Klaus Linde

Karin Meissner

More invasive and impressive therapeutic rituals are generally believed to be more powerful interventions than less impressive ones. This chapter reviews and discusses evidence from randomized clinical trials and meta-analyses for such a differential effectiveness of placebo interventions. Evidence from clinical research that different types of placebo are regularly associated with different magnitudes of placebo effect is limited. However, one area where hints from a variety of sources are accumulating is sham acupuncture in the treatment of pain. Furthermore, there is preliminary evidence that sham surgery and ambiguous evidence that sham injections are associated with enhanced placebo effects on pain. Among the factors that may account for a greater effectiveness of such treatment procedures are the lively perceptual context of the procedures themselves, the attention and enhanced emotional support by healthcare providers, and the increased expectation and motivation of patients. A differential effectiveness of placebo control procedures in clinical trials would have important implications for clinical research.

Chapter 23. What are the Best Placebo Interventions for the Treatment of Pain?

Placebo and Pain

Luana Colloca

Magne Arve Flaten

The placebo effect continues to fascinate scientists, scholars, and clinicians, resulting in an impressive amount of research, mainly in the field of pain. While recent experimental and clinical studies have unraveled salient aspects of the neurobiological substrates and clinical relevance of pain and placebo analgesia, an authoritative source remained lacking until now. By presenting and integrating a broad range of research, Placebo and Pain enhances readers’ knowledge about placebo and nocebo effects, reexamines the methodology of clinical trials, and improves the therapeutic approaches for patients suffering from pain. Review for Placebo and Pain: “This ambitious book is the first comprehensive and unified presentation of the placebo and nocebo phenomena in the area of pain. Written by the international leading experts in the field, the book provides an accurate up-to-date [work] on placebo and pain dealing with current perspectives and future challenging issues. --Ted Kaptchuk, Associate Professor of Medicine, Harvard Medical School Contains historical aspects of the placebo effect Discusses biological and psychological mechanisms of placebo analgesic responses Reviews implications of the placebo effect for clinical research and pain management Includes methodological and ethical aspects of the placebo effect

Karin Meissner

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