Andy
Senior Member (Voting rights)
Abstract
This commentary provides the authors’ point of view about the biopsychosocial perspective of placebo effect on musculoskeletal pain in the rehabilitation field.
Key Summary Points
Rehabilitation interventions, including physical therapies, play a leading role in the management of musculoskeletal pain, though their effects should still be clarified.
It is often argued that the effects of rehabilitation interventions are due to the “placebo effect”. This commentary provides the biopsychosocial perspective of placebo effect on musculoskeletal pain in rehabilitation.
In randomized controlled trials performed in a rehabilitation setting, for patients included in the placebo group (untreated or receiving sham physical therapy), there are beneficial physiological and psychological reactions due to the personality of the patient, the relationship between the therapist and the patient, the type of environment and location where rehabilitation is provided, the use of complicated devices or equipment, and the patient's expectations of improvement and/or recovery. The neurophysiological basis of a placebo effect in rehabilitation concerns psycho-neuro-endocrine-immunology.
Psychological mechanisms can induce a therapeutic effect in chronic pain conditions through the conscious anticipation of the benefit induced by the therapy, the conscious conditioning due to the sight of sophisticated instruments, and the unconditioned stimulus due to the administration of therapy.
Placebo analgesia results from different pain modulation mechanisms: the activation of descending circuits involving the dorsolateral prefrontal cortex, rostral anterior cingulate cortex, and periaqueductal gray; the modulation of pain processing by inhibiting the middle and posterior cingulate cortex, insula and thalamus; the inhibition of cholecystokinin (CCK); the activation of endocannabinoid system; and the modulation of prostaglandins synthesis.
Open access, https://link.springer.com/article/10.1007/s12325-021-01894-5
This commentary provides the authors’ point of view about the biopsychosocial perspective of placebo effect on musculoskeletal pain in the rehabilitation field.
Key Summary Points
Rehabilitation interventions, including physical therapies, play a leading role in the management of musculoskeletal pain, though their effects should still be clarified.
It is often argued that the effects of rehabilitation interventions are due to the “placebo effect”. This commentary provides the biopsychosocial perspective of placebo effect on musculoskeletal pain in rehabilitation.
In randomized controlled trials performed in a rehabilitation setting, for patients included in the placebo group (untreated or receiving sham physical therapy), there are beneficial physiological and psychological reactions due to the personality of the patient, the relationship between the therapist and the patient, the type of environment and location where rehabilitation is provided, the use of complicated devices or equipment, and the patient's expectations of improvement and/or recovery. The neurophysiological basis of a placebo effect in rehabilitation concerns psycho-neuro-endocrine-immunology.
Psychological mechanisms can induce a therapeutic effect in chronic pain conditions through the conscious anticipation of the benefit induced by the therapy, the conscious conditioning due to the sight of sophisticated instruments, and the unconditioned stimulus due to the administration of therapy.
Placebo analgesia results from different pain modulation mechanisms: the activation of descending circuits involving the dorsolateral prefrontal cortex, rostral anterior cingulate cortex, and periaqueductal gray; the modulation of pain processing by inhibiting the middle and posterior cingulate cortex, insula and thalamus; the inhibition of cholecystokinin (CCK); the activation of endocannabinoid system; and the modulation of prostaglandins synthesis.
Open access, https://link.springer.com/article/10.1007/s12325-021-01894-5
haha i have giggling for about 20 minutes at that rvallee
