Have you ever been told “This won’t hurt a bit” before having a shot, only to find that it hurts a lot? Your expectations have been violated.

A study at Wake Forest Baptist Medical Center identified through imaging the part of the brain that is activated when a person expects one level of pain but experiences another…

“This finding gives us a better understanding of the importance of how our expectations of pain affect the experience of pain,” said Fadel Zeidan, Ph.D., assistant professor of neurobiology and anatomy at Wake Forest Baptist and first author of the study. “This effect shows us how important it is to manage people’s expectations when it comes to pain.”

Previous studies have shown that the expectation of intense pain can make pain feel worse while the expectation of milder pain can make it hurt less. However, the brain mechanisms associated with processing mismatches between expected and experienced pain have been poorly understood.

This Wake Forest study found that activation of the parietal lobe and insular cortex are involved in processing real-time mismatches between expected and experienced pain.

The findings demonstrate that the powerful influence of expectations on the subjective experience of pain can be dramatically altered when there is a substantial difference between expected and experienced pain.

“Knowing how vital trust is to the doctor-patient relationship, we hope these findings will help physicians and other caregivers have a better understanding of the importance of how what patients expect affects their experience of pain,” Zeidan said.

This study was published in an online edition of the journal Pain.


May 27, 2015

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