title: Doubling Your Payoff: Winning Pain Relief Engages Endogenous Pain Inhibition
abstract: When in pain, pain relief is much sought after, particularly for individuals with chronic pain. In analogy to augmentation of the hedonic experience ("liking") of a reward by the motivation to obtain a reward ("wanting"), the seeking of pain relief in a motivated state might increase the experience of pain relief when obtained. We tested this hypothesis in a psychophysical experiment in healthy human subjects, by assessing potential pain-inhibitory effects of pain relief "won" in a wheel of fortune game compared with pain relief without winning, exploiting the fact that the mere chance of winning induces a motivated state. The results show pain-inhibitory effects of pain relief obtained by winning in behaviorally assessed pain perception and ratings of pain intensity. Further, the higher participants scored on the personality trait novelty seeking, the more pain inhibition was induced. These results provide evidence that pain relief, when obtained in a motivated state, engages endogenous pain-inhibitory systems beyond the pain reduction that underlies the relief in the first place. Consequently, such pain relief might be used to improve behavioral pain therapy, inducing a positive, perhaps self-amplifying feedback loop of reduced pain and improved functionality.
authors.affiliation: Alan Edwards Centre for Research on Pain, McGill University , Montreal, Quebec H3A 0C7, Canada ; Faculty of Dentistry, McGill University , Montreal, Quebec H3A 0C7, Canada ; Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University , 68159 Mannheim, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Becker
authors.affiliation: Alan Edwards Centre for Research on Pain, McGill University , Montreal, Quebec H3A 0C7, Canada ; Faculty of Dentistry, McGill University , Montreal, Quebec H3A 0C7, Canada.
authors.forename: Wiebke
authors.initials: W
authors.lastname: Gandhi
authors.affiliation: Alan Edwards Centre for Research on Pain, McGill University , Montreal, Quebec H3A 0C7, Canada ; Faculty of Dentistry, McGill University , Montreal, Quebec H3A 0C7, Canada.
authors.forename: Saskia
authors.initials: S
authors.lastname: Kwan
authors.affiliation: Alan Edwards Centre for Research on Pain, McGill University , Montreal, Quebec H3A 0C7, Canada ; Faculty of Dentistry, McGill University , Montreal, Quebec H3A 0C7, Canada.
authors.forename: Alysha-Karima
authors.initials: AK
authors.lastname: Ahmed
authors.affiliation: Alan Edwards Centre for Research on Pain, McGill University , Montreal, Quebec H3A 0C7, Canada ; Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University , Montreal, Quebec H3A 0C7, Canada.
authors.forename: Petra
authors.initials: P
authors.lastname: Schweinhardt
keywords: motivation; pain modulation; perception; relief; reward