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. 2024 Aug 29:18:1432270.
doi: 10.3389/fnint.2024.1432270. eCollection 2024.

Pain, mindfulness, and placebo: a systematic review

Alexandra Lopes  1 , Rute Sampaio  1   2 , Isaura Tavares  1   3   4
Affiliations

Pain, mindfulness, and placebo: a systematic review

Alexandra Lopes et al. Front Integr Neurosci. .

Abstract

Introduction: Pain is a complex phenomenon influenced by psychosocial variables, including the placebo effect. The effectiveness of mindfulness-based interventions (MBIs) for pain has been demonstrated in experimental studies and systematic reviews, but the mechanisms of action are only starting to be established. Whether the expectations of individuals experiencing pain can be manipulated during MBIs remains to be systematically evaluated, and what role placebo effects might play remains to be explored.

Methods: To evaluate the literature analyzing placebo effects in MBIs for pain, we performed a systematic review based on searches conducted in PubMed, Web of Science, and SCOPUS databases. Our search revealed a total of 272 studies, of which only 19 studies were included (10 acute pain and nine chronic pain), considering the inclusion and exclusion criteria related to expectations and placebo effects.

Results: From the 19 included studies, six measured placebo effects only in relation to the pharmacological intervention used in the study and not to an MBI.

Discussion: The results of the few studies that focused on the placebo effects of the MBIs indicate that placebo and expectations play a role in the MBIs' effects on pain. Although expectations and placebo effects are frequently discussed in the context of mindfulness and pain research, these results show that these factors are still not routinely considered in experimental designs. However, the results of the few studies included in this systematic review highlight a clear role for placebo and expectancy effects in the overall effects of MBIs for both acute and chronic pain, suggesting that routine measurement and further consideration in future studies are warranted. Additional research in this fascinating and challenging field is necessary to fully understand the connection between MBIs, placebo/expectations, and their effects on pain relief.

Keywords: cognitive-behavioral therapy; expectations; meditation therapy; mindfulness-based cognitive therapy (MBCT); mindfulness-based stress reduction (MBSR); pain measurements; placebo effects.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

Figures

Figure 1
Figure 1
PRISMA 2020 flow diagram for new systematic reviews which included searches of databases and registers only. *Means registered databases.
See this image and copyright information in PMC

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