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The Pain Process, Page 3/3

The following represents Arthur's opinions only and not necessarily those of Christie.

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Further evidence that psychology plays a critical role in the pain experience is given by the placebo effect.  Numerous studies have confirmed that some individuals given placebos will report a decrease in levels of pain.  In 2004, Wager and his colleagues used MRI to test whether or not the placebo effect had a measurable basis in science governing the brains’ response to pain.  They told their subjects they were testing a new pain-relieving cream.  While monitoring brain activity, volunteers were given shocks both with and without the cream applied.  The cream was merely a placebo, not known to the subjects.  Results showed a statistically significant placebo effect pattern in the prefrontal cortex, the area of the brain known for anticipation of pain relief, indicating a definitive difference in cases with and without the placebo.  They theorized that this activity in the prefrontal cortex triggered the release of endorphins in the midbrain, thus reducing the overall pain experienced.   While there is no universal agreement as to how the placebo effect alters the pain experience, it is widely accepted that individuals who believe they are going to have imminent pain relief often have a reduction in the severity of pain suffered compared to those who have an imminent fear.

While positive beliefs can reduce pain, conversely, negative beliefs can exacerbate it.  Recent pain research from Nicholson & Verma (2004) in chronic neuropathic pain, for example, demonstrates that the psychological state of the patient as being integral to the entire condition.  Depression, anxiety, and fear are key components in the overall prognosis of the chronic pain patient.  Recovery in these types of pain conditions cannot be independent of psychological treatment.  Dealing with the emotional-personal underlying issues is an important part in the overall pain management cycle.  Maintaining a healthy support system, a positive self-image, and an active lifestyle within the range of abilities of the patient (in severe disability, even if that means simply walking a few steps a day); can have a demonstrative and positive impact on overall quality of life and degree of pain and suffering.



Pain can be considered a ‘good’ thing when it corresponds to a damaging agent, acting as a protecting force against bringing harm upon the body by signaling one to seek relief and restoration.  Unfortunately, not all pain serves this purpose.  Pain may exist as a problem unto itself, causing its bearer to suffer in a manner that seems needless.    Because of this, it is of great importance that science continues its push to understanding the underlying pathways of the different types of pain, its casual forces, and the methods upon which to effectively relieve it.  Doing so will bring immense relief to millions who suffer pain to a degree far more than is necessary to protect against a noxious agent.  Furthermore, an individual’s personal beliefs and psychological state can dramatically affect the level of pain experienced whether for good or ill.  Recognizing that psychology plays an integral part in the overall experience of pain is important, as it expands the study of pain beyond that of physical causation.