Atlas of Chiropractic

Mastering the Message: The Science of Nocebo Effect with Dr. Jonathan Chung


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In this episode, Dr. Jonathan Chung and Dr. John Stenberg discuss the biopsychosocial model of pain and its impact on cervical chiropractic care. They emphasize the importance of individualized care and the limitations of the biopsychosocial model. They share personal experiences and highlight the role of stratifying patients and understanding biomarkers. The conversation also explores the nocebo effect and its impact on patient psychology. The episode concludes with a discussion on teaching patients to control pain and understand flare-ups. This conversation explores the importance of managing patient expectations, avoiding nocebos, and using patient-centered communication in upper cervical chiropractic care. It emphasizes the need to be mindful of language and to avoid using scare tactics or exaggerated claims. The conversation also highlights the significance of the therapeutic relationship and understanding the patient's life and circumstances. By focusing on empowering patients and promoting their resilience, chiropractors can provide more effective and meaningful care.


Takeaways:

  • The biopsychosocial model of pain expands our understanding of pain medicine beyond just tissue injury and emphasizes the complex interactions of biological, psychological, and social factors.
    • Individualized care is crucial in cervical chiropractic to address both the bio and psychosocial aspects of a patient's condition.
      • Stratifying patients based on their presentation and understanding relevant biomarkers can help provide more targeted and effective treatment.
        • The nocebo effect, where negative beliefs and expectations can lead to negative outcomes, should be considered when communicating with patients.
          • Teaching patients to control pain and understand flare-ups can empower them to manage their condition and improve their outcomes. Manage patient expectations by emphasizing their progress and the strategies in place to address any issues that may arise.
            • Avoid using scare tactics or exaggerated claims that can create unnecessary anxiety and dependency on chiropractic care.
              • Be mindful of language and use patient-centered communication that focuses on empowering patients and promoting their resilience.
                • Develop a strong therapeutic relationship with patients, taking the time to understand their life circumstances and providing support beyond chiropractic adjustments.


                • Here is the link for the full text PDF of the paper we discussed;

                  Beyond biopsychosocial: The keystone mechanism theory of pain


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                  @drjonathanchung

                  @zenith_chiro


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