Is pain all in the mind?

Two London doctors underwent a hair-raising experiment to see if other cultures offer something more effective than popping pills By Esther Walker It can e sharp or dull! it can last for a few seconds or for a lifetime" If it#s ad it can make you vomit$ and we spend millions a year trying to make it go away" %ain affects us all at some point" In the West$ the traditional treatment is a ottle of pills$ in the form of analgesics such as i uprofen or paracetamol" But painkillers can have unpleasant side effects$ including addiction" Is there an alternative to drugs? Two London doctors$ &hris and 'lexander ()*and)+ van Tulleken$ who are also identical twins$ set out to investigate if we can learn anything a out pain relief from other cultures" Both twins$ ,-$ studied medicine at .xford /niversity and trained at the city#s 0adcliffe &amera 1ospital" They elieve that Western medicine is missing a trick$ so they teamed up with &hannel 2 to do a series a out alternatives to Western medicine$ called 3edicine 3en! the second episode in the series examines pain" )We heard a out a 1indu festival in 3alaysia$ where people pierce themselves and claim to feel no pain$) says *and" )We wanted to learn whether there are ways of controlling extreme pain 4ust with your mind") 5o they decided to perform an experiment6 they#d oth get pierced at the festival$ ut one of them would prepare for it and the other wouldn#t" Because &hris and *and are identical twins$ they are ideal su 4ects6 one can e a control$ the other a varia le" )I prepared according to the 1indu priests$) says *and$ )while &hris 4ust rolled up on the day" I also spent a lot of time talking to people who had done it efore" The man who was going to pierce me said$ #7on#t worry$ I#ll put you in a trance#$ and I genuinely thought he would 4ust do something to me on the day") &hris was more sceptical" )I turned up with a hangover and I#d een doing all the things you#re not supposed to" I#ve never een a le to e hypnotised$ and I was certain that it was going to hurt" We were dressed up in sort of 'laddin trousers$ covered in eads and had turmeric in our hair" We felt pretty stupid until we got to the area where people were eing pierced and it was 8uite a som re atmosphere" )*and was pierced efore me and it was 8uite a violent process" The spikes are sharp$ ut not that sharp$ so they had to force them through" I saw *and#s arms come up from his sides to stop the guy from piercing his tongue$ ut someone held his arms ack") 'fter an hour$ the spikes were removed" &hris$ who had done no preparation for the event$ recovered 8uickly$ whereas *and didn#t find it so easy" )I really felt like I#d een assaulted$) he says" )I was really 8uite upset and choked up at the end 9 and was also in a lot of pain") &hris says6 )The others were simply acting like it was &hristmas$) says &hris" )It wasn#t ullshit and it wasn#t 4ust painful devotion 9 they were really entering some kind of trance state" We came away pretty convinced that it is a phenomenon") Britons spend :;<<m a year on over-the-counter pain relief$ and =< million of us suffer from chronic pain" The most common cause is arthritis$ followed y ack pain" )'ll pain is in the rain$) says *and" )The pain pathways to the rain have een so reinforced that even if the thing that#s making it hurt is taken away$ the rain still feels the pain") It is also su 4ective$ adds &hris" )I have seen patients with sprained ankles vomiting and white as a sheet6 they can#t cope at all" But then someone will come in having lost all the skin off one finger and e 8uite relaxed")

'nother dimension is place os" )The fact is that they work 9 and they work est when oth the patient and the doctor elieve that they will work$) says &hris" The modern understanding of the place o effect is in part down to 7r 1arry Beecher$ an 'rmy medic" 7r Beecher ran out of morphine while treating casualties in Italy" 1e gave them saline solution instead$ telling them that it was morphine 9 and found that in 2< per cent of cases their pain was relieved anyway" 7octors are increasingly prescri ing cognitive ehavioural therapy (&BT+ for chronic pain$ which can potentially ) reak) pain pathways to the rain" 7r >oan 1ester$ a consultant at ?ing#s &ollege 1ospital in London and president of the British %ain 5ociety$ elieves attitudes are changing" )The use of painkillers long-term certainly has pro lems$) she says" )They can work if used properly$ ut there is evidence that taking painkillers for headaches can make them worse" &hronic pain is made worse y the anxieties a out the pain itself$ which can e treated simply y allaying the patient#s fears" &BT can e very effective$ ut there is a shortage of practising psychologists 9 and pain can e very disa ling if it is left untreated") There has also een a resurgence in the num er of surgeries eing performed under hypnosis$ rather than general anaesthetic" 1ypnosis is thought to reduce oth lood loss during the operation and recovery time" In ,<<@$ a hernia operation was successfully performed on a hypnotised patient live on the 3ore2 television channel" )In a search to e so rational and scientific$ Western science has cut itself off completely from a form of healing that falls under the um rella term of the place o effect$) says *and" )'fter what we saw in making the programme$ we feel that#s a mistake") What pain is$ and how to stop it A When part of the ody is in4ured$ nerve endings transmit pain signals to the rain via the spinal cord" A 1owever$ the degree to which the pain is felt may depend on other factors such as degree of fear and the general health of the in4ured person" 1ence$ dental pain$ for example$ may e felt more severely than the treatment causing it would suggest" A 3ost over-the-counter painkillers work y locking the ody#s production of prostaglandins$ one of the chemicals that produce the sensation of pain" Barcotic painkillers such as morphine work y locking the chemical messengers that carry the pain signal to the rain" A %ain is exacer ated y tension$ so many relaxation techni8ues can ease it" Bo one knows for sure why it works$ ut acupuncture is particularly helpful for musculo-skeletal pain" It is availa le on the B15$ ut access is limited and many doctors dispute its effectiveness" A The most painful diseases are thought to e necrotising fasciitis (flesh-eating disease+$ trigeminal neuralgia (a nervous disorder causing pain in the nose$ eyes$ lips and 4aws 9 la elled the )suicide disease)+$ gout$ kidney stones$ gall stones and cluster headaches" ?ate %roctor