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Complementary and alternative medicines (CAM) are treatments for which either evidence is lacking, or for which evidence suggests no effect over a placebo treatment. When a non-evidence-based treatment is used alongside conventional medicine, it is considered ‘complementary’. When a non- evidence-based treatment is used instead of conventional medicine, it is considered ‘alternative’. Many forms of CAM have origins and/or a history of use beyond evidence-based medicine. Further, many CAM treatments are based on principles and/or evidence that are not recognised by the majority of independent scientists. When a person uses CAM and experiences an improvement in symptoms, this may be due to the placebo effect.1
CAM is widely used in sport, often by elite athletes. One example is Michael Phelps’ use of ‘cupping’ during the 2016 Olympics. Evidence for the effectiveness of CAM in sport has been reported in some work, but more studies have reported CAM outcomes as no better than placebo. The link between CAM and the placebo effect has been made explicit by health agencies1 and scientists.2 As a consequence, where credible causal mechanisms for apparent therapeutic effects are absent, placebo effects are often assumed.
The placebo effect was historically considered a non-specific phenomenon, …