Nocebo Effects, Patient-Clinician Communication, and Therapeutic Outcome

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All,Our words have consequences.NOCEBO EFFECTS ARE ADVERSE EVENTS PRODUCEDby negative expectations and represent the negativeside of placebo effects. It is now recognized

that nocebo effects exist and operate during routinetreatments, negatively affecting clinical outcomes evenwhen placebos are not administered...Clinicians’ efforts should be devoted to avoiding instilling

negative expectations during the informed consent process,procedural information, and follow-up assessments sothat the most effective patient-clinician communication canbe pursued while unwarranted and untenable nocebo responses

can be avoided.DC to MVA patient:   " Mrs. you have a serious spinal condition...[insert whiplash/subluxation/degeneration/lesion of choice].  Once your spine has been injured, you will never be the same...injured tissue heals with scaring... " etc

A. Simpson, DC | Vice President, Medical DirectorThe CHP Group | Smart Solutions. Healthy Results.

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 csimpson@... 503-619-2041 O | 503-367-0872 C6600 SW 105th Ave, Ste 115 | Beaverton, OR 97008

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JAMA-2012-Wang-569-70.pdf