A recent provocative research study has shown that the element of conscious expectation (and subconscious prediction) has a significant modulatory affect on the experience of pain. In this specific case the researchers focused on neck pain. This study has also helped to confirm the latest thinking on the multi-dimensional aspects of the origins of pain.
“EXPECTATION - a belief that something will happen or is likely to happen - is a powerful conscious mediator. Physiologically, it can stimulate our sympathetic drive causing our heart to race and our skin to sweat as we think about a singular future consequence. ”
With this study, researchers asked the question "Can illusionary visual cues change the outcome of predictable neck pain?" To achieve this, they recruited participants that actively experience pain upon head/neck rotation. Each participant was fitted with virtual reality goggles that showed a visual reference scene. As a participant individually turned their head to view the computer-generated 360 degree scene, researchers proceeded to document what degree of rotation illicited a painful response. The researchers then changed the scene's movement relative to the actual physical turn through altered visual perception. By subtly changing the rate of the scene's movement relative to the rate of the actual head turn, researchers were (on average) able to reduce a participant's range of motion by 7% or increase it by 6%. Whereupon previously during a head turn, the creation of a painful response would usually occur at a recurrent specific point in the range. The onset of a painful response was readily influenced by changing the visual cue the brain uses for perception (and expectation).
Here is a quote from the researcher's conclusion, "...when visual-proprioceptive feedback overstates true neck rotation, pain-free range of motion is reduced compared with that during accurate visual feedback. When visual-proprioceptive feedback understates true neck rotation, pain-free range of motion is increased compared with that during accurate visual feedback. "
Thankfully, there is continuing evidence (with this research and others like it) that changing the perception of the subconscious brain gives us an in-road to better outcomes with those in pain. This is already done with graded motor imagery and with manual therapy through the lens of dermoneuromodulation. Perhaps virtual reality setups like the one used in this study may make it into clinics as well. How cool is that?!?