How does the brain process pain, and how do our thoughts, feelings and actions influence the perception of pain, but also the effectiveness of treatments? What significance do patients' expectations and previous experiences have on the success of treatment? And how can we use these effects to improve pain therapy? Prof. Ulrike Bingel is researching the answers to these questions
Prof. Dr. med. Ulrike Bingel is Director of the Interdisciplinary Centre for Pain Medicine at the University Hospital Essen and spokesperson of the Collaborative Research Centre Treatment Expectation
A significant proportion of the effect of pain treatments – sometimes up to 70% – is based on expectation effects.
Prof. Ulrike Bingel, Director of the Interdisciplinary Centre for Pain Medicine at the University Hospital Essen and spokesperson of the Collaborative Research Centre Treatment Expectation
I am the director of the Interdisciplinary Centre for Pain Medicine at the University Hospital Essen (AöR). As a neurologist, I mainly treat patients with chronic pain, i.e. pain that persists for several months or keeps returning: back pain, nerve pain, headaches or pain arising in relation to other illnesses. I also devote a large part of my working day to research. This dual role as a medical doctor and a scientist, in my case of neurology and neuroscience, is also known as "clinician scientist".
And there are many exciting questions that interest me and my team in this regard:
- How does the brain process pain, and how do our thoughts, feelings and actions influence the perception of pain, but also the effectiveness of treatments?
- What role do patients' expectations and past experiences play in the success of a treatment? And how can we utilise these effects to bring about a better treatment of pain?
- How do we avoid the harmful effects of negative expectations, fears and worries - the so-called nocebo effects?
I find this to be a fascinating and clinically very important field of research. Because the answers to these questions could make treatments more effective and more tolerable, enabling us to provide more effective help for patients with chronic pain, but also patients with other diseases.
I studied medicine at the University of Essen and in London, trained as a neurologist in Hamburg, and spent time conducting research in the USA and Oxford. Since 2013, I have been a Professor of Clinical Neuroscience at the Medical Faculty of the University of Duisburg-Essen.
Prof. Ulrike Bingel: Physician and scientist
How I became committed to the field of chronic pain and pain therapy
I have always been interested in and curious about a lot of things. I was inspired by the topic of pain – at that time especially headache – by a professor (Prof. Peter Goadsby) whom I had the chance to meet during my internship year at the renowned Queens Square Hospital in London. I then started researching the brain and pain and underwent clinical training as a pain therapist, so one thing led to another.
That is many years ago now, but the unanswered questions have not lessened, although we have already gained many relevant insights and findings through functional imaging of the brain, among other things. Chronic pain, however, continues to be a major problem on a global and societal level and, above all, of course, for the individual patients and their families. The key to more effective treatments and preventive measures is an even better understanding of what happens in the brain and the rest of the nervous system.
Why I find placebo research so fascinating
So-called placebo effects are not the effects of sugar tablets or other sham treatments, but rather the interactions of cognitive processes, i.e. our expectations and past experiences, with physiological - i.e. bodily - processes. What exactly happens in the brain and body in this process is incredibly exciting to me. I am particularly motivated by the potential that lies beneath the understanding of these processes. If we could optimise the combination of the "biological pharmacy" controlled by our brain with established and newly developed treatment, this would – in my view - spark a brand-new era in medicine.
Last but not least, I am also fascinated by the question of how and why evolution has equipped us with these phenomena. No scientist or physician can answer all these questions alone. This research takes place at the intersection of many fields - that's very inspiring, and one is always learning something new.
What brings me joy in life
It makes me happy and I also feel very privileged that I get to spend (almost) the entire day dealing with these exciting questions. For me personally, the coexistence of the clinical side and the scientific side is not a double burden; rather, these two sides (apart from some tedious administrative matters) mutually stimulate and drive each other. The dialogue and cooperation across many disciplines within my wonderful team and with the many colleagues with whom I have been working nationally and internationally for a long time bring me great joy.
In my private life, I find happiness in the company of loved ones, in nature, in exercise and in good food, which is ideally cooked by someone else :).