New publication on nocebo hyperalgesia and other expectancy-related factors in daily fibromyalgia pain
Expectancies are known to shape pain experiences, but it remains unclear how different types of expectancies contribute to daily pain fluctuations in fibromyalgia. This study combines experimental and diary measures, aiming to provide insights into how experimentally-induced nocebo hyperalgesia and other, diary-reported, expectancy-related factors are associated with each other and with daily pain in fibromyalgia.
Forty-one female fibromyalgia patients underwent a lab procedure to measure nocebo hyperalgesia. They then completed an electronic diary three times daily for three weeks, reporting pain expectancy, anxiety, optimism, pain catastrophizing, and current pain intensity.
Results indicate that experimentally-induced nocebo hyperalgesia was not significantly related to diary-assessed expectancy-related factors and did not predict daily fibromyalgia pain. Increased levels of self-reported expectancy factors like pain expectancy and pain catastrophizing, but not anxiety and optimism, were associated with moment-to-moment increases in fibromyalgia pain, after controlling for current pain, time-of-day and other expectancy-related factors.
These exploratory findings indicate that self-reported expectancy-related factors, particularly pain expectancy and pain catastrophizing, are potentially more relevant for predicting daily pain experience than experimentally-induced nocebo hyperalgesia. Further translation of nocebo hyperalgesia is needed from experimental to Ecological Momentary Assessment research. Findings imply that targeting the decrease in pain expectancy and catastrophizing thoughts, for example via Cognitive Behavioral Therapy, have potential for improving daily pain levels in fibromyalgia.