Myths and Truths about Placebo Effect in Rehabilitation for Musculoskeletal Pain

Iolascon, Giovanni; Moretti, Antimo

doi:10.1007/s12325-021-01894-5

Cited by 8 publications

(2 citation statements)

References 31 publications

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“…Therefore, it seems that briefings about treatment in routine care might not be as important as previously thought ( 42 ). Other variables, such as previous therapeutic experiences ( 31 ) or patient satisfaction, might also be important for clinically managing placebo and nocebo effects, as these are factors that can impact the outcome of rehabilitation ( 45 ). Indeed, according to several double-blind trials testing pain treatments, the placebo effect can be similar to specific treatment effects ( 9 ).…”

Section: Discussionmentioning

confidence: 99%

Placebo and nocebo effects of percutaneous needle electrolysis and dry-needling: an intra and inter-treatment sessions analysis of a three-arm randomized double-blinded controlled trial in patients with patellar tendinopathy

Doménech-García,

Pecos-Martín,

Blasco-Abadía

et al. 2024

Front. Med.

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ObjectiveThis study aimed to investigate the influence of potential placebo and nocebo effects on pain perception of percutaneous needle electrolysis (PNE) in individuals with patellar tendinopathy.MethodsIn this secondary analysis of a three-arm randomized double-blinded controlled trial, intra and inter-session pain perception data from 48 sporting participants with patellar tendinopathy between 18 and 45 years were investigated. Participants were divided into 3 parallel groups: “no-sham group” [PNE intervention], “single-sham group” [sham PNE by using dry needling], and “double-sham group” [sham PNE by using sham needles]. Every group received 4 sessions of the needling therapies targeting the patellar tendon over 8 weeks and was instructed to perform a unilateral eccentric exercise program of the quadriceps muscle on the affected side. Clinical and needle-related pain was assessed before, during, and after each treatment session using a visual analog scale.ResultsNo differences were found between groups intra- or inter-session in terms of pain reduction (P = 0.424) despite clinical pain decreased in all groups since the first treatment session (P < 0.001). Furthermore, although the double-sham group showed a lower percentage of participants reporting needle-related pain during needle intervention (P = 0.005), the needle-related pain intensity after needle intervention was similar between groups (P = 0.682). Moreover, there were no group differences for the duration of pain sensation after any needle intervention (P = 0.184), extending in many cases beyond 24 h.ConclusionNeedling therapies for individuals with patellar tendinopathy are prone to elicit placebo effects regarding clinical pain and nocebo effects regarding needling-related pain. Clinicians and physical therapists treating musculoskeletal pain conditions should consider the added value and potential mechanisms of action before routinely using needle techniques.

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Section: Discussionmentioning

confidence: 99%

Placebo and nocebo effects of percutaneous needle electrolysis and dry-needling: an intra and inter-treatment sessions analysis of a three-arm randomized double-blinded controlled trial in patients with patellar tendinopathy

Doménech-García,

Pecos-Martín,

Blasco-Abadía

et al. 2024

Front. Med.

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show abstract

“…Therefore, it seems that briefings about treatment in routine care might not be as important as previously thought (42). Other variables, such as previous therapeutic experiences (31) or patient satisfaction, might also be important for clinically managing placebo and nocebo effects, as these are factors that can impact the outcome of rehabilitation (45). Indeed, according to several double-blind trials testing pain treatments, the placebo effect can be similar to specific treatment effects (9).…”

Section: Discussionmentioning

confidence: 99%

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Highlights of three metabolites HDL and reduction in blood pressure values after dietary fiber supplementation in overweight and obese normotensive women: a metabolomic study

da Silva,

Monteiro,

Fechine

et al. 2023

Metabolomics

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Introduction The prevalence of hypertension and obesity are a worldwide concern. Objetives Assess the metabolites profile after intervention with mixed dietary fiber in overweight and obese normotensive women. Methods This is a randomized double blind placebo-controlled study. Through a simple randomization process, two groups were allocated, with eleven women (group 1) receiving 12 g of mixed dietary fiber and thirteen women (group 2) receiving 12 g of placebo (corn starch) for eight weeks. Anthropometric and biochemical tests and lifestyle were analyzed. As for evaluation metabolomics, used a 1H NMR. The data matrix generated 96 samples and 225 variables, which was exported in the ASCII format for the “The Unscrumbler” statistics software (version 9.7, CAMO Process). Results After the intervention with mixed dietary fiber, significant differences were observed between the main types of metabolites, referring to the increase in the relative peak areas of in three HDL metabolites 4.94 ppm (0.0086*), HDL 1.28 ppm (0 .0337*), HDL 0.88 ppm (0.0224*) and an α-glucose metabolite 4.90 ppm (0.0106) and the reduction in systolic blood pressure (SBP) (0.0292*) of 7 mmHg in the reference range and in the placebo group there was a reduction in SBP (0.0118*) of 4 mmHg and of a choline metabolite 3.65 ppm (0.0266*), which does not call into question the validity of these results in the literature. Conclusion The synergism of the functions of these statistically highlighted metabolites contributed to prevention the increase in SBP after fiber intervention in overweight and obese normotensive women.

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Myths and Truths about Placebo Effect in Rehabilitation for Musculoskeletal Pain

Abstract: This commentary provides the authors' point of view about the biopsychosocial perspective of placebo effect on musculoskeletal pain in the rehabilitation field.

Cited by 8 publications

References 31 publications

Placebo and nocebo effects of percutaneous needle electrolysis and dry-needling: an intra and inter-treatment sessions analysis of a three-arm randomized double-blinded controlled trial in patients with patellar tendinopathy

Placebo and nocebo effects of percutaneous needle electrolysis and dry-needling: an intra and inter-treatment sessions analysis of a three-arm randomized double-blinded controlled trial in patients with patellar tendinopathy

Data_Sheet_1.CSV

Highlights of three metabolites HDL and reduction in blood pressure values after dietary fiber supplementation in overweight and obese normotensive women: a metabolomic study

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