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  • ‘Caution, this treatment is a placebo. It might work, but it might not’: why emerging mechanistic evidence for placebo effects does not legitimise complementary and alternative medicines in sport

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Editorial
‘Caution, this treatment is a placebo. It might work, but it might not’: why emerging mechanistic evidence for placebo effects does not legitimise complementary and alternative medicines in sport
  1. Chris Beedie1,
  2. Greg Whyte2,
  3. Andrew M Lane3,
  4. Emma Cohen4,
  5. John Raglin5,
  6. Phil Hurst1,
  7. Damian Coleman1,
  8. Abby Foad1
  1. 1 School of Human and Life Sciences, Canterbury Christ Church University, Canterbury, Kent, UK
  2. 2 Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
  3. 3 Institute of Sport, University of Wolverhampton, Walsall, UK
  4. 4 Institute of Cognitive and Evolutionary Anthropology, University of Oxford, Oxford, Oxfordshire, UK
  5. 5 School of Public Health, Indiana University, Bloomington, Indiana, USA
  1. Correspondence to Dr Chris Beedie, School of Human and Life Sciences, Canterbury Christ Church University, N Holmes Rd, Canterbury, Kent CT1 1QU, UK; chris.beedie{at}canterbury.ac.uk

https://doi.org/10.1136/bjsports-2017-097747

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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, …

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