Pain Archive

A novel study suggests that the "nocebo effect" could be why some people believe they cannot tolerate statins.

Are you hesitant to fill your statin prescription because you're worried the drug will cause muscle aches and other side effects? Although you're far from alone (see "A royal pain?"), the reality is that all drugs have side effects, and statins aren't worse than other drugs. And fears about statin side effects may be depriving people of a potentially lifesaving medication.

The nocebo effect — the flip side of the well-known placebo effect — occurs when people experience negative effects from a drug, placebo, or other treatment based on an expectation of harm. Because of the widespread belief that statins cause muscle aches, statins have been suspected of triggering a strong nocebo effect. A recent study confirmed this observation (see "A study to assess statin side effects").

Ask the doctors

Q. I eat a lot of shellfish and recently developed gout in my knee. Did my diet cause the condition?

A. As you probably know, gout is a painful form of arthritis that occurs when high levels of a waste product called uric acid build up in the body. It can settle into joints, where it forms sharp crystals that can trigger inflammation, redness, and pain. Your diet may have aggravated the condition, but didn't cause it.

Women are disproportionately affected by conditions that cause chronic pain, but they sometimes have difficulty getting a definitive diagnosis as to what is causing their pain and may be less likely to receive appropriate treatments even when they do.

Bring this article to your doctor appointment.

You've run out of options for hip pain and you're facing a possible hip replacement (see "Anatomy of a hip replacement"). Once your doctor has determined that you're a good candidate for surgery — based on your medical history, images of your hip, steps you've taken to reduce pain (such as weight loss and low-impact exercise programs), and how pain has affected your daily function — you'll need to ask lots of questions.

"This is not a time to be shy. Be aggressive and get answers. The doctor expects that," says Dr. Scott Martin, an associate professor of orthopedic surgery at Harvard Medical School and medical editor of the Harvard Medical School Guide Total Hip Replacement.

Listening to music may offer a range of benefits for cardiovascular health.

Music's capacity to evoke emotion is one reason people love listening to it so much. Whether you want to feel energized and uplifted or calm and relaxed, you can probably conjure a few examples of melodies that put you in your desired frame of mind. As it turns out, those mood-related benefits may extend to your heart.

"The beating of your heart and your fight-or-flight system are regulated by your brain. Once you understand that, it makes sense that listening to music that evokes a certain mood might affect the heart's function," says Dr. Andrew Budson, a lecturer in neurology at Harvard Medical School and chief of cognitive and behavioral neurology at the VA Boston Healthcare System.

These painful flare-ups can occur suddenly and for no apparent reason. Here's what you can do about them.

Have you ever woken up with a mysterious egg-shaped swelling on your elbow or knee and have no clue what caused it? There is a good chance you have bursitis.

"Bursitis is definitely more common as you get older and just comes with the territory of living a longer and more active life," says Dr. Robert Shmerling, senior faculty editor at Harvard Health Publishing and Corresponding Member of the Faculty of Medicine at Harvard Medical School.

Research we're watching

Google searches for "chest pain" spiked in March and April of 2020 during the initial sharp rise in COVID-19 infections, according to a new study. The findings suggest that people were attempting to self-diagnose heart attacks — and may explain why fewer people sought treatment for heart attacks in hospitals during the pandemic.

The study relied on Google Trends, a tool that monitors search term queries over time. The authors looked at searches for "chest pain" and five control terms — "toothache," "abdominal pain," "knee pain," "heart attack," and "stroke" — from January 2017 through May 2020. Searches for chest pain (a common symptom of heart attack but not COVID-19) spiked in states with high rates of COVID-19 infection (New York, New Jersey, and Illinois), while searches for other terms stayed steady.

The benefits of tub baths are more than skin deep. Bathing regularly can help ease pain and potentially benefit your heart.

You know that sinking into a warm bath at the end of a long day can help you relax and unwind, but did you know it might also be good for your health? Research shows that using baths as a form of medical therapy, sometimes referred to as balneotherapy (see "Balneotherapy, or bath therapy"), can bring health benefits — among them, easing certain types of chronic pain, helping your skin, and potentially even improving heart health.

The condition is an all-too-real problem for men, and one of the more difficult to treat.

After age 50, men often have periods of discomfort "down there." It could be a cramping, aching, or throbbing pain in and around your pelvis and genitals. You also may have issues in the bedroom and bathroom. While the problems are real, the cause is often difficult to pinpoint.

It's called chronic pelvic pain syndrome (CPPS) — also known as chronic prostatitis — and it's one of the most puzzling and difficult-to-manage conditions for older men.