肩痛的负面预期和相关的反安慰剂效应:临床医生和研究人员的观点。

IF 1.4 Q4 CLINICAL NEUROLOGY
Pain management Pub Date : 2025-02-01 Epub Date: 2025-02-20 DOI:10.1080/17581869.2025.2467022
Enrique Lluch-Girbés, Lirios Dueñas, Filip Struyf, Eleonora Maria Camerone, Giacomo Rossettini
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引用次数: 0

摘要

反安慰剂效应,一种负面预期会加重症状的现象,在肌肉骨骼疾病的背景下越来越得到承认。虽然实验证据在一定程度上检验了肩痛的负面预期,但它们与反安慰剂效应的具体关系及其在临床实践中的表现仍未得到探索。从这个角度来看,临床医生和研究人员首先从基础科学的角度检查反安慰剂效应背后的心理生物学和神经生理学,从而使临床医生对这一现象有一个强有力的理解。然后概述了肩痛患者中反安慰剂效应的主要潜在来源,即诊断标签、诊断成像和特殊测试、正常的医学化和过度治疗。随后提出了实用的临床策略来减轻这些来源引起的反安慰剂效应。最后,讨论了反安慰剂对肩痛患者影响的研究意义。总的来说,这一观点提供了负面预期和相关反安慰剂效应对肩痛结果的影响的全面概述。通过识别日常临床实践中可能出现的反安慰剂效应的潜在来源,为减轻肩痛患者的相关负面预期提供指导。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Negative expectations and related nocebo effects in shoulder pain: a perspective for clinicians and researchers.

The nocebo effect, a phenomenon wherein negative expectations can worsen symptoms, is increasingly acknowledged within the context of musculoskeletal conditions. While experimental evidence has, to some extent, examined negative expectations in shoulder pain, their specific relationship with nocebo effects and their manifestation in clinical practice remains unexplored. In this perspective, clinicians and researchers are guided by first examining the psychobiology and neurophysiology underlying nocebo effects from a basic science standpoint, thereby equipping clinicians with a robust understanding of the phenomenon. What are considered the primary potential sources of nocebo effects in individuals with shoulder pain are then outlined - namely, diagnostic labels, diagnostic imaging and special tests, the medicalization of normality, and overtreatment. Practical clinical strategies are subsequently proposed to mitigate nocebo effects arising from these sources. Finally, the research implications for advancing the study of nocebo effects in people with shoulder pain are discussed. Overall, this perspective provides a comprehensive overview of the impact of negative expectations and associated nocebo effects on shoulder pain outcomes. By identifying potential sources of nocebo effects that may emerge in everyday clinical practice, guidance on mitigating related negative expectations in patients with shoulder pain is offered.

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来源期刊
Pain management
Pain management CLINICAL NEUROLOGY-
CiteScore
2.90
自引率
5.90%
发文量
62
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