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The belief in therapy supports the success of treatment
A study by the University Medical Center Hamburg-Eppendorf showed that the belief in therapy decisively supports the efficiency of the administered agents. On the other hand, anyone who takes a critical stance on the treatment can completely negate the therapeutic goal. Despite the administration of highly potent agents, the pain persisted almost unchanged because the study participants knew nothing about the administration of the pain medication.
The scientific team focused on the effectiveness of pain relieving drugs in the experimental setup. The researchers found that the patient's attitude to the mechanism of action of the painkiller administered plays a crucial role. Anyone who believes in the effect of pain therapy significantly increases the success of the treatment. On the other hand, if you don't believe in the therapy and tend to take a critical stance, you also reduce pain reduction.
Painkillers only worked by faith The research team led by neurologist Ulrike Bingel from the University Medical Center Hamburg-Eppendorf (UKE) undertook a study with a total of 22 healthy volunteers. All participants volunteered to set up the experiment and were between 20 and 40 years old. The researchers inflicted pain on the participants and then tested the effect of a pain medication under various conditions. The participants were given a heat-pain stimulus for several seconds in multiple doses. The heat effect led to moderate to severe pain. The average pain scale was 70 out of 100. During the heat stimulus, some subjects were given a very strong pain reliever with opioids (remifentanil) with the help of an infusion. Opioids are “opium-like” drugs that are made from natural and synthetic substances and have morphine-like properties.
During the first trial, the participants did not know that the infusion was given a pain reliever. The measured pain intensity decreased only slightly during the "secret" administration from 66 to 55. After the first experiment, the medical staff informed the test subjects that a pain reliever was being administered for the first time, even though one was injected during the first round. Suddenly the pain sensation dropped to 39.
In the third round of the study, the participants were told that the pain medication is now being stopped. In fact, the same dose of pain reliever was administered without the subjects knowing about it. Despite the administration of the remedy, the pain value rose again to 64. The pain sensation was almost as high as before the pain medication infusion. "The negative expectation and the fear of pain completely destroyed the effect of the drug," explained neurology expert Bingel. It turned out that one's own expectations, which are linked to a treatment, also have a strong influence on the mechanism of action of the pain reliever. If the test subjects promised themselves a lot of the remedy, the pain was also relieved. If they took a negative attitude, the pain sensation was relieved only slightly or not at all.
The body's own pain system is activated by faith. The observed effect was less subjective, since with the help of magnetic resonance imaging (MRI) pain processing in the special brain areas was analyzed. If participants were told that they were being given a strong pain reliever, this knowledge also activated the body's pain system. As a result, the effect of the agent was strengthened and the subject felt less pain.
Help for patients with chronic pain The researchers are now hoping that the study results will be used to treat patients with chronic pain. Many patients suffer from chronic pain for years because they are desperate and anxious and have lost faith in medicine. "Now we know that negative expectations of the therapy also affect its success," said study author Bingel. Now it is clear that negative expectations can "adversely affect the therapeutic success of actually potent painkillers". (sb)
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