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The Problem with Placebos

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The Problem with Placebos

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Numerous clinical trials that explored the effect of spinal adjusting (or manipulation, aka SMT) on various conditions have concluded that adjusting had no effect, because SMT and the placebo (or “sham” adjustment) had similar beneficial results.

What these studies failed to emphasize was that the sham manipulation and the specific adjustment both demonstrated clinical benefits, compared with no care or standard medical management.

The Problem with Placebos Page reviews many articles which discuss the problems with developing a truly neutral sham adjustment, and roundly criticizes those studies which manipulate that data to appear as if SMT did not provide clinical benefit.

About the Author:

I was introduced to Chiro.Org in early 1996, where my friend Joe Garolis helped me learn HTML, the "mark-up language" for websites. We have been fortunate that journals like JMPT have given us permission to reproduce some early important articles in Full-Text format. Maintaining the Org website has been, and remains, my favorite hobby.

2 Comments

  1. Obie Bendix April 5, 2009 at 9:59 pm

    Nevertheless, the development of sham procedures must be pursued diligently to ever refine our investigative techniques.

  2. Frank April 6, 2009 at 11:10 am

    Tony Rosner posits some interesting thoughts on that topic in his JMPT article:

    Fables or Foibles: Inherent Problems with RCTs

    http://www.journals.elsevierhealth.com/periodicals/ymmt/article/PIIS0161475403000940/fulltext

    RTCs are considered the gold standard. And yet, they work best with drug trials, where you do, or don’t get the drug.

    The problem with “physical” modalities is that physical contact must be made to make the placebo credible, and we don’t know how much that contact contributes to the “non-specific” effects of care.

    Here’s a trick question: Can you design a placebo form of massage, to compare “real” massage with?

    Thanks for your input!

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