If you're a long term listener you'll know that we constantly mention both placebo and nocebo and how powerful they can be so we decided it's time we fully explored the topic. While we have a bit of fun (Nothing New) this is a very important topic and as Tom states, in the end, it can be incredibly powerful and damaging. 

If you're new here and the idea of placebo and nocebo is alien then let us quickly explain. Placebo. An example we've often used is one in our recovery series. A lot of data we look at refers to a perceived feeling. So when they ask someone for example "did massage improve your DOMs" they are more likely to say yes over the group who had nothing done. If someone says this massage is going to help with soreness you're automatically invested in that result regardless if it's true or not. (We are not saying massage is placebo by the way.) Nocebo. So we are looking at the complete opposite here. Once again not saying this is true but if in the same study they said this massage is going to make your legs really sore you might struggle to walk you would do well to assume that those told that statement would get off the massage table and walk funny. This probably wouldn't happen because in society we often associate massage with relaxation and recovery so we are automatically placebo through societal norms anyway. Already in this small paragraph, you can see how in-depth this can go and how complicated it can get. This episode could have been a lot longer!

Language is super important. What we say can have a major impact on someone's life. The psychological power of both placebo and nocebo can cause long-lasting effects so we MUST be careful. Especially in regards to the final statements by Tom, take it in and remember the power of language going forward.

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Studies Mentioned

Effects of placebos without deception compared with no treatment: A systematic review and meta-analysis

The Placebo and Nocebo effect on sports performance: A systematic review

Learning one’s genetic risk changes physiology independent of actual genetic risk

Effects of mental training on muscular force, hormonal and physiological changes in kickboxers

Altered placebo and drug labelling changes the outcome of episodic migraine attacks

Physiotherapists' beliefs and attitudes influence clinical practice in chronic low back pain

The enduring impact of what clinicians say to people with low back pain

There is more to pain than tissue damage

A randomised clinical trial of the efficacy of drop squats or leg extension/leg curl exercises

No relationship between the acromiohumeral distance and pain in adults with subacromial pain syndrome: a systematic review and meta-analysis

BONUS STUDY that we didn't mention but super interesting! SHAM surgery, where people are put to sleep and then are "told" they have had surgery.