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The power and value of placebo and nocebo in painful osteoarthritis.

Dieppe, P., Goldingay, S. and Greville-Harris, M., 2016. The power and value of placebo and nocebo in painful osteoarthritis. Osteoarthritis and Cartilage, 24 (11), 1850 - 1857.

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OC article May 3rd.pdf - Accepted Version
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DOI: 10.1016/j.joca.2016.06.007


This paper reviews some recent advances in our understanding of the effects of sham or dummy interventions on pain and other symptoms in osteoarthritis (OA), and outlines two new approaches to the investigation of placebo and nocebo effects. We argue that the placebo effect provides us with a valuable way of investigating the nature of conditions like OA. For example, by examining which symptoms, biochemical markers or imaging features do or do not respond to placebo, we might learn more about the relationships between pathology and symptoms in OA. Placebo and nocebo effects are positive or negative outcomes resulting from the human interactions and contexts in which healthcare consultations take place. Subtle changes in behaviours and the environments in which consultations take place can have major effects on pain and other symptoms being experienced by people with OA. Nocebo effects are particularly powerful, leading to many health-care professionals (HCPs) causing unintended harm to their clients. Based on our own research, we conclude that beneficial outcomes are most likely to occur when both the (HCP) and the client feel safe and relaxed, and when the experiences of the client are validated by the (HCP). These findings have important implications for clinical practice. We believe that research in this field needs to be 'trans-disciplinary', escaping from the constraints of the purely biomedical, deterministic, positivist paradigm of most medical research. We provide the example of our own work which combines performance studies and scholarship, with psychology and medicine.

Item Type:Article
Uncontrolled Keywords:healing response; invalidation; nocebo; pain; placebo; validation; biomedical research; humans; nocebo effect; osteoarthritis; pain; placebo effect
Group:Faculty of Science & Technology
ID Code:32889
Deposited By: Symplectic RT2
Deposited On:14 Oct 2019 13:31
Last Modified:14 Mar 2022 14:18


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