Science Savvy

This episode explores how pain is not just a bodily signal but a brain-made experience shaped by context, expectations, and emotions. It covers top-down modulation (stress or adrenaline can suppress pain; mood can amplify it), the role of placebo and endogenous opioids, and surprising findings sugar pill placebo effects.

It also summarizes practical, non-pharmacological strategies like cognitive behavioral therapy, exercise, mindfulness, pain education, and social support, that engage the brain’s own analgesic systems to reduce pain or improve coping.

Bibliography / references used to write the episode:

Wang et al. (2025). The effect of music therapy for patients with chronic pain: systematic review and meta-analysis. Medicine (Baltimore).

Garza-Villarreal et al. (2017). Music-Induced Analgesia in Chronic Pain Conditions: A Systematic Review and Meta-Analysis. Pain Physician.

IsHak et al. (2018). Pain and Depression: A Systematic Review. Harv Rev Psychiatry.

Lunde et al. (2024). Role of Expectations in Placebo Analgesia: Systematic Review and Meta-Analysis. Psychosom Med.

Hohenschurz-Schmidt et al. (2024). Placebo analgesia in physical and psychological interventions: systematic review and meta-analysis. Eur J Pain.

Borg et al. (2025). Open-label placebo effects in chronic musculoskeletal pain: systematic review and meta-analysis. Sci Rep.

Morley et al. (1999). Meta-analysis of CBT for chronic pain. Pain.

Maglione et al. (2016). Mindfulness Meditation for Chronic Pain: Systematic Review and Meta-analysis. Rand Health Q.

Part two of this Science Savvy pain series explains how common painkillers work, why many provide limited relief, and how pain is shaped by nerves, the spinal cord, the brain, and emotion!! (emotion?!?!)... we even talk about porn, sexual arousal, and its impact on pain... the ffff

The episode covers common drugs like ibuprofen, paracetamol, local anesthetics (at your dentist office) through to not-so-common drugs like opioids. We also talk about why expectations, social support, and non-drug approaches matter - a little bit of hope man, please.

As always, the full bibliography below:
1. None, M., None, A. A. & None, S. A. (2025). Pharmacological Agents Targeting Pain Pathways: A Systematic Review of Analgesic Efficacy and Physiological Correlates. Journal of Contemporary Clinical Practice, 11(9), 683-691.

2. Mallet C, Desmeules J, Pegahi R, Eschalier A. An Updated Review on the Metabolite (AM404)-Mediated Central Mechanism of Action of Paracetamol (Acetaminophen): Experimental Evidence and Potential Clinical Impact. J Pain Res. 2023;16:1081-1094
https://doi.org/10.2147/JPR.S393809

3. Moore RA, Derry S, Aldington D, Wiffen PJ. Single dose oral analgesics for acute postoperative pain in adults - an overview of Cochrane reviews. Cochrane Database Syst Rev. 2015 Sep 28;2015(9):CD008659. doi: 10.1002/14651858.CD008659.pub3. PMID: 26414123; PMCID: PMC6485441.

4. Mourkojannis, C., Wolf, MI., Wittkamp, C.A. et al. Pain modulation by self-generated expectations. Sci Rep 15, 31588 (2025). https://doi.org/10.1038/s41598-025-17276-8

5. Ghlichloo I, Gerriets V. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) [Updated 2023 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK547742/

6. Lakhsassi L, Borg C, Martusewicz S, van der Ploeg K, de Jong PJ. Does heightened subjective sexual arousal lower pain in women? PLOS ONE. 2025;20(??):e0323095. doi:10.1371/journal.pone.0323095

7. Lakhsassi L, Borg C, Martusewicz S, van der Ploeg K, de Jong PJ. The influence of sexual arousal on subjective pain intensity during a cold pressor test in women. PLOS ONE. 2022;17(10):e0274331. doi:10.1371/journal.pone.0274331

8. Whipple B, Komisaruk BR. Elevation of pain threshold by vaginal stimulation in women. Pain. 1985;21(4):357–367.

9. Hambach A, Evers S, Summ O. The impact of sexual activity on idiopathic headaches: An observational study. Cephalalgia. 2013;33(6):384–389. doi:10.1177/0333102413476374

Pain is weird. You only feel it in your brain… yet your brain has no pain receptors.

In part 1 of this 3-episode series, we unpack why pain is less a “signal” and more a decision your nervous system makes to feel it, shaped by reflexes, memory, mood, and context. You will learn why a hot stove makes you yank your foot back before you even feel anything, how “sharp” and “throbbing” travel on different nerve highways, and why chronic pain can become a disease of its own.

We discuss mind-bending paradoxes like phantom limb pain, referred pain (why heart attacks can hurt in your arm/jaw rather than your heart), and why two people with the same injury can rate pain totally differently.

 

Bibliography:

Greenwald BD (2012). Can the Brain Itself Feel Pain? BrainLine.

Derderian C, Shumway KR, Tadi P (2023). Physiology, Withdrawal Response. StatPearls.

Nicholas M et al. (2019). The IASP classification of chronic pain for ICD-11: chronic primary pain. PAIN 160(1): 19–27pmc.ncbi.nlm.nih.gov.

de Almeida KPO et al. (2020). Chronic Facial Pain: Trigeminal Neuralgia… Int J Environ Res Public Health 17(19):7012mdpi.com.

Mills SEE et al. (2019). Chronic pain: a review of its epidemiology… Br J Anaesth 123(2): e273–e283pmc.ncbi.nlm.nih.gov.

Limakatso K et al. (2020). The prevalence and risk factors for phantom limb pain… PLoS ONE 15(10):e0240431journals.plos.org.

Venda Nova C et al. (2020). Treatment outcomes in trigeminal neuralgia – a systematic review. World Neurosurg X 6:100070pubmed.ncbi.nlm.nih.gov.

Melzack R (1975). The McGill Pain Questionnaire: major properties and scoring methods. Pain 1(3):277–299sralab.org.

This episode dives into cultural sleep patterns, the science-backed benefits and timing of naps, and how circadian rhythms and so-called "sleep pressure" affect night time sleep.

It also covers sex and age differences in sleep needs, the risks of too little or too much sleep, and practical sleep hygiene tips to improve sleep quality.

Bibliography:

Blume C, Garbazza C, Spitschan M. Effects of light on human circadian rhythms, sleep and mood. Somnologie (Berl). 2019 Sep;23(3):147-156. doi: 10.1007/s11818-019-00215-x. Epub 2019 Aug 20. PMID: 31534436; PMCID: PMC6751071.

Chen, Chun-Lin et al. “Associations among sleep quality, sleep duration, and Alzheimer's disease biomarkers: A systematic review and meta-analysis.” Alzheimer's & dementia : the journal of the Alzheimer's Association vol. 21,3 (2025): e70096. doi:10.1002/alz.70096

Hudachek, Lauren, and Erin J Wamsley. “A meta-analysis of the relation between dream content and memory consolidation.” Sleep vol. 46,12 (2023): zsad111. doi:10.1093/sleep/zsad111

Dutheil, F.; Danini, B.; Bagheri, R.; Fantini, M.L.; Pereira, B.; Moustafa, F.; Trousselard, M.; Navel, V. Effects of a Short Daytime Nap on the Cognitive Performance: A Systematic Review and Meta-Analysis. Int. J. Environ. Res. Public Health 2021, 18, 10212. https://doi.org/10.3390/ijerph181910212

Cappuccio FP, D'Elia L, Strazzullo P, Miller MA. Sleep duration and all-cause mortality: a systematic review and meta-analysis of prospective studies. Sleep. 2010 May;33(5):585-92. doi: 10.1093/sleep/33.5.585. PMID: 20469800; PMCID: PMC2864873.

Sabia, S., Fayosse, A., Dumurgier, J. et al. Association of sleep duration in middle and old age with incidence of dementia. Nat Commun 12, 2289 (2021). https://doi.org/10.1038/s41467-021-22354-2

This episode explores why sleep is SUPER important for body repair, immune function, literally cleaning your brain, and protecting you from diseases like Alzheimer's.

We get into some FUN topics like dreams: why we dream, whether there are any benefits to dreaming, and how sleep is different for different animals.

Give it a listen, and stay tuned for part two!

Bibliography:

Blume C, Garbazza C, Spitschan M. Effects of light on human circadian rhythms, sleep and mood. Somnologie (Berl). 2019 Sep;23(3):147-156. doi: 10.1007/s11818-019-00215-x. Epub 2019 Aug 20. PMID: 31534436; PMCID: PMC6751071.

Chen, Chun-Lin et al. “Associations among sleep quality, sleep duration, and Alzheimer's disease biomarkers: A systematic review and meta-analysis.” Alzheimer's & dementia : the journal of the Alzheimer's Association vol. 21,3 (2025): e70096. doi:10.1002/alz.70096

Hudachek, Lauren, and Erin J Wamsley. “A meta-analysis of the relation between dream content and memory consolidation.” Sleep vol. 46,12 (2023): zsad111. doi:10.1093/sleep/zsad111

Dutheil, F.; Danini, B.; Bagheri, R.; Fantini, M.L.; Pereira, B.; Moustafa, F.; Trousselard, M.; Navel, V. Effects of a Short Daytime Nap on the Cognitive Performance: A Systematic Review and Meta-Analysis. Int. J. Environ. Res. Public Health 2021, 18, 10212. https://doi.org/10.3390/ijerph181910212

Cappuccio FP, D'Elia L, Strazzullo P, Miller MA. Sleep duration and all-cause mortality: a systematic review and meta-analysis of prospective studies. Sleep. 2010 May;33(5):585-92. doi: 10.1093/sleep/33.5.585. PMID: 20469800; PMCID: PMC2864873.

Sabia, S., Fayosse, A., Dumurgier, J. et al. Association of sleep duration in middle and old age with incidence of dementia. Nat Commun 12, 2289 (2021). https://doi.org/10.1038/s41467-021-22354-2