Doubting your doctor increases the pain felt

in collaboration with

Dr. Marc Lévêque (Neurosurgery – Pain)

What if the pain you feel during a medical procedure is partly about whether or not you trust your doctor? This is the conclusion of a new study which establishes that brain activity related to pain can evolve negatively in consultation, when your practitioner does not seem worthy of trust. And which highlights more than ever the importance of the patient-doctor link in the care.

An effect that can be seen in imaging

To understand the neurobiological mechanisms that may be at the origin of the sensation of pain in consultation, researchers from the University of Miami therefore conducted a study on 42 subjects subjected to a painful medical procedure (here, thermal stimulation on the arms) and treated by virtual doctors. These were created from scratch by an algorithm and appeared to be more or less trustworthy, depending on the given image. When participants received painful thermal stimulation from doctors they did not trust, they reported more severe pain.

A sensation confirmed by functional neuroimaging: the more the participants were suspicious of the doctor involved, the greater their brain activity was in the regions of the brain involved in pain.

The Importance of Belief in the Patient/Physician Relationship

For Dr. Marc Lévêque, neurosurgeon specializing in pain, and author of Let’s free ourselves from pain (Buchet Chastel, 2022), this study has the advantage of pointing out the effects of the relationship between patients and doctors on pain in real time, thanks to imaging. But only confirms a fact that is very important in the care, the pain, like the treatment. “We know that the effect of a treatment, or even a placebo, will be all the more powerful when the patient is convinced of its effectiveness. For this it is essential that the doctor or nurse administers it with conviction”. Other elements may be taken into account in the confidence given: the reputation of the professional, the route of administration chosen, as well as the cost of a consultation. “We all tend to think that the more expensive the better” reveals the doctor. “These examples show us that the psychological aspect is fundamental in the placebo effect as, moreover, in the painful fact” he continues. Thus, the empathy, the conviction and the authority of the practitioner will have a valid effectiveness in particular on the pain, but also on the sleep or the anxiety.