A feasibility study into the placebo- and nocebo-effects of open-label verbal suggestion on expectation, pressure-pain threshold and pain perception in ESO students.
Item
- Title
- A feasibility study into the placebo- and nocebo-effects of open-label verbal suggestion on expectation, pressure-pain threshold and pain perception in ESO students.
- Author(s)
- Cleave, A
- Abstract
- Background: Pain is influenced by nociceptive inputs and contextual factors. Positive verbal suggestions are associated with reduced expectation of pain, and analgesia. Clinically, placebo- and nocebo-effects influence patient outcomes. However, the effects of verbal suggestion alone have not been explored. Objective: To investigate the placebo- and nocebo-effects of verbal suggestion on expectation, pressure-pain threshold (PPT) and pain perception (PP). Design: Feasibility study, independent measures, randomised controlled trial (RCT). Methods: Participants were screened using the exclusion criteria: conditions causing excessive pain or bruising, current pain >7/10, and recent analgesia, and allocated to one of three pre-randomised groups. The placebo group received the suggestion of less pain and words of emotional reassurance, the nocebo group received the suggestion of more pain and pain-related words, while the control group received no verbal suggestion. Outcome measures: expectation, PPT and PP were recorded. Non-parametric Kruskal-Wallis and Mann-Whitney U were used to establish differences between groups. Results: 114 participants (female=64 and male=50) were recruited. There were significant differences in expectation of pain between placebo and nocebo groups p=0.0053, and in PPT between the placebo and nocebo groups p=0.0016, and placebo and control p=0.0445. For PPT there were significant differences between genders. For women the effect on PPT was stronger than for men, significant between placebo and nocebo p=0.0225, placebo and control p=0.0104, and for men, non-significant p=0.6521. Discussion: Results suggest placebo verbal suggestion reduces expectation of pain, while nocebo verbal suggestion increases expectation of pain. Paradoxical results for PPT suggests expectation of more pain increases PPT, while expectation of less pain decreases PPT. Conclusion: Verbal suggestion has effects on expectation and PPT. Therefore, as part of a biopsychosocial framework clinicians should integrate skilful verbal communication with their specific therapeutic interventions. However, from this study the results for PPT are unexpected. For this reason, this study should be repeated with a larger sample size to confirm these results.
- presented at
- European School of Osteopathy
- Date Accepted
- 2020
- Date Submitted
- 28.10.2020 18:08:18
- Type
- osteo_thesis
- Language
- English
- Submitted by:
- 62
- Pub-Identifier
- 16653
- Inst-Identifier
- 1229
- Keywords
- Nocebo, pain, placebo, verbal suggestion.
- Recommended
- 0
- Item sets
- Thesis
Cleave, A, “A feasibility study into the placebo- and nocebo-effects of open-label verbal suggestion on expectation, pressure-pain threshold and pain perception in ESO students.”, Osteopathic Research Web, accessed April 29, 2024, https://www.osteopathic-research.com/s/orw/item/202