DR MICHAEL MOSLEY: From chilli cream to swearing, how to beat pain without popping pills
I have had loads of emails recently from readers asking me about pain, and how best to treat it.
According to the British Pain Society, about 28 million people in the UK suffer from chronic pain, and the numbers just keep on rising.
Drugs such as ibuprofen, paracetamol and opioids can be very effective, at least in the short term.
But they come with significant side effects when taken in high doses or for prolonged periods of time. So what are the other options – that are actually backed by science?
Swearing has been proven to help reduce pain following a study by Keele University
Mind tricks can help you conquer pain
Of course, if you are in long-term pain, it’s important to talk to your GP rather than trying to struggle on alone.
It might take persistence but a referral to a pain specialist or devoted pain clinic is ideal.
They don’t just dish out pills at these clinics. In fact, they spend a lot of time doing the opposite: they may offer the help of a physiotherapist for manipulation of the muscles and joints or psychological support.
They often recommend things such as cognitive behavioural therapy, and mindfulness.
Mindfulness, in particular, has become popular in recent years because of evidence that it can reduce stress and anxiety. But it also appears to be effective at helping people in chronic pain.
There are, broadly speaking, two types of pain – acute and chronic. Acute pain might be a result of something like getting too close to the fire. You get burnt, you jump away.
With chronic pain, things are different. You have an ‘amplifier’ in your brain that governs the intensity of the pain, and in people who suffer from chronic pain, this amplifier seems to be permanently turned up.
It means you go on feeling pain even when an original injury has healed.
Although practising mindfulness won’t make pain go away, it can teach you how to turn down the ‘volume control’, as well as reducing feelings of anxiety and depression, which often make the pain worse. You can find some free courses, approved by the NHS, on the website meditainment.com.
A devoted pain clinic often steers a patient away from prescribing pills and focuses on other techniques to deal with the symptoms
A couple of years ago I took part in an experiment, run by researchers from Oxford University that also showed the power of the mind when it comes to pain.
We asked people suffering from chronic back pain to test some powerful painkillers.
In fact, the pills we gave them were all placebos, containing nothing but ground-up rice.
Yet nearly half of our participants reported significant relief from taking the pills.
The reason placebos work is not because people are gullible. Taking a placebo – just believing that we are doing something that will help us – can change brain activity, dampening down pain signals.
Despite being cheap and clearly effective, placebos are not widely used because it is unethical for your doctor to lie to you. If they gave you a placebo, they would have to tell you that it contained no active ingredient.
Yet, interestingly, placebos can work even when people know they are taking them. In one study, patients with irritable bowel syndrome were told they were getting a placebo.
Despite this, 59 per cent said it had improved their symptoms.
Try capsaicin… but definitely not chillies
One interesting remedy involves a compound derived from chillies – capsaicin.
We don’t really know how capsaicin works. It is thought to reduce pain by making the nerves less sensitive to pain messages.
You can get capsaicin creams from the chemist. When you rub it on to a painful joint, you feel a warm, almost burning sensation.
Don’t, however, try to use chilli juice! As cooks know only too well, it gets everywhere, and can cause absolute agony if (as I have) you forget that it’s on your hands and then accidentally rub it into your eyes
After a few applications, the pain begins to ease. That is because the capsaicin depletes your nerves’ reserves of pain-transmitting chemicals.
Capsaicin cream is used mainly for nerve pain such as neuralgia and osteoarthritis.
Don’t, however, try to use chilli juice! As cooks know only too well, it gets everywhere, and can cause absolute agony if (as I have) you forget that it’s on your hands and then accidentally rub it into your eyes.
Turn air blue… and don’t hold back!
And what about acute pain? Well, next time you stub your toe, rather than just hopping around, why not swear out loud?
A few years ago Dr Richard Stephens, a psychologist from Keele University, decided to test the painkilling power of cursing. He recruited 64 volunteers and asked them to keep their hands in a bucket of freezing cold water, a classic way of safely inducing pain in an experimental setting, for as long as possible while swearing out loud.
Then they did it again, but using inoffensive words.
To his surprise the volunteers were able to tolerate the pain and keep their hands in the bucket for almost twice as long when they were turning the air blue.
Dr Stephens thinks that aggressive swearing triggers the release of natural stress hormones that dull pain.
If you want to maximise this effect, he recommends that you reserve your swearing for when you really need it.
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