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Negativity tied to Pain

Posted 06-09-2011 at 02:02 AM by Ted_Hutchinson

Study finds negativity tied to physical pain

For placebo effects in medicine, seeing is believing.
The gold standard for determining the efficacy of biomedical therapies is the detection of a significant difference between the therapeutic effects of an active pharmacological agent or procedure and a matched inert placebo in a randomized controlled trial.
Detecting this difference has become a challenge for medicine, especially for outcomes that are based on patient self-rated scales.
Yet factors that contribute to placebo responses have received scant attention.
In this issue of Science Translational Medicine, Bingel et al. report on an example of how noninvasive whole-brain imaging contributes to our understanding of brain-based placebo effects.
Here we highlight ways in which neuroimaging is catalyzing a revolution in society's perspective of placebo effects by providing a compelling visualization of how brain activities that reflect a person's thoughts, feelings, and past experiences can enhance or antagonize his or her response to a medical treatment.
The effect of treatment expectation on drug efficacy: imaging the analgesic benefit of the opioid remifentanil
Evidence from behavioral and self-reported data suggests that the patients' beliefs and expectations can shape both therapeutic and adverse effects of any given drug.
We investigated how divergent expectancies alter the analgesic efficacy of a potent opioid in healthy volunteers by using brain imaging.
The effect of a fixed concentration of the μ-opioid agonist remifentanil on constant heat pain was assessed under three experimental conditions using a within-subject design:
1) with no expectation of analgesia,
2)with expectancy of a positive analgesic effect, and
3) with negative expectancy of analgesia (that is, expectation of hyperalgesia or exacerbation of pain).
We used functional magnetic resonance imaging to record brain activity to corroborate the effects of expectations on the analgesic efficacy of the opioid and to elucidate the underlying neural mechanisms.
Positive treatment expectancy substantially enhanced (doubled) the analgesic benefit of remifentanil.
In contrast, negative treatment expectancy abolished remifentanil analgesia.
These subjective effects were substantiated by significant changes in the neural activity in brain regions involved with the coding of pain intensity.
The positive expectancy effects were associated with activity in the endogenous pain modulatory system, and the negative expectancy effects with activity in the hippocampus.
On the basis of subjective and objective evidence, we contend that an individual's expectation of a drug's effect critically influences its therapeutic efficacy and that regulatory brain mechanisms differ as a function of expectancy.
We propose that it may be necessary to integrate patients' beliefs and expectations into drug treatment regimes alongside traditional considerations in order to optimize treatment outcomes.
Your attitude and expectations of any medical intervention depend on your preconceptions about that treatment plan.

This is why I think it's important that people STUDY the science BEFORE they dismiss the ideas I talk about and provide links to.

When you understand the basics of the way inflammation (or the inflammatory response) is creating the pain, then you will better understand how it is that building up your arsenal of anti-inflammatory reserves can, over time, reduce the amount of pain you experience.

If you approach any medical intervention with the expectation that it will be a waste of time and probably a waste of money you are doomed from the start and may as well not bother because that very negativity will have added to your inflammatory status and will itself be abolishing the potential for optimum results.

I know improving my anti-inflammatory status has reduced my pain levels such that I am only aware of pain when I've not paced my activities and done too much. But because I know I'm basically in control of that situation I'm absolutely confident that if I keep on doing what I've been doing the pain will decrease.

If you start with negative thoughts you will end up with negative results.
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