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Placebo and nocebo effect in pain
Carmen-Édith Belleï-Rodriguez1, Luana Colloca2
1Department of Pain Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, MD, United States; Faculty of Nursing, University of Montreal, Montreal, QC, Canada.
Handbook of Clinical Neurology
|October 29, 2025
Summary
The placebo effect influences pain perception through descending pain processing and analgesia, particularly impacting the motivational-affective dimension. Understanding these complex mechanisms is key for effective pain management.
Area of Science:
- Neuroscience
- Pain Management
- Psychology
Background:
- Pain modulation mechanisms are crucial for understanding the placebo effect.
- The placebo effect influences multiple dimensions of pain perception.
Purpose of the Study:
- To explore the neurophysiological underpinnings of placebo-induced pain modulation.
- To emphasize descending pain processing and placebo-induced analgesia in chronic pain.
Main Methods:
- Focus on the motivational-affective dimension of placebo responses.
- Examines the roles of expectations, past experiences, and social learning.
- Considers individual characteristics like age, sex, gender, race, and sleep patterns.
Main Results:
- Placebo effect modulates nociceptive, sensory-discriminative, and cognitive-affective pain dimensions.
- Motivational-affective dimension significantly impacts placebo responses.
- Individual factors interact to influence placebo-induced pain relief.
Conclusions:
- Placebo-induced pain relief is complex and multifactorial.
- Further research is needed to optimize clinical outcomes by understanding interacting factors.
- Elucidating these mechanisms is pivotal for advancing pain management strategies.
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