you are told to expect it.
- Pain science is pretty interesting stuff. Our recent blogs tend to back this up, like the one on different people’s experiences with being shot and the difference between your back hurting and being injured.
We have an online free pain science education series that you can join if you are interested in learning more about how pain works. This is ideal for the persistent pain sufferer – knowledge is power!!
If you would like to speak with one of our physios one-on-one for a free chat about how we can help, call us on 8356 1000 to organise a free 15 minute phone consult or book online here!
Reference: Pain. 1998 Feb;74(2-3):327-31
