Placebo, nocebo, and neuropathic pain

Pain
Lene VaseKathryn T Hall

Abstract

Over the last decade, the apparent increase in placebo responses in randomized controlled trials (RCTs) of neuropathic pain have complicated and potentially limited development and availability of new effective pain medication. Placebo analgesia and nocebo hyperalgesia effects are well described in nociceptive and idiopathic pain conditions, but less is known about the magnitude and mechanisms of placebo and nocebo effects in neuropathic pain. In neuropathic pain, placebo treatments have primarily been used as control conditions for active agents under investigation in RCTs and these placebo responses are typically not controlled for the natural history of pain and other confounding factors. Recently, mechanistic studies that control for the natural history of pain have investigated placebo and nocebo effects in neuropathic pain in their own right. Large placebo analgesia but no nocebo hyperalgesic effects have been found, and the underlying mechanisms are beginning to be elucidated. Here we review placebo and nocebo effects and the underlying mechanisms in neuropathic pain and compare them with those of nociceptive and idiopathic pain. This allows for a novel discussion on how knowledge of psychological, neurobiological, and g...Continue Reading

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Jan 24, 2018·BMC Musculoskeletal Disorders·Giacomo RossettiniMarco Testa
Feb 17, 2017·Nature Reviews. Disease Primers·Luana CollocaSrinivasa N Raja
Jul 31, 2018·Pain Research & Management : the Journal of the Canadian Pain Society = Journal De La Société Canadienne Pour Le Traitement De La Douleur·Xaver FuchsRobin Bekrater-Bodmann
Jan 19, 2021·BJA Education·J S PerfittS Jones

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