The Placebo Response and Healthcare

An Overview of Placebos & Nocebos - Rossettini et al. 2018

The placebo response and the therapeutic encounter

The way a clinician presents themselves and their treatment has influence on therapeutic outcomes. The magnitude of a response may be influenced by mood, expectation, and conditioning, this is often referred to as the placebo response.

The placebo response is real and it is effective!

The placebo effect isn't a single phenomenon but a number of responses involving cortical, subcortical and emotional responses. Any therapeutic encounter can trigger significant biological changes that ease symptoms.

The existence of placebo-induced effects do not negate treatment-induced results, patients feel better after a therapeutic encounter because of a complex physiological response to the treatment that INCLUDES, but is not LIMITED to placebo.

Learn more about the placebo response in this 5 min TED-Ed video.


More to Explore

Bialosky, J.E., Bishop, M.D., Penza, C.W. (2017). Placebo Mechanisms of Manual Therapy: A Sheep in Wolf's Clothing? J Orthop Sports Phys Ther.
https://www.ncbi.nlm.nih.gov/pubmed/28459190

Blasini, M., Peiris, N., Wright, T., Colloca, L. (2018). The Role of Patient-Practitioner Relationships in Placebo and Nocebo Phenomena. Int Rev Neurobiol.
https://www.ncbi.nlm.nih.gov/pubmed/30146048

Damien, J., Colloca, L., Bellei-Rodriguez, C.É., Marchand, S. (2018). Pain Modulation: From Conditioned Pain Modulation to Placebo and Nocebo Effects in Experimental and Clinical Pain. Int Rev Neurobiol.
https://www.ncbi.nlm.nih.gov/pubmed/30146050

Evers et al. (2018). Implications of Placebo and Nocebo Effects for Clinical Practice: Expert Consensus. Psychother Psychosom.
https://www.ncbi.nlm.nih.gov/pubmed/29895014

Kaptchuk, T.J., Miller, F.G. (2018). Open label placebo: can honestly prescribed placebos evoke meaningful therapeutic benefits? BMJ.
https://www.ncbi.nlm.nih.gov/pubmed/30279235

Kaptchuk, T.J., Miller, F.G. (2015). Placebo Effects in Medicine. N Engl J Med.
https://www.ncbi.nlm.nih.gov/pubmed/26132938

Ongaro, G., Kaptchuk, T.J. (2018). Symptom perception, placebo effects, and the Bayesian brain. Pain.
https://www.ncbi.nlm.nih.gov/pubmed/30086114

Rossettini, G., Carlino, E., Testa, M. (2018). Clinical relevance of contextual factors as triggers of placebo and nocebo effects in musculoskeletal pain. BMC Musculoskelet Disord. 
https://www.ncbi.nlm.nih.gov/pubmed/29357856

Skyt, I., Moslemi, K., Baastrup, C., Grosen, K., Svensson, P., Jensen, T.S., Vase, L. (2018). Does conditioned pain modulation predict the magnitude of placebo effects in patients with neuropathic pain? Eur J Pain.
https://www.ncbi.nlm.nih.gov/pubmed/29266627