{"id":640223,"date":"2010-01-19T03:00:00","date_gmt":"2010-01-19T08:00:00","guid":{"rendered":"tag:www.mindhacks.com:\/\/a93ec03f8a47c8590ef9ce1ef11a8fc0"},"modified":"2010-01-19T03:00:00","modified_gmt":"2010-01-19T08:00:00","slug":"hard-as-nails","status":"publish","type":"post","link":"https:\/\/mereja.com\/index\/640223","title":{"rendered":"Hard as nails"},"content":{"rendered":"<p><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" align=\"right\" class=\"right\" src=\"https:\/\/i0.wp.com\/www.mindhacks.com\/blog\/files\/2010\/01\/nail_boot.jpg?resize=183%2C113\" width=\"183\" height=\"113\" \/><a href=\"http:\/\/idiolect.org.uk\/\">Tom<\/a> alerted me to this fantastic brief <a href=\"http:\/\/www.bmj.com\/cgi\/content\/full\/310\/6971\/70\/F20\">case<\/a> published in the <i>British Medical Journal<\/i> where a builder is admitted to hospital in great pain after a nail penetrated all the way through his boot. But it turned out that the pain was entirely psychological, as the nail had missed his foot by sliding between his toes.<\/p>\n<blockquote>\n<p>A builder aged 29 came to the accident and emergency department having jumped down on to a 15 cm nail. As the smallest movement of the nail was painful he was sedated with fentanyl and midazolam. The nail was then pulled out from below. When his boot was removed a miraculous cure appeared to have taken place. Despite entering proximal to the steel toecap the nail had penetrated between the toes: the foot was entirely uninjured.\n<\/p><\/blockquote>\n<p>As Tom mentioned &#8220;One of the things I love about it is that the builder had no incentive to &#8216;fake&#8217;. He knew he should have acted tough so we know that the pain he felt wasn&#8217;t over-acting. It was imaginary pain, but it was real imaginary pain!&#8221;<\/p>\n<p>This isn&#8217;t really the <a href=\"http:\/\/en.wikipedia.org\/wiki\/Nocebo\">nocebo effect<\/a>, where &#8216;side-effects&#8217; appear after having taken nothing but a placebo, but more similar to what doctors might describe in its persistent form as <a href=\"http:\/\/en.wikipedia.org\/wiki\/Somatization_disorder\">somatisation disorder<\/a> where physical symptoms appear that aren&#8217;t explained by tissue damage.<\/p>\n<p>However, both are similar in that real pain arises from beliefs, expectations and perceptions. We now know that all pain has a significant mental component and, consequently, psychological therapy is an <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/19370592\">effective<\/a> <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/19370688\">treatment<\/a> for chronic pain.<\/p>\n<p>It&#8217;s no coincidence that Tom picked up this snippet in a talk by psychologist <a href=\"http:\/\/bham.academia.edu\/StuartDerbyshire\">Stuart Derbyshire<\/a> who has done some fantastic <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/sites\/entrez?db=pubmed&#038;orig_db=PubMed&#038;term=derbyshire%20s%20%5bau%5d%20hypnot*&#038;cmd=search\">studies<\/a> on the neural basis of psychologically controlled and induced pain by using hypnosis in fMRI scanners.<\/p>\n<p>\n<a href=\"http:\/\/www.bmj.com\/cgi\/content\/full\/310\/6971\/70\/F20\">Link<\/a> to brief piece in the <i>BMJ<\/i>.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tom alerted me to this fantastic brief case published in the British Medical Journal where a builder is admitted to hospital in great pain after a nail penetrated all the way through his boot. But it turned out that the pain was entirely psychological, as the nail had missed his foot by sliding between his [&hellip;]<\/p>\n","protected":false},"author":2674,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"advanced_seo_description":"","jetpack_seo_html_title":"","jetpack_seo_noindex":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[4821],"tags":[],"class_list":["post-640223","post","type-post","status-publish","format-standard","hentry","category-news"],"jetpack_featured_media_url":"","jetpack_shortlink":"https:\/\/wp.me\/p9NivD-2Gyb","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/mereja.com\/index\/wp-json\/wp\/v2\/posts\/640223","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/mereja.com\/index\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/mereja.com\/index\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/mereja.com\/index\/wp-json\/wp\/v2\/users\/2674"}],"replies":[{"embeddable":true,"href":"https:\/\/mereja.com\/index\/wp-json\/wp\/v2\/comments?post=640223"}],"version-history":[{"count":0,"href":"https:\/\/mereja.com\/index\/wp-json\/wp\/v2\/posts\/640223\/revisions"}],"wp:attachment":[{"href":"https:\/\/mereja.com\/index\/wp-json\/wp\/v2\/media?parent=640223"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/mereja.com\/index\/wp-json\/wp\/v2\/categories?post=640223"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/mereja.com\/index\/wp-json\/wp\/v2\/tags?post=640223"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}