Effects of Placebo on the Management of Chronic Low Back Pain

Abstract

A placebo is the result of an individual's neurobiological and psychophysiological responses to a substance or therapy that has no therapeutic effect but produces an improvement. Previously, some commonly prescribed therapies for chronic low back pain have been shown to be no better than placebo or only marginally more effective. The aim of this systematic literature review was therefore to examine the effects of placebo on the management of chronic low back pain. A review of the literature available in the PubMed, CINAHL and PEDro databases from 2012 to 2023 provided a set of nine studies. The results of the included studies suggest that placebo is part of any therapy in the form of various interacting biopsychosocial factors. Placebo has been shown to have the greatest effect on the emotional aspect of the pain experience, with less effect on the functional capacity of the patient. The authors of the included studies confirmed that expectation is the most important factor in placebo analgesia, which is also influenced by the physiotherapist through (in)adequate communication. In addition to the individual's expectations, his/her experience and mindset toward the therapy may also determine to what extent the placebo will work. All of these factors vary from individual to individual. Therefore, it is not possible to give a unique answer about placebo effects and factors, and further research in this area is needed in the future.