The Nocebo Effect Concept
I know, it doesn’t sound very fun or exciting, but it is still very important because of the number of patients I see who have unwittingly become the victims of the Nocebo Effect.
First of all, what is the Nocebo Effect? If you look on the internet it describes the dilemma medical doctors have when prescribing medications. As you know from all the ads on T.V. and in magazines most medications come with a compliment of side effects that make most people decide they would rather just have their original disease instead of the 90 other things that could happen. The dilemma? They are finding that when the doctor tells his patient about these side effects, a fair number of them develop these side effects simply because they were told about them. Doctors are wondering if they should just say, “Here, take these and you’ll be fine,” or risk telling a person about all the crap that might happen and then watching them become afflicted!
Well, you should pay attention to that, but since I don’t prescribe medication, we are going to take a slightly different look at the Nocebo Effect, and from a perspective that I see all too often.
Because the insurance industry loves tests, and exams and x-rays and MRIs… they will pay for these things, and guess what? Every one of these tests, especially X-rays and MRI’s come back remarkable for something- disc herniations, degenerative changes, arthritis, and on and on and on. I often warn patients when they see these reports they are probably going to feel pretty bad about themselves and think, “I didn’t realize I was that messed up!”
This is the Nocebo Effect. The doctor tells the patient they are a mess, they are full of arthritis and degeneration and THIS IS WHAT’S CAUSING YOUR PAIN, AND THERE IS NOTHING YOU CAN DO FOR THIS EXCEPT ACCEPT IT AND LEARN TO LIVE WITH IT.
This creates a negative outlook on the part of the patient, and they usually have a poor prognosis- meaning they don’t recover well and actually don’t do better. And what was the problem? The degeneration, the disc bulges, arthritis? No- it was the doctor telling the patient that they had to live with it because they had all of these degenerative problems. As a result, patients then start to “take care” of themselves and stop walking, stop exercising, start taking it easy and go into a general decline.
Here’s the deal. In most cases these degenerative changes, bulges, and arthritic findings are all part of the normal aging process, and… wait for it DO NOT CAUSE PAIN AND/OR DYSFUNCTION.
So a guy goes, sees his doctor, gets films, is told he is a mess, and then stops living and creating a life because the doctor tells him nothing can be done about it. OUCH!!!!!
Well, I have a ton more to say about this, but for now, just think about that. The doctor’s negative attitude is causing negative results in his patients, and keeping those patients from achieving wellness.
Sure there are true pathological causes for pain- diseases, cancers and so forth, but when dealing with back pain, and pain, in general, this is true in less than 5% of all cases. Instead, the problem is a combination of dysfunction and poor diet, and SOMETHING CAN BE DONE ABOUT THESE!
Please let me know what you think, and if you’ve been told live with it, consider asking the doctors and staff at Paragon. We have been helping patients do more than just live with it for over 33 years.
Okay, well talk more about Nocebo and what you can do in the next exciting adventure!