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The Placebo Effect

12/26/2013

2 Comments

 
Picture
Each month at the Harris Health Orthopedic Residency, one of the clinicians holds a journal club. Last month, one of my fellow residents and I chose to lead the journal club. We chose the recent JOSPT editorial written by Dr. Benz and Dr. Flynn entitled, "Placebo, Nocebo, and Expectations: Leveraging Positive Outcomes." This article was a great introduction to the topic of the Placebo Effect.

To begin, you must first ask yourself: "How much do I currently use the placebo effect in my practice?" or better yet, "Am I using placebo effects without knowing it?" A placebo is defined as a simulated or otherwise medically ineffectual treatment for a disease or other medical condition intended to deceive the recipient. To answer the first question, we ALL use placebos with each patient interaction, whether intentionally or not. Our clinical mannerisms, our tone of voice, how we dress, and the clinic environment are all placebo effects. BUT, in order for a placebo to be effective, the patient must be able to assign a positive meaning to these things. An interesting study looked at two groups of people given a certain medication. One group was given an Aspirin, the second group was given the generic form of Aspirin. The chemical composition was the exact same; however, the group who received Aspirin had much better results. How is this possible? The group who received Aspirin were able to assign a meaning or positive correlation with that intervention. They could both physiologically and psychologically agree with the treatment, and therefore the treatment was more effective. The placebo effect is all about expectations! 

Dr. Benz and Flynn conclude the editorial by saying we should use the placebo as another "tool in the proverbial tool kit." They say that the power of the mind to react positively to a genuinely weak (think sham) but perceptually agreeable intervention is far more compelling than forcing a highly evidenced based intervention on a patient who cannot assign meaning to that intervention. 

Next time you are trying to "sell" a patient on an intervention, think about the words you use, how you approach the subject, and the patient's expectation. Above all, act confident. If you display confidence in the treatment, the patient will have more confidence as well. 

-Jim 


2 Comments
www.thebestdissertations.org link
9/21/2014 03:31:37 pm

With the fame of yoga rising all through the western world, you have most likely found out about its recuperating powers at this point. Nonetheless, you still aren't certain exactly what sort of yoga may be a good fit for your lifestyle.

Reply
solagard roof paint link
10/10/2022 05:48:56 am

The placebo effect is one of the oldest medical theories. It's an incredibly powerful concept, and has been proven to be extremely effective countless times over. In this blog post we're going to talk about what the Placebo Effect is, how it works, and introduce some examples that might help illustrate it.

Reply



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  • Home
  • About Us
  • TSPT Academy
  • Resources
    • Newsletter
    • Orthopedic Blog
    • Featured Articles
    • Research Articles
    • Residency Corner
  • Special Tests
    • Cervical Spine >
      • Alar Ligament Test
      • Bakody's Sign
      • Cervical Distraction Test
      • Cervical Rotation Lateral Flexion Test
      • Craniocervical Flexion Test (CCFT)
      • Deep Neck Flexor Endurance Test
      • Posterior-Anterior Segmental Mobility
      • Segmental Mobility
      • Sharp-Purser Test
      • Spurling's Maneuver
      • Transverse Ligament Test
      • ULNT - Median
      • ULNT - Radial
      • ULNT - Ulnar
      • Vertebral Artery Test
    • Thoracic Spine >
      • Adam's Forward Bend Test
      • Passive Neck Flexion Test
      • Thoracic Compression Test
      • Thoracic Distraction Test
      • Thoracic Foraminal Closure Test
    • Lumbar Spine/Sacroiliac Joint >
      • Active Sit-Up Test
      • Alternate Gillet Test
      • Crossed Straight Leg Raise Test
      • Extensor Endurance Test
      • FABER Test
      • Fortin's Sign
      • Gaenslen Test
      • Gillet Test
      • Gower's Sign
      • Lumbar Quadrant Test
      • POSH Test
      • Posteroanterior Mobility
      • Prone Knee Bend Test
      • Prone Instability Test
      • Resisted Abduction Test
      • Sacral Clearing Test
      • Seated Forward Flexion Test
      • SIJ Compression/Distraction Test
      • Slump Test
      • Sphinx Test
      • Spine Rotators & Multifidus Test
      • Squish Test
      • Standing Forward Flexion Test
      • Straight Leg Raise Test
      • Supine to Long Sit Test
    • Shoulder >
      • Active Compression Test
      • Anterior Apprehension
      • Biceps Load Test II
      • Drop Arm Sign
      • External Rotation Lag Sign
      • Hawkins-Kennedy Impingement Sign
      • Horizontal Adduction Test
      • Internal Rotation Lag Sign
      • Jobe Test
      • Ludington's Test
      • Neer Test
      • Painful Arc Sign
      • Pronated Load Test
      • Resisted Supination External Rotation Test
      • Speed's Test
      • Posterior Apprehension
      • Sulcus Sign
      • Thoracic Outlet Tests >
        • Adson's Test
        • Costoclavicular Brace
        • Hyperabduction Test
        • Roos (EAST)
      • Yergason's Test
    • Elbow >
      • Biceps Squeeze Test
      • Chair Sign
      • Cozen's Test
      • Elbow Extension Test
      • Medial Epicondylalgia Test
      • Mill's Test
      • Moving Valgus Stress Test
      • Push-up Sign
      • Ulnar Nerve Compression Test
      • Valgus Stress Test
      • Varus Stress Test
    • Wrist/Hand >
      • Allen's Test
      • Carpal Compression Test
      • Finkelstein Test
      • Phalen's Test
      • Reverse Phalen's Test
    • Hip >
      • Craig's Test
      • Dial Test
      • FABER Test
      • FAIR Test
      • Fitzgerald's Test
      • Hip Quadrant Test
      • Hop Test
      • Labral Anterior Impingement Test
      • Labral Posterior Impingement Test
      • Long-Axis Femoral Distraction Test
      • Noble Compression Test
      • Percussion Test
      • Sign of the Buttock
      • Trendelenburg Test
    • Knee >
      • Anterior Drawer Test
      • Dial Test (Tibial Rotation Test)
      • Joint Line Tenderness
      • Lachman Test
      • McMurray Test
      • Noble Compression Test
      • Pivot-Shift Test
      • Posterior Drawer Test
      • Posterior Sag Sign
      • Quad Active Test
      • Thessaly Test
      • Valgus Stress Test
      • Varus Stress Test
    • Foot/Ankle >
      • Anterior Drawer
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      • Impingement Sign
      • Navicular Drop Test
      • Squeeze Test
      • Talar Tilt
      • Tarsal Tunnel Syndrome Test
      • Test for Interdigital Neuroma
      • Windlass Test