Effects of mirthful laughter on pain tolerance: A randomized controlled investigation, 2019, Lapierre et al

Andy

Andy

Senior Member (Voting rights)
Introduction
Chronic pain is a debilitating condition that affects many people. Currently, there is no single treatment known to cure or assure relief from chronic pain. Accordingly, the management of patients’ discomfort is an integral part of treating chronic pain. Such treatment, however, is not effective for many patients. We investigated whether mirthful laughter provided by comic relief can influence pain tolerance and muscle soreness in young healthy participants.

Methods
Forty participants underwent a randomized controlled cross-over designed experiment. Each participant was exposed to a comedy video eliciting mirthful laughter and an uninteresting documentary. Delayed onset muscle soreness was induced in one leg at a time by eccentric exercise. Pain tolerance was tested using blunt force application and assessed subjectively using a visual analog scale.

Results
Watching the comedy video elicited a significantly greater irregular breathing pattern compared with watching the documentary video (p < 0.001). After watching the comedy, the participants’ positive affect was increased (Δ2 ± 1) while it was largely decreased (Δ-11 ± 2) after watching the documentary video (p < 0.001). Pain tolerance was decreased by 17 ± 5 N after viewing the documentary video (p < 0.001), but did not change significantly after watching the comedy.

Conclusions
Thirty minutes of watching a comedy eliciting laughter favorably influenced pain tolerance in healthy humans.
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Paywall, https://www.bodyworkmovementtherapies.com/article/S1360-8592(19)30118-4/fulltext
Scihub, https://sci-hub.se/10.1016/j.jbmt.2019.04.005
 
Andy said:
Paywall, https://www.bodyworkmovementtherapies.com/article/S1360-8592(19)30118-4/fulltext
Scihub, https://sci-hub.se/10.1016/j.jbmt.2019.04.005
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Only reading the abstract, but:

Pain tolerance was decreased by 17 ± 5 N after viewing the documentary video (p < 0.001), but did not change significantly after watching the comedy.

Conclusions
Thirty minutes of watching a comedy eliciting laughter favorably influenced pain tolerance in healthy humans.
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That seems a bit of an odd way of phrasing it. How bad was this documentary?!
 
The documentary was boring and they've become more fed up of their pain whilst watching it.

Edit: just realised they are healthy patients. OK, so the documentary was so boring that it made them in a bad mood and so less tolerant of pain?
 
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How could someone do such a bad study (I'm referring to both the design and the conclusions which they drew). These people surely have a science degree. My degree was only like 25% science, and this paper could have been used as an example of glaringly bad research in, like, one of our first classes on evaluating research, and I guarantee you that everyone in the class would have seen problems in it.
 
Is it laughter than might do it - or is it the distraction? When I think of all the other distractions I employ to take my mind off the [include symptom of your choice] they all perform similarly depending of course on the severity of the symptom at the time. Sure, I can laugh myself into a peeing situation and I won't feel no pain - although laughter does seem to do unpleasant things to my body too especially in my head and it can affect my ability to stand... - but I'm not about to order a supply of laughing gas :)
 
From the abstract :

Chronic pain is a debilitating condition that affects many people. Currently, there is no single treatment known to cure or assure relief from chronic pain.
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When did "chronic pain" become a separate condition in its own right? It doesn't usually manifest without a reason. How much time, effort, and resources do doctors actually spend on identifying the cause? They just label the patient in various nasty ways and kick them out the door.
 
Thirty minutes of watching a comedy eliciting laughter favorably influenced pain tolerance in healthy humans.
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This is a non-sequitur, because they found no difference in pain tolerance to the blunt force after the comedy.

Pain tolerance in the sore leg decreased 17 ± 5 N after viewing the documentary (p < 0.001, ES = 0.50), but did not change significantly after watching the comedy (Fig. 2). Similar trends were seen in the control (non-sore) leg (p < 0.001, ES ¼ 0.43) (21 ± 5 N vs. 2 ± 3 N).
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This is important as it shows that the reduction in pain tolerance has nothing to do with the induced soreness in the limb due to exercise. Hence it is possible to assume that no drop in pain tolerance is the expected result and there is something peculiar/uncontrolled bias going on in the documentary group. The study curiously was a crossover design with a single investigator that performed all the experiments, which could have biased the result. There was no control measure of altered pain sensitivity independent of the video watching.

There were no significant changes in the VAS score from viewing either video. There were no significant differences in pain tolerance between the comedy and documentary at 24 h after viewing the videos.
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There was no relationship between the quantity of laughing and the change in pain tolerance after watching the comedy.
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The current findings contradict a previous study reporting that watching a humorous film did not reduce pain compared with a documentary film (Nevo et al., 1993).
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Random thoughts (beyond "oh FFS" and problems others have already mentioned):

Chronic pain is not the same as acute pain. And the VAS is mostly pointless with chronic pain. Helpful for triaging acute pain but by and large measure function is more important with regard to chronic pain.

How does one measure whether laughter is "mirthful" or not?


Arnie Pye said:
When did "chronic pain" become a separate condition in its own right?
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Alas, Chronic Pain Syndrome is a diagnosis (ICD-10 code G89.4). My own clinician uses for my unexplained chronic wide-spread burning pain (i.e. I don't have a clue what is causing this so let's just use this diagnosis...). The argument for its use as a diagnosis in its own right has been that chronic pain causes neuroplastic effects (I'm probably not phrasing that correctly but then the folks using this line of thinking are probably a wee bit muddled in their own thinking...:whistle:) that become a disease in and of itself regardless of what is causing the pain, though MUS reinforce the need for greater psychosocial emphasis in its treatment.
 
Michelle said:
I don't have a clue what is causing this so let's just use this diagnosis...
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I do know what is causing a lot of my chronic pain. I had surgery in 2003 that massively reduced my chronic pain in the area that was operated on, and the surgery still has benefits nearly 17 years later. I do get pain where I was operated on but it is a shadow of what it was in the 70s, 80s, 90s and the early 2000s. Nobody will look into investigating the other areas I get pain even though they are caused by the same problem I had in the area I was operated on. I've been told I'm just imagining all my ill-health and chronic pain, it's all in my head, there is nothing wrong with me etc.
 
Arnie Pye said:
I've been told I'm just imagining all my ill-health and chronic pain, it's all in my head, there is nothing wrong with me etc.
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Yes, as a kid I got the same thing. "Growing pains" or that it was psychosomatic. Thankfully as an adult, my PCPs (aka GPs) have always taken my pain seriously. They just don't know what's causing it. Diagnoses have ranged from Fibromyalgia to Peripheral Neuropathy to hEDS to Chronic Pain Syndrome to, of course, Pain, non-specific. I think they tend to just pick whichever one insurance is most likely to pay for treatment of (things like physical therapy or pain medications). While I'd much rather my clinician simply state "I don't know" when he or she doesn't, insurance is less accepting of that answer. Which is one of the reasons why we're in such a muddle about things like Fibromyalgia and hEDS, imho.
 
Good grief this is pathetic.

How does that even pass peer review? Chronic pain studied via acute pain in healthy people? Why not actual patients?
Pain tolerance ... did not change significantly after watching the comedy.

Conclusions
Thirty minutes of watching a comedy eliciting laughter favorably influenced pain tolerance in healthy humans.
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Did not change = favorably influenced? Down is up?

Aspirations are a valid conclusion now? This is deeply unserious.
 
Trish said:
I haven't read the paper, and I'm not going to but, er, what's ''mirthful laughter''. I mean here's a definition of mirth: amusement, especially as expressed in laughter. So isn't all laughter mirthful?
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Trish, you should know better! :emoji_wink:Characters in Harry Potter are several times described as laughing mirthlessly.

E.g.
"‘He’s got Dark powers the rest of us can only dream of!’ Pettigrew shouted shrilly. ‘How else did he get out of there? I suppose He Who Must Not Be Named taught him a few tricks!’ Black started to laugh, a horrible, mirthless laugh that filled the whole room. ‘Voldemort, teach me tricks?’ he said."

Plus think of Sirius laughing when he is captured after Pettigrew blows up the street...

I know I'm being facetious but I don't care because frankly any opportunity to quote harry potter...
 
I am fairly sure that 'mirthful laughter' does not have a precise scientific meaning.

Which doesn't bode well when combined in the same sentence as 'a randomized controlled investigation'.

But...surely mirth is something that only happens at certain types of festivities, where possibly large amounts of alcohol are consumed, so perhaps it could be defined in terms of someone's blood alcohol level?
 
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