Nocebo hyperalgesia can be induced by the observation of a model showing natural pain expressions

Key Points

1. Patients’ pain and expectation of pain can be influenced through observation.

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BACKGROUND & OBJECTIVE

Nocebo hyperalgesia is a worsening of pain through contexts such as conditioning or verbal suggestion (1). This has a powerful impact from social influences that can alter pain behavior. Studies have started to show that observing a model demonstrate pain can induce nocebo hyperalgesia, however the previous studies on this topic did so in a non-natural human way of expressing pain (1). Given that pain has a social communicative role, this study looked to build on prior papers by increasing the ecological validity through using facial expressions of pain as a component of inducing the nocebo hyperalgesia.

Nocebo hyperalgesia is a worsening of pain through contexts such as conditioning or verbal suggestion.

This study showed that simple observation of an intervention with subsequent painful facial expressions led to an increase in pain expectation.

METHODS

In this study 80 female participants went through a 2x2 mixed design where participants were randomized into 1 of 2 groups – nocebo condition, or control – with a subdivision of receiving first hand stimulation with or without ointment application.

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