Pain in Europe VIII – 8th EFIC Congress, 9–12 October 2013, Florence

Laughter and humour can help chronic pain patients increase their pain tolerance and improve their quality of life – and provide more job satisfaction in the interdisciplinary pain team. This has been demonstrated by Swiss pain specialists who presented their concept to the Congress of the European Pain Federation EFIC in Florence.

Florence, 10 October 2013 – Laughter is the best medicine according to the popular proverb. The fact that humour can actually provide relief to chronic pain patients was reported by a team of Swiss experts at the Congress of the European Pain Federation EFIC in Florence. “Humour is a suitable strategy for increasing pain tolerance on the one hand and for improving the quality of life in chronic pain patients on the other,” said Thomas Benz (RehaClinic Zurzach, Switzerland). "Another positive aspect is that humour also encourages job satisfaction in members of an interdisciplinary pain team.” Targeted humour interventions should therefore be given a place in multimodal pain therapy concepts, according to the experts.

A possible explanation for the positive effects of laughter and humour could be that humour activates the release of endorphins and relieves muscular tension, thus having an effect on pain on both a mental and physical level. “As a result, humour helps to reflect pain, thus helping both the patients as well as their carers to deal better with stress,” said Prof Willibald Ruch, Zurich University. “Humour can be used specifically as a cognitive technique, for example in terms of a distraction to control the pain and increase pain tolerance.”

The laughter, however, needs to “come from the heart” in order to relieve pain, said Prof Ruch. “Our studies show that only 'real' delight, actually experienced and accompanied by a Duchenne expression, leads to increased pain tolerance.” An indicator for the “Duchenne smile” is that not only are the corners of the mouth pulled upward, but that also the eyes are involved showing the typical small wrinkle at the outer corners. Prof Ruch stated that “smiles and laughter that are faked or underlaid by negative feelings did not lead to this effect.” Studies by the Swiss researcher also showed that the effect of laughter has a lasting effect. In one of his studies it was showed that people watching a Monty Python film or one by the Swiss comedian Emil and laughing were able to keep their hands in ice water longer than those who were not laughing. “Subsequent measurement showed that the increased pain tolerance was also present 20 minutes after laughing.”

“Currently we are still on new ground in terms of therapeutic use of humor,” said Thomas Benz. Although there is to date no uniform consensus on how the positive effects of humour on pain perception and its processing can best be applied in the clinical setting, previous experience with the phenomenon of “laughter as pain killers” is promising, according to the expert. “Humour groups, direct humour, clownish humour or humour diaries are tools of humour intervention that can be applied in an interdisciplinary pain management approach. In our clinic, such methods have already become an integral part of rehabilitation and pain management, showing sustainable effectiveness,” said Thomas Benz.

Source: EFIC Summary Benz et al, Humor – A New Strategy for Pain Treatment in Multidisciplinary Programs?

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