The effects of placebos and nocebos on physical performance
Abstract
In this chapter we present and discuss recent studies on the mechanisms underlying placebo and nocebo effects in physical performance, showing how expectations and both pharmacological and nonpharmacological preconditioning procedures can be very effective in inducing placebo responses, with important implications for sport competitions. Furthermore, we place these findings within the biological model of central governor of fatigue, whose main goal is to protect our body from damage. A crucial aspect of this emerging field of placebo studies is related to the limit beyond which these procedures can be called doping in all respects.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Matching participants according to their beliefs reduces the known performance bias due to placebo and nocebo effects.
“This methodology should be continued in the replication study since matching participants according to their beliefs will reduce the known performance bias due to placebo and nocebo effects [21].”
Cites
A new view of pain as a homeostatic emotion
Craig, A. D. (2003) · Trends in Neurosciences · doi:10.1016/s0166-2236(03)00123-1 · Cited by 1,024 · see citing works
Amanzio, M., & Benedetti, F. (1999) · The Journal of Neuroscience · doi:10.1523/jneurosci.19-01-00484.1999 · Cited by 899 · see citing works
The regulation of respiration and circulation during the initial stages of muscular work
Krogh, A., & Lindhard, J. (1913) · The Journal of Physiology · doi:10.1113/jphysiol.1913.sp001616 · Cited by 891 · see citing works
The placebo response in medicine: minimize, maximize or personalize?
Enck, P., Bingel, U., Schedlowski, M., & Rief, W. (2013) · Nature Reviews Drug Discovery · doi:10.1038/nrd3923 · Cited by 671 · see citing works
Neuroanatomical correlates of hunger and satiation in humans using positron emission tomography
Tataranni, P. A., Gautier, J., Chen, K., Uecker, A., Bandy, D. J., Salbe, A. D., Pratley, R. E., Lawson, M. A., Reiman, E. M., & Ravussin, É. (1999) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.96.8.4569 · Cited by 592 · see citing works
Getting the pain you expect: mechanisms of placebo, nocebo and reappraisal effects in humans
Tracey, I. (2010) · Nature Medicine · doi:10.1038/nm.2229 · Cited by 553 · see citing works
Noakes, T. D. (2012) · Frontiers in Physiology · doi:10.3389/fphys.2012.00082 · Cited by 512 · see citing works
Placebo and the New Physiology of the Doctor-Patient Relationship
Benedetti, F. (2013) · Physiological Reviews · doi:10.1152/physrev.00043.2012 · Cited by 492 · see citing works
Gibson, A. S. C., Lambert, E. V., Rauch, L., Tucker, R., Baden, D. A., Foster, C., & Noakes, T. D. (2006) · Sports Medicine · doi:10.2165/00007256-200636080-00006 · Cited by 458 · see citing works
How Placebos Change the Patient's Brain
Benedetti, F., Carlino, E., & Pollo, A. (2011) · Neuropsychopharmacology · doi:10.1038/npp.2010.81 · Cited by 446 · see citing works
Self-citationHow prior experience shapes placebo analgesia
Colloca, L., & Benedetti, F. (2006) · Pain · doi:10.1016/j.pain.2006.04.005 · Cited by 443 · see citing works
BOLD fMRI Identifies Limbic, Paralimbic, and Cerebellar Activation During Air Hunger
Evans, K. C., Banzett, R. B., Adams, L., McKay, L., Frackowiak, R. S. J., & Corfield, D. R. (2002) · Journal of Neurophysiology · doi:10.1152/jn.2002.88.3.1500 · Cited by 391 · see citing works
Lambert, E. V., Gibson, A. S. C., & Noakes, T. D. (2004) · British Journal of Sports Medicine · doi:10.1136/bjsm.2003.011247 · Cited by 383 · see citing works
Mechanisms of placebo and placebo-related effects across diseases and treatments.
Benedetti, F. (2008) · The Annual Review of Pharmacology and Toxicology · doi:10.1146/annurev.pharmtox.48.113006.094711 · Cited by 381 · see citing works
Breathlessness in humans activates insular cortex
Banzett, R. B., Mulnier, H. E., Murphy, K., Rosen, S. D., S. Wise, R. J., & Adams, L. (2000) · NeuroReport · doi:10.1097/00001756-200007140-00012 · Cited by 350 · see citing works
How placebo responses are formed: a learning perspective
Colloca, L., & Miller, F. G. (2011) · Philosophical Transactions of the Royal Society B: Biological Sciences · doi:10.1098/rstb.2010.0398 · Cited by 323 · see citing works
Brain responses associated with consciousness of breathlessness (air hunger)
Mario Liotti, A., Brannan, S., Egan, G. F., Shade, R. E., Madden, L., Abplanalp, B., Robillard, R., Lancaster, J. L., Zamarripa, F., Fox, P. T., et al. (2001) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.98.4.2035 · Cited by 303 · see citing works
The Conscious Perception of the Sensation of Fatigue
Gibson, A. S. C., Baden, D. A., Lambert, M., Lambert, E. V., Harley, Y. X. R., Hampson, D., Russell, V. A., & Noakes, T. D. (2003) · Sports Medicine · doi:10.2165/00007256-200333030-00001 · Cited by 293 · see citing works
Placebo Effects – Understanding the Mechanisms in Health and Disease
Aebischer, B. (2016) · physioscience · doi:10.1055/s-0035-1567078 · Cited by 270 · see citing works
The Placebo Effect in Sports Performance
Beedie, C., & FOAD, A. J. (2009) · Sports Medicine · doi:10.2165/00007256-200939040-00004 · Cited by 261 · see citing works
Placebo Effects of Caffeine on Cycling Performance
Beedie, C., STUART, E. M., COLEMAN, D. A., & FOAD, A. J. (2006) · Medicine & Science in Sports & Exercise · doi:10.1249/01.mss.0000233805.56315.a9 · Cited by 210 · see citing works
Placebo effect of carbohydrate feedings during a 40-km cycling time trial
CLARK, V. R., Hopkins, W. G., Hawley, J. A., & Burke, L. M. (2000) · Medicine & Science in Sports & Exercise · doi:10.1097/00005768-200009000-00019 · Cited by 190 · see citing works
Brannan, S., Mario Liotti, A., Egan, G. F., Shade, R. E., Madden, L., Robillard, R., Abplanalp, B., Stofer, K. A., Denton, D. A., & Fox, P. T. (2001) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.98.4.2029 · Cited by 188 · see citing works
Learning potentiates neurophysiological and behavioral placebo analgesic responses
Colloca, L., Tinazzi, M., Recchia, S., Le Pera, D., Fiaschi, A., Benedetti, F., & Valeriani, M. (2008) · Pain · doi:10.1016/j.pain.2008.04.021 · Cited by 180 · see citing works
Reduced neuromuscular activity and force generation during prolonged cycling
Gibson, A. S. C., Schabort, E. J., & Noakes, T. D. (2001) · American Journal of Physiology-Regulatory, Integrative and Comparative Physiology · doi:10.1152/ajpregu.2001.281.1.r187 · Cited by 180 · see citing works
Benedetti, F., Pollo, A., & Colloca, L. (2007) · Journal of Neuroscience · doi:10.1523/jneurosci.3330-07.2007 · Cited by 157 · see citing works
The top‐down influence of ergogenic placebos on muscle work and fatigue
Pollo, A., Carlino, E., & Benedetti, F. (2008) · European Journal of Neuroscience · doi:10.1111/j.1460-9568.2008.06344.x · Cited by 146 · see citing works
Self-citationSupraspinal regulation of physical fatigue
Tanaka, M., & Watanabe, Y. (2011) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2011.10.004 · Cited by 134 · see citing works
Placebo mechanisms across different conditions: from the clinical setting to physical performance
Pollo, A., Carlino, E., & Benedetti, F. (2011) · Philosophical Transactions of the Royal Society B Biological Sciences · doi:10.1098/rstb.2010.0381 · Cited by 95 · see citing works
Self-citationPlacebo effects in competitive sport: qualitative data.
Beedie, C. (2007) · PubMed · Cited by 83 · see citing works
Hilty, L., Jäncke, L., Luechinger, R., Boutellier, U., & Lutz, K. (2010) · Human Brain Mapping · doi:10.1002/hbm.21177 · Cited by 76 · see citing works
Expectancy Effects and Strength Training: Do Steroids Make a Difference?
Maganaris, C. N., Collins, D. J., & Sharp, M. A. (2000) · The Sport Psychologist · doi:10.1123/tsp.14.3.272 · Cited by 75 · see citing works
Placebo-Induced Changes in Excitatory and Inhibitory Corticospinal Circuits during Motor Performance
Fiorio, M., Emadi Andani, M., Marotta, A., Classen, J., & Tinazzi, M. (2014) · The Journal of Neuroscience · doi:10.1523/jneurosci.3931-13.2014 · Cited by 70 · see citing works
Antidepressants and the placebo response
Kirsch, I. (2009) · Epidemiology and Psychiatric Sciences · doi:10.1017/s1121189x00000282 · Cited by 70 · see citing works
Muscular Activity and Carbohydrate Metabolism
Hill, A. V. (1924) · Science · doi:10.1126/science.60.1562.505 · Cited by 52 · see citing works
Preventing motor training through nocebo suggestions
Pollo, A., Carlino, E., Vase, L., & Benedetti, F. (2012) · European Journal of Applied Physiology · doi:10.1007/s00421-012-2333-9 · Cited by 49 · see citing works
Self-citationKalasountas, V., Reed, J., & Fitzpatrick, J. F. (2007) · Journal of Applied Sport Psychology · doi:10.1080/10413200601123736 · Cited by 49 · see citing works
Frisaldi, E., Carlino, E., Lanotte, M., Lopiano, L., & Benedetti, F. (2014) · Cortex; a journal devoted to the study of the nervous system and behavior · doi:10.1016/j.cortex.2013.12.003 · Cited by 42 · see citing works
Self-citationIdentification of placebo responsive participants in 40km laboratory cycling performance.
Beedie, C., FOAD, A. J., & Coleman, D. A. (2008) · Europe PMC (PubMed Central) · Cited by 29 · see citing works
The Effects of Manipulating Verbal Suggestions on Physical Performance
Carlino, E., Benedetti, F., & Pollo, A. (2014) · Zeitschrift für Psychologie · doi:10.1027/2151-2604/a000178 · Cited by 28 · see citing works
Self-citationCarlino, E., Pollo, A., & Benedetti, F. (2012) · Current Opinion in Supportive and Palliative Care · doi:10.1097/spc.0b013e32835269c1 · Cited by 25 · see citing works
Self-citationEffect of anabolic steroids on reflex components.
Ariel, G. B., & SAVILLE, W. (1972) · Journal of Applied Physiology · doi:10.1152/jappl.1972.32.6.795 · Cited by 16 · see citing works
Review: benefits of antidepressants over placebo limited except in very severe depression
Kirsch, I. (2010) · Evidence-Based Mental Health · doi:10.1136/ebmh.13.2.49 · Cited by 9 · see citing works
Benedetti, F., & Schedlowski, M. (2014) · Handbook of Experimental Pharmacology · doi:10.1007/978-3-662-44519-8 · Cited by 8 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Enhance placebo, avoid nocebo: How contextual factors affect physiotherapy outcomes
Testa, M., & Rossettini, G. (2016) · Manual Therapy · doi:10.1016/j.math.2016.04.006 · Cited by 259 · see citing works
Mestre, T., Lang, A. E., & Okun, M. S. (2016) · Movement Disorders · doi:10.1002/mds.26500 · Cited by 99 · see citing works
Burke, L. M., Sharma, A. P., Heikura, I. A., Forbes, S. F., Holloway, M., McKay, A. K. A., Bone, J. L., Leckey, J. J., Welvaert, M., & Ross, M. L. (2020) · PLOS ONE · doi:10.1371/journal.pone.0234027 · Cited by 96 · see citing works
Jones, M. D., Valenzuela, T., Booth, J., Taylor, J. L., & Barry, B. K. (2017) · Journal of Pain · doi:10.1016/j.jpain.2017.07.006 · Cited by 54 · see citing works
Rossettini, G., Andani, M. E., Negra, F. D., Testa, M., Tinazzi, M., & Fiorio, M. (2018) · Scientific Reports · doi:10.1038/s41598-018-30228-9 · Cited by 33 · see citing works
Nature of the placebo and nocebo effect in relation to functional neurologic disorders
Carlino, E., Piedimonte, A., & Benedetti, F. (2016) · Handbook of clinical neurology · doi:10.1016/b978-0-12-801772-2.00048-5 · Cited by 34 · see citing works
Self-citationFrisaldi, E., Bottino, P., Fabbri, M., Trucco, M., Ceglia, A. D., Esposito, N., Barbiani, D., Camerone, E. M., Costa, F., Destefanis, C., et al. (2021) · Neurological Sciences · doi:10.1007/s10072-021-05171-9 · Cited by 34 · see citing works
Placebo effects: From pain to motor performance
Carlino, E., Guerra, G., & Piedimonte, A. (2016) · Neuroscience Letters · doi:10.1016/j.neulet.2016.08.046 · Cited by 30 · see citing works
Self-citationNocebo Effects on Muscular Performance – An Experimental Study About Clinical Situations
Zech, N., Seemann, M., Grzesiek, M., Breu, A., Seyfried, T., & Hansen, E. (2019) · Frontiers in Pharmacology · doi:10.3389/fphar.2019.00219 · Cited by 29 · see citing works
The interplay of exercise, placebo and nocebo effects on experimental pain
Colloca, L., Corsi, N., & Fiorio, M. (2018) · Scientific Reports · doi:10.1038/s41598-018-32974-2 · Cited by 23 · see citing works
Zech, N., Schrödinger, M., Seemann, M., Zeman, F., Seyfried, T., & Hansen, E. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.01693 · Cited by 21 · see citing works
The placebo phenomenon and the underlying mechanisms
Theodosis‐Nobelos, P., Filotheidou, A., & Triantis, C. (2020) · HORMONES · doi:10.1007/s42000-020-00243-5 · Cited by 21 · see citing works
Nocebo effects on motor performance: A systematic literature review
Horváth, Á., Köteles, F. G., & Szabó, A. (2021) · Scandinavian Journal of Psychology · doi:10.1111/sjop.12753 · Cited by 17 · see citing works
Ozpolat, M. C., Okcay, Y., Ulusoy, K. G., & Yıldız, O. (2025) · European Journal of Clinical Pharmacology · doi:10.1007/s00228-025-03818-6 · Cited by 15 · see citing works
Functional brain anatomy of exercise regulation
Lutz, K. (2018) · Progress in brain research · doi:10.1016/bs.pbr.2018.07.006 · Cited by 12 · see citing works
The Impact of Treatment of Overactive Bladder on Physical Activity Limitations
Chu, C. M., Harvie, H. S., Smith, A. L., Arya, L. A., & Andy, U. U. (2016) · Journal of Women s Health · doi:10.1089/jwh.2015.5643 · Cited by 10 · see citing works
Chesterton, P., Evans, W., Livadas, N., & McLaren, S. J. (2018) · Journal of Manual & Manipulative Therapy · doi:10.1080/10669817.2018.1542558 · Cited by 9 · see citing works
Expectations Come True: The Placebo Effect of Exercise on Affective Responses
Wang, Y., Guo, L., Fan, J.-Y., & Mao, Z. (2022) · Research Quarterly for Exercise and Sport · doi:10.1080/02701367.2022.2121372 · Cited by 9 · see citing works
McLemore, B. H., McLemore, S. G., Rogers, R. R., Pederson, J. A., Williams, T. D., Marshall, M. R., & Ballmann, C. G. (2020) · Journal of Functional Morphology and Kinesiology · doi:10.3390/jfmk5020040 · Cited by 9 · see citing works
Aziz, A. R., Lim, D., Sahrom, S. B., Muhamed, A. M. C., Ihsan, M., Girard, O., & Chia, M. (2019) · Science & Sports · doi:10.1016/j.scispo.2019.07.014 · Cited by 7 · see citing works
The influence of nocebo information on fatigue and urge to stop: An experimental investigation
Lenaert, B., Bennett, M., Boddez, Y., & Heugten, C. M. V. (2021) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2021.101656 · Cited by 7 · see citing works
The Placebo Effect in Exercise and Mental Health Research
Raglin, J. S., & Lindheimer, J. B. (2024) · Current topics in behavioral neurosciences · doi:10.1007/7854_2024_506 · Cited by 4 · see citing works
The placebo effect in breath holding: a preliminary behavioral investigation
Piedimonte, A., Barbiani, D., Benedetti, F., Zamfira, D. A., & Carlino, E. (2020) · Neuroscience Letters · doi:10.1016/j.neulet.2020.135434 · Cited by 4 · see citing works
Self-citationThe paradox of human milk doping for anti-doping
Forgues, C., Mazanov, J., & Smith, J. P. (2017) · Performance Enhancement & Health · doi:10.1016/j.peh.2017.08.002 · Cited by 4 · see citing works
de Souza, H. L. R., Hurst, P., de Oliveira, G. T., Meireles, A. A. F. D. M., Arriel, R. A., Hohl, R., Garcia, M. A. C., & Marocolo, M. (2025) · International Journal of Sports Physiology and Performance · doi:10.1123/ijspp.2024-0217 · Cited by 1 · see citing works
The Roles of Endogenous Opioids in Placebo and Nocebo Effects: From Pain to Performance to Prozac
Kerr, P. L., & Gregg, J. M. (2024) · Advances in neurobiology · doi:10.1007/978-3-031-45493-6_10 · Cited by 1 · see citing works
Martino, J., Smoliga, J. M., & Mabry, L. M. (2024) · Journal of Manual & Manipulative Therapy · doi:10.1080/10669817.2024.2396706
Mahmoudi, M. B., Letafatkar, A., Hadadnezhad, M., Shojaedin, S. S., & Rossettini, G. (2026) · Pain Management · doi:10.1080/17581869.2026.2676725
- Authors
- Carlino, E., Piedimonte, A., & Frisaldi, E.
- Affiliations
- University of Turin (IT)
- Corresponding author
- Carlino, Elisa
- Venue
- Handbook of experimental pharmacology
- Publisher
- Springer Berlin Heidelberg
- Published
- 2014
- Volume
- 225
- Pages
- 149-157
- ISSN
- 0171-2004 (ISSN-L)
- 1865-0325
- OpenAlex
- W2188705459
- Cited by
- 28
- References
- 44
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 3 · 2022: 1 · 2021: 3 · 2020: 5 · 2019: 2 · 2018: 4 · 2017: 2 · 2016: 5
- FWCI
- 5.45
- Type
- book chapter
- Language
- en
- Open access
- closed
- Licence
- Locations
- Handbook of experimental pharmacology (publishedVersion)
- PubMed (publishedVersion)
- Institutional Research Information System University of Turin (University of Turin) (submittedVersion)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
- Social Sciences › Psychology › Developmental and Educational Psychology › Sport Psychology and Performance
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports Performance and Training
- Keywords
- placebo effect, nocebo effect, physical performance, expectations, preconditioning, fatigue, doping, sport competition, non-pharmacological treatment
- MeSH terms
- Fatigue, Humans, Learning, Motor Activity, Placebo Effect, Nocebo Effect
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
