The Nocebo Effect

I’m sure you’ve heard of the term, “placebo” – a substance or treatment that has no physical effects, but may be perceived as beneficial via psychological processes.

BUT have you heard of “nocebo”?

Nocebo means a detrimental effect on health produced by psychological or psychosomatic factors such as negative expectations of treatment or prognosis. In physical therapy circles, nocebos or more specifically “nocebic” language has become a hot talking point in the management of patients.

Examples of nocebic language:

you’ve most likely heard: “deadlifting will ruin your back”, “Running will give you knee arthritis”, “You have to squat with your knees behind your toes or you’ll hurt yourself”, “sitting with slouched posture will hasten the melting of the polar ice caps and kill all the polar bears!!!”

Jokes aside, hearing common phrases like this can make beginning to exercise seem like a daunting process because of the fear of injury. Deadlifting, running, or squatting with your knees past your toes are not likely to injure you in a vacuum.

Injuries and/or pain are often multifactorial in nature.

If injuries and pain were only biomechanical we would not have the continuing volume of chronic pain and injuries plaguing the health care system.

My main point – far too many Americans do not meet recommended exercise guidelines or even come close to it.

Common nocebic beliefs are just another barrier beyond work time/stress, family obligations, commuting, etc to getting people moving and improving their health.

Let’s lift each other up and be positive about people seeking out new exercises and taking the time to improve their health.

If you are unsure if an exercise is safe for you, please feel free to contact myself or a physical therapist in your area to help answer your concerns!   

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