Placebo effect in pain syndrome
Psychological analysis of pain has shown the possibility of its regulation through personal processes. Psychopharmacologist, MD, Professor Izyaslav Lapin on the analgesic placebo effect.
What you will learn in the article
- How psychological analysis of pain supports regulation through personal processes
- Why the analgesic placebo effect is compared with standard analgesics by time-effect curve and cumulation
- How surgical intervention can produce an analgesic placebo effect
- Why expectation, learning and anxiety are discussed in explanations of placebo pain relief
- How placebo effects in duodenal ulcer and dentistry are used as examples of pain relief
Table of Contents
Although the analgesic placebo effect varies greatly, it often exceeds the average for a positive placebo effect of 33%. The placebo effect in pain syndromes of different localization and origin is characterized by the same features (time-effect curve, peak of maximum action, cumulation) as the effect of standard analgesics. Surgical intervention can have an analgesic placebo effect, which is often not taken into account in group assessments of the effectiveness of spinal surgery.
Patients, as a rule, are not aware of their analgesic placebo effects, and therefore, as in all cases, it was not possible to determine the personality profile of placebo reactors.
The explanation of the analgesic placebo effect most often emphasizes the role of anxiety, the phenomena of expectation and learning.
The analgesic placebo effect naturally has a positive effect on the outcome of any treatment, including surgical treatment, in which the patient and the doctor believe in the effectiveness. At the same time, the placebo effect plus favorable periods of the course of the disease can create a false impression about the effectiveness of any particular treatment method, and the true causes of pain relief or disappearance may remain unclear.
It is probably the high analgesic placebo effect that has determined the practice of prescribing placebos by hospital nurses, when in 89% of cases pain complaints are the indication for prescribing.
In patients with duodenal ulcer, placebo eliminated pain to the same extent as antacid. As with all other diseases studied, the magnitude of the positive placebo effect varied depending on the personality of the investigating physician. In dentistry, the analgesic placebo effect in postextraction pain, localized osteitis, and myofascial syndrome is also very high. The analgesic placebo effect in dentistry is analyzed in detail in the reviews devoted to this issue.
Postoperative pain is relieved by both placebo and naloxone, but by different mechanisms.
Source: Lapin I. P. “Placebo and therapy”
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Key takeaways
- The analgesic placebo effect often exceeds the average positive placebo effect of 33%
- Placebo pain effects can show the same time-effect curve and maximum action peak as standard analgesics
- Patients are usually not aware of their analgesic placebo effects
- In 89% of hospital nurse placebo prescriptions, pain complaints were the indication
- In duodenal ulcer patients, placebo eliminated pain to the same extent as an antacid
Published
July, 2024
Duration of reading
1-2 min
Category
The placebo
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