To Avoid Pain During an Injection, Look Away

Common advice really does reduce discomfort, study in PAIN® reports

Philadelphia, PA, May 14, 2012 – Health professionals commonly say, “Don’t look and it won’t hurt” before administering an injection, but is there any scientific basis for the advice? A group of German investigators has found that, in fact, your past experience with needle pricks, along with information you receive before an injection, shape your pain experience. Their research is published in the May issue of PAIN®.

“Throughout our lives, we repeatedly experience that needles cause pain when pricking our skin, but situational expectations, like information given by the clinician prior to an injection, may also influence how viewing needle pricks affects pain,” says lead author Marion Höfle, a doctoral student in the research Multisensory Integration group led by Dr. Daniel Senkowski, at the Charité - Universitätsmedizin Berlin and the University Medical Center Hamburg-Eppendorf. 

While watching video clips showing a needle pricking a hand, a Q-tip touching the hand, or a hand alone, study participants concurrently received painful or non-painful electrical stimuli applied to their own hand. The clips were presented on a screen located above the participants’ hand, giving the impression that the hand on the screen belonged to them.

Participants reported that their pain was more intense and more unpleasant when they viewed a needle pricking a hand than when they saw a hand alone. In addition, observing needle pricks increased the unpleasantness of pain compared to viewing Q-tip touches. These findings were paralleled by enhanced activity of the autonomic nervous system, as measured by pupil dilation responses. This demonstrates that previous painful experiences with needles enhance unpleasantness of pain when viewing needle pricks.

Situational expectations also influenced perceived pain intensity. Prior to the stimulation, participants were told that either the needle or the Q-tip clip was more likely to be associated with painful than with non-painful electrical stimulation. The researchers found that presentation of clips that were more likely to be associated with pain lead to higher pain intensity experiences than the presentation of clips that were less likely to be associated with pain. This shows that expectations regarding the painfulness of medical treatments influence the intensity of pain that the treatment ultimately produces. 

Taken together, the study reveals several important findings. “Clinicians may be advised to provide information that reduces a patient’s expectation about the strength of forthcoming pain prior to an injection,” Höfle notes. She further states that, “because viewing a needle prick leads to enhanced pain perception as well as to enhanced autonomic nervous system activity, we’ve provided empirical evidence in favor of the common advice not to look at the needle prick when receiving an injection.”

 

# # #

 

Notes for editors
“Viewing a needle pricking a hand that you perceive as yours enhances unpleasantness of pain,” by M. Höfle, M. Hauck, A.K. Engel, and D. Senkowski (DOI: 10.1016/j.pain.2012.02.010). It appears in PAIN®, Volume 153, Issue 5 (May 2012) published by Elsevier.

Full text of the articles is available to credentialed journalists upon request. Contact Christine Rullo at +1 215 239 3709 or painmedia@elsevier.com for copies. Journalists wishing to set up interviews should contact Marion Höfle at +49 (40) 7410 55856 (phone), +49 (40) 7410 57752 (fax), or e-mail: m.hoefle@uke.uni-hamburg.de.

About PAIN®
PAIN®, the official journal of the International Association for the Study of Pain® (IASP®), publishes 12 issues per year of original research on the nature, mechanisms, and treatment of pain. This peer-reviewed journal provides a forum for the dissemination of research in the basic and clinical sciences of multidisciplinary interest and is cited in Current Contents and MEDLINE. It is ranked 2nd out of the 26 journals in the Anesthesiology category according to the Journal Citation Reports 2010 published by Thomson Reuters. www.painjournalonline.com

About the International Association for the Study of Pain® (IASP®)
Founded in 1973, IASP® is the world's largest multidisciplinary organization focused specifically on pain research and treatment. It is the leading professional forum for science, practice, and education in the field of pain bringing together scientists, clinicians, health care providers, and policy makers to stimulate and support the study of pain and to translate that knowledge into improved pain relief worldwide. IASP currently has more than 7,500 members from 130 countries and in 87 chapters. www.iasp-pain.org

About Elsevier

Elsevier is a world-leading provider of information solutions that enhance the performance of science, health, and technology professionals, empowering them to make better decisions, deliver better care, and sometimes make groundbreaking discoveries that advance the boundaries of knowledge and human progress. Elsevier provides web-based, digital solutions — among them ScienceDirect, Scopus, Elsevier Research Intelligence, and ClinicalKey — and publishes nearly 2,200 journals, including The Lancet and Cell, and over 25,000 book titles, including a number of iconic reference works.

The company is part of Reed Elsevier Group PLC, a world leading provider of professional information solutions in the Science, Medical, Legal and Risk and Business sectors, which is jointly owned by Reed Elsevier PLC and Reed Elsevier NV. The ticker symbols are REN (Euronext Amsterdam), REL (London Stock Exchange), RUK and ENL (New York Stock Exchange).

Media contact
Christine Rullo
Health Sciences Journals, Elsevier
+1 215 239 3709
painmedia@elsevier.com