Thursday, December 8, 2011

Swearing to Beat Pain – Dubious Science Revisited

Research Update Swearing can help to relieve acute pain, investigators have reported for a second time. Such is the state of research in the pain management field, that research of questionable importance is not only worth doing, but doing again. And, why it would merit a lengthy article in a supposedly sagacious pain journal is perplexing. Was this a joke?

More than two years ago, in an UPDATE [here], we first described a study that investigated the benefits of swearing to help relieve the pangs of acute pain. It was a rather novel experiment that attracted much news media attention at the time. Richard Stephens and colleagues from Keele University in the United Kingdom had 64 college student volunteers hold their hands in a tub of ice water (a cold-pressor pain test) for as long as possible while repeating a swear word of their choice; each then repeated the experiment but using a commonplace word they would use to describe a table.

While swearing, subjects’ heart rates increased and they were able to tolerate the ice-water-induced pain for significantly longer periods of time. Apparently, swearing — that is, cussing or the use of offensive or obscene language — triggers both emotional and physical responses that squelch pain perception; a sort of “stress-induced analgesia.” Good to know… but we warned readers not to try the experiment on their own at home.

Apparently not fully satisfied with the results from this first experiment, Stephens wanted to know if people who normally swear frequently in daily life might not benefit as much from swearing at pain. So he, along with Claudia Umland, rounded up another group of hapless college students (N=71) to repeat the experiment. This time, however, students were first asked how often they normally swear in a typical day [Stephens and Umland 2011].

Writing in the December 2011 edition of the Journal of Pain published by the American Pain Society, the researchers again found that students could withstand painfully cold water significantly longer by repeatedly swearing, as compared with reciting a neutral word; thus, verifying results from the first study. And, in this latest iteration of the experiment, they found that people who do not usually swear very often could hold their hands in ice-cold water significantly longer when they used foul language than students who regularly pepper their conversations with curse words.

This makes sense: if a person is accustomed to cussing, the benefit of swearing to reduce pain loses its impact. Or, as the researchers concluded in a news article [here], "Used in moderation, swearing can be an effective and readily available short-term pain reliever if, for example, you are in a situation where there is no access to medical care or painkillers. However, if you’re used to swearing all the time, our research suggests you won’t get the same effect.”

So, the best advice seems to be to clean up your language and swearing will do more good the next time you stub a toe or smash a finger. Again, however, we suggest not intentionally putting this to a test at home.

COMMENTARY: Our disappointment with this sort of research is that the first time around it was a rather novel, somewhat entertaining, look at an everyday occurrence — cursing at a painful mishap. Now, with this second published report on the same basic concept we are wondering if this is what passes as serious science these days in the pain management field.

As a small-scale experiment, the study actually was adequately designed and well-executed, with meticulous statistical analyses. However, a major flaw might have been a poorly quantified self-estimate of daily swearing among participants, which was a critical independent variable.

The authors note that past research has determined that people “utter, on average, approximately 80 to 90 swear words per day”; which seems somewhat unbelievable. In contrast, the average number of daily swear words per day estimated by the college students was only 18.80 words for males, 11.51 for females. We question (a) whether college students really keep good track of how many times they cuss in a day, and (b) whether those estimates were accurate — or, were these British students just particularly well-mannered as compared with “average” people.

Finally, we wonder why this study merited a full, 8-page article complete with tables and graphs in the Journal of Pain. Surely, the American Pain Society must have more consequential research at hand to fill its journal’s pages — or, maybe not.

We also wondered if perhaps this article was part of a special holiday edition intended to have a whimsical theme, like the British Medical Journal does in their end-of-year issue. For example, we recall such an article in BMJ bemoaning the lack of randomized controlled trials on the effectiveness of parachutes in preventing painful death; a major obstacle discussed was recruiting subjects for the control condition of jumping from an airplane without a parachute.

As far as we can tell, this study of swearing to beat pain in the Journal of Pain was not intended as a joke. Enough said.

REFERENCE: Stephens R, Umland C. Swearing as a Response to Pain — Effect of Daily Swearing Frequency. J Pain. 2011(Dec);12(12):1274-1281 [abstract here].

Postscript 12/27/2011: After grousing about the study above, and questioning why any serious journal would devote space to it, we recently revisited the journal edition in which it appeared. In fair balance we must note that the other articles in that edition seem quite worthwhile and important, and we plan to do UPDATES in the near future on several of them. —SBL