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Table 1

Return to:   Imperfect Placebos Are Common In Low Back Pain Trials:
A Systematic Review Of The Literature

Characteristics of included trials

StudyPlacebo interventionAssessment of blinding and expectationsStrategies to facilitate blinding
IndistinguishabilityInert placeboEquivalenceNaïve subjects
Acupuncture
 Itoh et al. [74] Mock insertion of a needle〈F〉 Belief in the insertion of needles: no significant differences between groups✓✓
 Inoue et al. [73] Mock insertion of a needle〈F〉 Belief in the insertion of needles: no significant differences between groups✓✓
 Kerr et al. [85]Detuned TENS〈F〉 Willingness to try the treatment again in future: no significant differences between groups✓✓
 Molsberger et al. [106]Superficial needling at non-acu pointsNot assessed✓✓✓
 Leibing et al. [95]Superficial needling at non-acu pointsNot assessed✓✓
 Sherman et al. [128]Mock insertion of a needle〈B〉 Belief in the efficacy of acupuncture and 〈F〉 belief in the insertion of needles: no significant differences between groups; 〈F〉 Credibility scale: groups were different on item related to pain relief (P = 0.01)✓✓✓
 Carlsson and Sjölund [25]Detuned TENSNot assessed✓✓
 Macdonald et al. [99]Detuned TENSNot assessed✓
 Duplan et al. [42]Superficial needling at non-acu pointsNot assessed✓✓
 Mendelson et al. [104]Superficial needling at non-acu points〈B〉 Expectation of pain relief: change in pain in response to treatment was not correlated to expectation of pain relief (no data provided)✓✓
Back school
 Chenard et al. [28] Detuned TENSNot assessed✓✓
 Bergquist-Ullman and Larsson [11] Lowest intensity SWDNot assessed
Behavioural
 Basler et al. [10]Detuned USNot assessed✓✓
 Snook et al. [130]"Ineffective" exercisesNot assessed✓
 Strong [132]Health education video〈F〉 Credibility scale: no significant differences between groups✓✓
 Goossens et al. [62]Group discussionNot assessed✓✓
 Nicholas et al. [111]Group discussion〈B; F〉 Expectation scale: no significant differences between groups at baseline; higher expectations in experimental group after treatment (P < 0.05)✓✓
 Stuckey et al. [133]Encouragement to relax Not assessed✓✓
 Bush et al. [21]Biofeedback with "temperature tones"Not assessed✓✓✓
Electrotherapy
 Lee et al. [94]Detuned PEMTNot assessed✓✓
 Bertalanffy et al. [15]Detuned TENSNot assessed✓✓
 Jarzem et al. [77] Detuned TENSNot assessed✓✓✓
 Jarzem et al. [76]Detuned TENS〈F〉 Evaluation of reported and actual use of TENS units: no significant differences between groups✓✓
 Topuz et al. [137] Detuned TENSNot assessed✓✓✓
 Sator-Katzenschlager et al. [122] Needling without electrical stimulation〈F〉 Belief in provision of real stimulation: no significant differences between groups; 〈F〉 Willingness to repeat treatment if necessary: 87% of patients in experimental group and 0% in placebo group would repeat treatment✓✓
 Weiner et al. [143]Needling without electrical stimulationNot assessed✓
 Glaser et al. [57]TENS〈B; F〉 Expectation scale: no significant differences between groups✓✓
 Carlsson and Sjölund [25]Detuned TENSNot assessed✓✓
 Hackenberg et al. [63]Lowest intensity radiotherapyNot assessed✓✓✓
 Cheing and Hui-Chan [27]Detuned TENSNot assessed✓✓
 Basford et al. [8]Inactive laser probesNot assessed✓✓✓
 Ghoname et al. [50]Needling without electrical stimulation〈F〉 Willingness to pay out-of-pocket for treatment: more patients in group receiving PENS therapy willing to pay compared to other groups (P < 0.02)✓✓
 Ghoname et al. [49]Needling without electrical stimulation〈F〉 Willingness to pay out-of-pocket for treatment: more patients in group receiving electrical stimulation of 15–30 Hz willing to pay compared to other groups (P < 0.05)✓
 Ghoname et al. [51]Needling without electrical stimulationNot assessed✓
 Moore and Shurman [107]Detuned TENS〈F〉 Choice of therapy among those who would continue treatment: 38% NMES/TENS; 25% none; 21% NMES; 8% TENS; 8% placebo✓✓✓
 Herman et al. [69]Detuned TENSNot assessed✓✓✓
 Klein and Eek [89]Inactive laser probesNot assessed✓✓✓
 Deyo et al. [37, 38]Detuned TENS〈F〉 Perception that TENS units were functioning properly: 84% of patients in placebo group guessed they had functioning units (blinding reported as partially successful)✓✓✓
 Gibson et al. [54]Detuned SWDNot assessed✓✓
Exercise
 Goldby et al. [59]Educational bookletNot assessed
 Geisser et al. [48]Nonspecific exercises/positioning without muscle energy〈F〉 Belief in provision of real treatment: no significant differences between groups✓
 Tasleem et al. [136]Lowest intensity SWDNot assessed
 Preyde [116]Inactive laser probesNot assessed✓✓
 Ghoname et al. [50]Needling without electrical stimulation〈F〉 Willingness to pay extra money for therapy: no significant differences between groups receiving exercise and placebo✓✓
 Cherkin et al. [29]Educational bookletNot assessed
 Spratt et al. [131]Abdominal wrap/advice to walk/videoNot assessed✓✓
 Faas et al. [43]US with lowest possible doseNot assessed✓
Hansen et al. [67]Semi hot pack/10% body weight tractionNot assessed✓✓
 Deyo et al. [37, 38]Detuned TENS〈F〉 Perception that TENS units were functioning properly: 84% of patients in placebo group guessed they had functioning units (blinding reported as partially successful)✓✓
Heatwrap therapy
 Nadler et al. [109] Placebo tabletsNot assessed✓
 Nadler et al. [110]Placebo tabletsNot assessed✓
Insoles
 Shabat et al. [127]Placebo insole〈F〉 Choice of therapy among those who would continue treatment: majority of patients would prefer the true insole (P < 0.05) ✓✓✓
Magnet therapy
 Collacott et al. [33]Demagnetised deviceNot assessed✓✓✓✓
Massage
 Preyde [116]Inactive laser probesNot assessed✓✓
Neuroreflexotherapy
 Kovacs et al. [93]Epidermal implants in adjacent points Not assessed✓✓✓
Pharmaceutical (oral or topical)
 Muehlbacher et al. [108]Matching placebo tabletsNot assessed✓✓✓
 Bannwarth et al. [7]Matching placebo tabletsNot assessed✓✓✓
 Khoromi et al. [87]Diphenhydramine tabletsNot assessed✓✓
 Ketenci et al. [86]Placebo capsulesNot assessed✓✓✓
 Katz et al. [82]Matching placebo tabletsNot assessed✓✓✓✓
 Brizzi et al. [20]Drug-free hydroelectrophoresisNot assessed✓✓✓
 Coats et al. [32]Matching placebo tabletsNot assessed✓✓✓
 Hoiriis et al. [72]Matching placebo tablets〈F〉 Belief in provision of real medication: no significant differences between groups✓✓✓
 Pallay et al. [112]Matching placebo tabletsNot assessed✓✓✓
 Peloso et al. [114]Matching placebo tabletsNot assessed✓✓✓
 Frerick et al. [47]Matching placebo plasterNot assessed✓✓✓
 Ruoff et al. [120]Placebo tabletsNot assessed✓✓✓
 Birbara et al. [17]Matching placebo tabletsNot assessed✓✓✓
 Dreiser et al. [41]Placebo tabletsNot assessed✓✓✓
 Katz et al. [83]Placebo tabletsNot assessed✓✓✓
 Dreiser et al. [40]Placebo tabletsNot assessed✓✓✓
 Keitel et al. [84] Matching placebo plasterNot assessed✓✓✓
 Chrubasik et al. [30]Matching placebo tabletsNot assessed✓✓✓
 Dickens et al. [39]Matching placebo capsulesNot assessed✓✓✓
 Schnitzer et al. [124]Placebo capsulesNot assessed✓✓✓
 Atkinson et al. [4]Diphenhydramine tabletsNot assessed✓✓
 Chrubasik et al. [31]Matching lactose tabletsNot assessed✓✓✓
 Atkinson et al. [5]Matching placebo capsulesNot assessed✓✓✓
 Worz et al. [145]Placebo tabletsNot assessed✓✓✓
 Weber et al. [142]Matching placebo capsulesNot assessed✓✓✓
 Goodkin et al. [60]Matching placebo tabletsNot assessed✓✓✓
 Marcel et al. [101]Matching placebo tabletsNot assessed✓✓✓
 Schnebel and Simmons [123]Matching lactose capsulesNot assessed✓✓✓
 Berry and Hutchinson [14]Matching placebo tabletsNot assessed✓✓✓
 Berry and Hutchinson [13]Matching placebo tabletsNot assessed✓✓✓
 Amlie et al. [2]Matching placebo tabletsNot assessed✓✓✓
 Ginsberg and Famaey [55]Massage with placebo ointmentNot assessed✓
 Haimovic and Beresford [64]Matching placebo tabletsNot assessed✓✓✓
 Dapas et al. [35]Placebo tabletsNot assessed✓✓✓
 Jagemann [75]Placebo tabletsNot assessed✓✓✓
Pheasant et al. [115]Atropine tabletsNot assessed✓✓✓
 Berry et al. [12]Matching placebo tabletsNot assessed✓✓✓
 Alcoff et al. [1]Placebo pillsNot assessed✓✓✓
 Ghosh et al. [52]Matching placebo tabletsNot assessed✓✓✓
 Gold [58]Placebo tabletsNot assessed✓✓✓
Pharmaceutical (injection or infusion)
 Finckh et al. [45]0.9% saline infusionNot assessed✓✓✓✓
 Arden et al. [3]Normal saline injection〈F〉 Belief in the provision of real treatment: no significant differences between groups✓✓✓✓
 Korhonen et al. [92]Saline infusionNot assessed✓✓✓✓
 Wasan et al. [141]Saline infusion〈B〉 Expectation scale: expectations for pain relief significantly correlated with pain outcomes (P < 0.05)✓✓✓
 Khot et al. [88]Normal saline injectionNot assessed✓✓✓
 Tuzun et al. [139]Placebo injectionNot assessed✓✓✓
 Mauro et al. [102]Placebo injectionNot assessed✓✓✓
 Dechow et al. [36]Normal saline injectionNot assessed✓✓✓
 Medrik-Goldberg et al. [103]Normal saline infusion〈F〉 Belief in provision of real treatment: no significant difference between groups✓✓✓
 Tajiri et al. [135]Physiologic saline injectionNot assessed✓✓✓
 Revel et al. [118]Saline injectionNot assessed✓✓✓
 Carette et al. [23]Isotonic saline injection〈F〉 Belief in the provision of a placebo injection: no significant differences between groups✓✓✓
 Ghozlan and Dropsy [53]Isotonic saline injection/matching placebo tabletsNot assessed✓✓✓
 Babej-Dölle et al. [6]Isotonic saline injectionNot assessed✓✓✓
 Fine et al. [46]Isotonic saline infusionNot assessed✓✓✓
 Szpalski and Hayez [134]Placebo injection/matching placebo tabletsNot assessed✓✓✓
 Bush and Hillier [22]Normal saline injectionNot assessed✓✓✓
 Carette et al. [24]Isotonic saline injectionNot assessed✓✓✓✓
 Treves et al. [138]Glucose infusionNot assessed✓✓✓
 Lilius et al. [97]Physiologic saline injectionNot assessed✓✓✓
 Ginsberg et al. [56]Isotonic saline injectionNot assessed✓✓
 Klenerman et al. [90]Normal saline injectionNot assessed✓✓✓✓
 Chapman and Brena [26]Normal saline injectionNot assessed✓✓✓
 Hofferberth et al. [71]Placebo injectionNot assessed✓✓✓
 Brena et al. [19]Saline injectionNot assessed✓✓✓
Spinal manipulative therapy
 Hall et al. [65]Foot massage〈F〉 Belief in provision of real treatment: no significant differences between groups ✓✓
 Geisser et al. [48]Nonspecific exercises/positioning without muscle energy〈F〉 Belief in provision of real treatment: no significant differences between groups✓
 Hawk et al. [68]Up to 12N postero-anterior force applied lateral to spine/effleurage〈F〉 Perception of group assignment: patients in placebo group more likely to accurately perceive their group assignment. 〈B; F〉 Expectation of improvement: no significant differences between groups at baseline; patients in placebo group had lower expectations at visit 4 (P = 0.04)✓
 Hoiriis et al. [72]Positioning and light pressure〈F〉 Belief in provision of true chiropractic adjustments: more patients in chiropractic group believed real adjustments were provided (P < 0.001)✓✓
 Licciardone et al. [96]Range of motion/light touch/simulated osteopathic techniquesNot assessed✓
 Goodsell et al. [61]Lying proneNot assessed✓
 Cherkin et al. [29]Educational bookletNot assessed
 Wreje et al. [146]Gluteus medius transverse frictionNot assessed✓
 Sanders et al. [121]Light touchNot assessed✓✓✓
 Gibson et al. [54]Detuned SWDNot assessed✓
 Jayson et al. [78]Microwave with lowest settingNot assessed✓
 Bergquist-Ullman and Larsson [11] Low intensity SWDNot assessed
Traction
 Sherry et al. [129]TENSNot assessed✓
 Beurskens et al. [16]Traction up to 20% total body weight〈F〉 Belief in provision of real treatment: no significant differences between groups✓✓✓✓
 Reust et al. [117]5 kg traction Not assessed✓✓✓✓
TENS Transcutaneous electrical nerve stimulation, SWD short-wave diathermy, PEMT pulsed electromagnetic therapy, PENS percutaneous electrical nerve stimulation, NMES neuromuscular electrical stimulation, US ultra-sound

〈B〉 Measure taken at baseline. 〈F〉 Measure taken at follow-up