Effect of Auditory Cues on Placebo-Induced Hypoalgesia Using a Deactivated Transcutaneous Electrical Nerve...

Background Placebo responses can be influenced by contextual and sensory cues. This pilot randomized controlled study investigated whether auditory cues modulate the analgesic response associated with a deactivated transcutaneous electrical nerve stimulation (TENS) intervention. Methods Thirty-eight healthy adults (aged 18-38) were randomly assigned to receive a deactivated TENS intervention with synchronized auditory cues or without sound. Participants were informed that the device was a modern, sensation-free TENS unit designed to relieve pain. Interventions were delivered in a single session under participant and assessor blinding. Pressure pain thresholds (PPT) were measured before and after the intervention using a handheld pressure algometer. Results The sound-enhanced group demonstrated a statistically significant increase in PPT following the intervention (p = 0.03), whereas no significant change was observed in the silent group. No significant baseline differences were identified between groups. Conclusions Auditory cues may augment the analgesic response within a sham TENS intervention in healthy individuals. These preliminary findings highlight the potential role of contextual sensory factors in modulating pain perception. However, given the pilot nature of this study and its retrospective trial registration, results should be interpreted with caution and require replication in larger, adequately powered trials before any generalizations can be drawn.