Placebo and nocebo effect in pain

Abstract

Understanding the mechanisms of pain modulation is pivotal for elucidating the role of the placebo effect in pain management. This chapter addresses the neurophysiological underpinnings of pain modulation induced by the placebo effect, emphasizing the mechanisms of descending pain processing and placebo-induced analgesia in chronic pain conditions. The placebo effect can modulate various dimensions of pain perception, including the nociceptive, sensory-discriminative, and the cognitive-affective dimensions. In this chapter, the focus is on the motivational-affective dimension and its significant impact on placebo responses, particularly focusing on the roles of expectations, past experiences, and social learning. Additionally, the placebo effect is influenced by individual characteristics, such as age, sex, gender, race, and sleep patterns. Highlighted are the complexity of placebo-induced pain relief and the need for further research into these interacting factors to optimize clinical outcomes.

Keywords: Conditioning; Expectation; Orofacial pain; Pain; Social learning.