Changing the view on placebo and long-term pain

What are you researching?

“I do research on pain and placebo. I want to understand what happens in the brain when people experience pain, and examine how perception of pain can be affected by cognitive factors such as expectations. The brain imaging technique fMRI is my most important tool.”

What have you discovered?

“I have contributed to the emergence of an overall picture of how placebo works. We now know that placebo can create visible physical changes in the body and often represents a significant portion of a treatment response.

My most important contribution is that I have demonstrated that placebo is not an exclusively intellectual process, as was previously believed. Placebo also has an effect through the brain's lower structures, outside our consciousness. It therefore works in young children, people with intellectual disabilities and older people with dementia.

Within pain research, I have been part of a movement that has worked experimentally to elucidate what happens when a person develops chronic pain. We have noticed that the central nervous system changes in several ways. This has contributed to the acceptance of so-called nociplastic pain as a medical term.

In the future, I would like to find out who is at a high risk of developing long-term pain. For this purpose, we are building a large database with genetics, brain imaging and other data, where we will be following research subjects for a long period of time.”

What do you hope that your research will lead to?

“I think that it may lead to new pain treatments in the long run, and tools for pain diagnostics and prevention before that. I also hope that the healthcare system will harness knowledge about the placebo effect to shape patients' expectations and obtain better treatment results.”

Text: Anders Nilsson, in translation from Swedish
First published in the booklet ‘From Cell to Society 2023’