Placebo

Practitioners across the globe have developed countless ways of treating musculoskeletal dysfunction. Some rooted deeply in evidence, experience, and logic, others with their roots firmly planted in pseudoscience. Many of these treatments that are less than logical seem, at times, to achieve results. Why does this happen? Why do ineffective treatments sometimes seem helpful? This and more will be explored in the following articles. 

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Essential Literature

Genetics and the placebo effect: the “Placebome”
Hall KT. 2015
Conclusion:
Placebos are indispensable controls in randomized clinical trials (RCTs), and placebo responses significantly contribute to routine clinical outcomes. Recent neurophysiological studies reveal neurotransmitter pathways that mediate placebo effects. Evidence that genetic variations in these pathways can modify placebo effects raises the possibility of using genetic screening to identify placebo responders and thereby increase RCT efficacy and improve therapeutic care.

Research on placebo analgesia is relevant to clinical practice
Charles Gay Mark Bishop 2014
Conclusion:
Chiropractors and manual therapists should embrace analgesic-placebo-research in an attempt to maximize endogenous pain relieving mechanisms to produce maximum clinical benefit. Historical views that placebo responses are fake, passive, undesirable, and require deception and therefore should be minimized and avoided in clinical practice are outdated. Further, statements that contend the placebo response represents a single mechanism are too simplistic.

Why do ineffective treatments seem helpful? A brief review
Steve Hartman 2009
Conclusion:
Occasionally, purposeful clinical treatment leads directly to symptom improvement. More often, patients and practitioners award credit to a particular therapy when healing is unrelated (or even imaginary). Independent of any specific treatment, measurable signs and symptoms often improve, due to the self-correcting course of many diseases; regression to the mean; placebo effects; and other factors coincident with (but directly unrelated to) treatment. Even more worrisome, symptom improvement may be only imagined, consequent to various forms of confirmation bias, and peripheral factors leading to psychological palliation. 

A Comprehensive Review of the Placebo Effect: Recent Advances and Current Thought
Price et. al. 2008
Conclusion:
Our understanding and conceptualization of the placebo effect has shifted in emphasis from a focus on the inert content of a physical placebo agent to the overall simulation of a therapeutic intervention. Some placebo responses, such as analgesia, are initiated and maintained by expectations of symptom change and changes in motivation/emotions. Placebo factors have neurobiological underpinnings and actual effects on the brain and body. They are not just response biases.