Pain Management – it’s a sham

If we posit that pain is an output of the brain that is based on the perception of threat, it would follow that decreasing threat, whatever it may be, would positively influence a person’s pain experience. This has led to some exciting therapeutic advances aimed at altering threat, which include encouraging patients to rewrite their pain experience … [Read more...]

Placebo responses and central neuropathic pain: from meta- to pooled analysis of clinical trial data

Defined as a reduction in pain without a biologically active therapeutic, the placebo response includes the placebo effect (i.e., psychobiological factors that cause a reduction in rating) in addition to other contributing factors, such as natural and expected fluctuations in pain [4]. To improve the design of future clinical trials, recent work … [Read more...]

When is a Placebo Acceptable in the Clinic?

We recently published a paper with the mouthful title “Placebo Use in Pain Management:  A Mechanism-Based Educational Intervention Enhances Placebo Treatment Acceptability”[4].  Before I get to the the findings from that paper, I’d like to provide some context of where this paper fits in the larger placebo analgesia literature. Placebo is not … [Read more...]

Learning from others pain. Nocebo hyperalgesia induced by social observational learning

In 2009 Luana Colloca and Fabrizio Benedetti (Colloca & Benedetti, 2009) proved that placebo analgesia can be induced by social observational learning. Since sex seems to be an important factor that affects pain perception, placebo analgesia, and social observational learning, we wanted to study the effect of the sex of both the model and … [Read more...]

Putting the placebo out to pasture

I’ve long had this kind of fascination with the placebo effect, it’s like a kind of magic that even grownups are allowed to believe in. In fact, it’s a magic trick so good that you’d considered a bit off if you didn’t believe in it. This being the case I found it a bit traumatic when I first read a review of placebo effects in clinical trials that … [Read more...]

Placebo Analgesia

One of the best workshops I attended at the IASP congress in Milano was on placebo analgesia, run by three very classy speakers: Luana Colloca, Ulrike Bingel, and Regine Klinger. I learnt lots about the neurobiological mechanisms of placebo and nocebo, and came away with lots to ponder.  This is what I learnt: The rostral anterior cingulate … [Read more...]