Pre-exposure, but not overshadowing, inhibits nocebo hyperalgesia

Nocebo hyperalgesia is a pervasive problem that significantly adds to the burden of pain [3, 7, 40, 44]. It occurs when features of the treatment context elicit negative expectancies that amplify pain. Numerous studies demonstrate that nocebo hyperalgesia can influence a range of behavioural, psychophysiological, and neurobiological indices of pain [1, 10, 45, 48]. However, one of the most concerning aspects of nocebo hyperalgesia to emerge recently is that, once established, it seems resistant to extinction [10-12, 57, 58].

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