Positive Thinking and Medication Efficacy


We hear a lot about the power of positive thinking these days. The premise is that your thoughts create your experience. New studies say that concept appears to apply to how well pain medication works too. 

Research published recently in the journal Science Translational Medicine demonstrates how positive and negative thinking impacts the effects of pain medication. Scientists studied 22 healthy adult volunteers to find out if their expectations about how well a pain treatment would work would impact their perception of pain.

The volunteers were placed in an MRI machine and given strong, opiod pain medication constantly through an IV while a heat source was applied to their leg and set to a level where it would cause pain. Then researchers conveyed different messages about what type of pain treatment the volunteers were receiving at different points in their test. They were told they should expect a difference in their pain because they were either receiving the opiod medication, plain un-medicated saline or they were told their medication had been turned off. The actual dose and administration of pain medication they received remained constant throughout the test, regardless of what the volunteer was told.

  • Researchers discovered that when volunteers were told they were receiving pain medication and should expect it to relieve their pain, the volunteers stated and demonstrated they felt less pain.
  • When they were told their pain might get worse because they were receiving saline or no pain medication, volunteers reported and demonstrated feeling more pain, even though they were receiving the same level of IV opioid medication.

MRI scans demonstrated activity in the brain's pain networks that corresponded to the volunteers' reports of pain. This showed the volunteers really did experience different levels of pain when their expectations were changed, even though the administration of pain and pain medication remained constant.

Scientists have long known about the power of the mind-body connection and the placebo effect (where patient's symptoms improve when they think they're receiving medication, even when they're only receiving un-medicated sugar pills). While this limited study performed on healthy volunteers undergoing short durations of pain does not mimic the experiences of unhealthy and/or chronic pain patients, it does provide new evidence about how powerful patient perception is in treating pain. 

Many patients have a pessimistic attitude toward pain treatment, especially if they've suffered for a long time. They may come to their doctor with the expectation that since nothing has worked so far to relieve their pain, nothing new the doctor has to offer will work either. 

Patients and doctors must come to terms with how thought impacts experience and deal with negative attitudes about pain management. That's not to say that pain is all in the patient's head. Instead, it supports the concept that the mind, body and spirit are integrated and the best way to treat one area involves supporting the others too. 


Science Translational Medicine

Sci Transl Med 16 February 2011:
Vol. 3, Issue 70, p. 70ra14
DOI: 10.1126/scitranslmed.3001244

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