Context and placebo in manual therapy
published in March - April 2019 - in Il Fisioterapista - issue n.2
Paolo Bizzarri

Musculoskeletal rehabilitation is based on manual therapy, therapeutic exercise and therapeutic education. Several manual techniques and methods have been proposed in the past, but without clinically significant differences being found between one technique and another in highquality trials. Numerous studies have been conducted but have failed to identify biomechanical factors able to predict successful outcomes following manual therapy programs. Recent studies have evaluated the role of contextual factors and placebo mechanisms in improving the condition of patients with musculoskeletal pain. This article presents the available literature on contextual factors and placebo in manual therapy and discusses the potential clinical consequences.