Placebos for Knee Osteoarthritis: Reaffirmation of “Needle Is Better Than Pill”
Authors: Weiya Zhang, Kun Zou, Michael Doherty
Journal: Annals of Internal Medicine (2015)

Editorials1 September 2015Placebos for Knee Osteoarthritis: Reaffirmation of "Needle Is Better Than Pill"Weiya Zhang, PhD, Kun Zou, PhD, and Michael Doherty, MA, MDWeiya Zhang, PhDFrom School of Medicine, University of Nottingham, Nottingham, United Kingdom., Kun Zou, PhDFrom School of Medicine, University of Nottingham, Nottingham, United Kingdom., and Michael Doherty, MA, MDFrom School of Medicine, University of Nottingham, Nottingham, United Kingdom.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M15-1580 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Many studies and randomized, controlled trials (RCTs) have confirmed that, for many conditions, placebo treatment is more effective than no treatment. Patient expectancy is a key determinant of the placebo effect, and this is influenced by a patient's illness perceptions and experience, as well as various contextual factors (including the patient–practitioner interaction, the environment in which the treatment is received, the branding and color of medications, and whether a treatment is new and expensive or old and cheap) (1). The route of administration also influences expectancy, with greater placebo effects occurring with treatments delivered by needles (injections and acupuncture) or ...References1. Doherty M, Dieppe P. The "placebo" response in osteoarthritis and its implications for clinical practice. Osteoarthritis Cartilage. 2009;17:1255-62. [PMID: 19410027] doi:10.1016/j.joca.2009.03.023 CrossrefMedlineGoogle Scholar2. Kaptchuk TJ, Stason WB, Davis RB, Legedza AR, Schnyer RN, Kerr CE, et al. Sham device v inert pill: randomised controlled trial of two placebo treatments. BMJ. 2006;332:391-7. 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[PMID: 12210616] CrossrefMedlineGoogle Scholar7. Hill AB. Suspended judgment. Memories of the British Streptomycin Trial in Tuberculosis. The first randomized clinical trial. Control Clin Trials. 1990;11:77-9. [PMID: 2161313] CrossrefMedlineGoogle Scholar8. Zhang W. Is placebo a possible therapy for osteoarthritis? From placebo to obecalp.. In: Lindgren KA, eds. Placebo: Placebo Effects in Musculoskeletal Disorders. Helsinki, Finland: Rehabilitation Orton Foundation; 2013:61-8. Google Scholar9. Walach H. The efficacy paradox in randomized controlled trials of CAM and elsewhere: beware of the placebo trap [Editorial]. J Altern Complement Med. 2001;7:213-8. [PMID: 11439833] CrossrefMedlineGoogle Scholar10. Di Blasi Z, Harkness E, Ernst E, Georgiou A, Kleijnen J. Influence of context effects on health outcomes: a systematic review. Lancet. 2001;357:757-62. [PMID: 11253970] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From School of Medicine, University of Nottingham, Nottingham, United Kingdom.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M15-1580.Corresponding Author: Michael Doherty, MA, MD, Academic Rheumatology, Clinical Sciences Building, City Hospital, Hucknall Road, Nottingham NG5 1PB, United Kingdom; e-mail, michael.[email protected]ac.uk.Current Author Addresses: Professors Zhang and Doherty and Dr. Zou: Academic Rheumatology, Clinical Sciences Building, City Hospital, Hucknall Road, Nottingham NG5 1PB, United Kingdom.This article was published online first at www.annals.org on 28 July 2015. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEffectiveness and Implications of Alternative Placebo Treatments Raveendhara R. Bannuru , Timothy E. McAlindon , Matthew C. Sullivan , John B. Wong , David M. Kent , and Christopher H. Schmid Effectiveness and Implications of Alternative Placebo Treatments Raveendhara R. Bannuru , Timothy E. McAlindon , Matthew C. Sullivan , John B. Wong , David M. Kent , and Christopher H. 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