"The dark side of musculoskeletal Care” : why do ineffective techniques seem to work? a comprehensive review of complementary and alternative therapies

The increasing interest in complementary and alternative medicines (CAMs) for musculoskeletal care has sparked significant debate, particularly regarding their biological plausibility and clinical effectiveness. This comprehensive review critically examines the use of two of the most widely utilized...

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Autores principales: Mamud Meroni, Lucas, Tarcaya, Germán E., Carrasco Uribarren, Andoni, Rossettini, Giacomo, Flores Cortes, Mar, Ceballos Laita, Luis
Formato: Artículo publishedVersion
Lenguaje:Inglés
Publicado: MDPI Multidisciplinary Digital Publishing Institute, Suiza 2025
Materias:
SISTEMA MUSCULOESQUELETICO
TERAPIAS COMPLEMENTARIAS
OSTEOPATIA
QUIROPRACTICA
EFECTO PLACEBO
Acceso en línea:https://hdl.handle.net/20.500.14340/2061
Aporte de:
Repositorio institucional de la Universidad de Flores de Universidad de Flores
id I89-R270-20.500.14340-2061
record_format dspace
spelling I89-R270-20.500.14340-20612025-02-18T17:52:32Z urn:issn:2227-9059 https://hdl.handle.net/20.500.14340/2061 doi:10.3390/biomedicines13020392 "The dark side of musculoskeletal Care” : why do ineffective techniques seem to work? a comprehensive review of complementary and alternative therapies 2025 Mamud Meroni, Lucas Tarcaya, Germán E. Carrasco Uribarren, Andoni Rossettini, Giacomo Flores Cortes, Mar Ceballos Laita, Luis MDPI Multidisciplinary Digital Publishing Institute, Suiza eng SISTEMA MUSCULOESQUELETICO TERAPIAS COMPLEMENTARIAS OSTEOPATIA QUIROPRACTICA EFECTO PLACEBO The increasing interest in complementary and alternative medicines (CAMs) for musculoskeletal care has sparked significant debate, particularly regarding their biological plausibility and clinical effectiveness. This comprehensive review critically examines the use of two of the most widely utilized CAMs—osteopathy and chiropractic care—over the past 25 years, focusing on their biological plausibility, clinical effectiveness, and potential mechanisms of action. Our analysis of current research and clinical studies reveals that osteopathy and chiropractic are based on concepts such as “somatic dysfunction” and “vertebral subluxation”, which lack robust empirical validation. While these therapies are often presented as credible treatment options, studies evaluating their effectiveness frequently exhibit serious methodological flaws, providing insufficient empirical support for their recommendation as first-line treatments for musculoskeletal conditions. The effects and mechanisms underlying osteopathy and chiropractic remain poorly understood. However, placebo responses—mediated by the interaction of contextual, psychological, and non-specific factors—appear to play a significant role in observed outcomes. The integration of therapies with limited biological plausibility, whose effects may primarily rely on placebo effects, into healthcare systems raises important ethical dilemmas. This review highlights the need for rigorous adherence to scientific principles and calls for a more comprehensive investigation into biobehavioral, contextual, and psychosocial factors that interact with the specific effects of these interventions. Such efforts are essential to advancing our understanding of CAMs, enhancing clinical decision-making, promoting ethical practices, and guiding future research aimed at improving patient care in musculoskeletal disorders. Fil: Mamud Meroni, Lucas. Universidad de Flores; Argentina. Fil: Tarcaya, Germán E. Universidad de Flores; Argentina. Fil: Carrasco Uribarren, Andoni. Universitat International de Catalunya; España. Fil: Rossettini, Giacomo. Universidad de Verona; Italia. Fil: Flores Cortes, Mar. Universidad de Málaga; España. Fil: Ceballos Laita, Luis. Universidad de Valladolid; España. info:eu-repo/semantics/article info:ar-repo/semantics/artículo info:eu-repo/semantics/publishedVersion info:eu-repo/semantics/openAccess http://creativecommons.org/licenses/by/4.0/ Creative Commons Atribución 4.0 Internacional (CC BY 4.0) application/pdf
institution Universidad de Flores
institution_str I-89
repository_str R-270
collection Repositorio institucional de la Universidad de Flores
language Inglés
topic SISTEMA MUSCULOESQUELETICO
TERAPIAS COMPLEMENTARIAS
OSTEOPATIA
QUIROPRACTICA
EFECTO PLACEBO
spellingShingle SISTEMA MUSCULOESQUELETICO
TERAPIAS COMPLEMENTARIAS
OSTEOPATIA
QUIROPRACTICA
EFECTO PLACEBO
Mamud Meroni, Lucas
Tarcaya, Germán E.
Carrasco Uribarren, Andoni
Rossettini, Giacomo
Flores Cortes, Mar
Ceballos Laita, Luis
"The dark side of musculoskeletal Care” : why do ineffective techniques seem to work? a comprehensive review of complementary and alternative therapies
topic_facet SISTEMA MUSCULOESQUELETICO
TERAPIAS COMPLEMENTARIAS
OSTEOPATIA
QUIROPRACTICA
EFECTO PLACEBO
description The increasing interest in complementary and alternative medicines (CAMs) for musculoskeletal care has sparked significant debate, particularly regarding their biological plausibility and clinical effectiveness. This comprehensive review critically examines the use of two of the most widely utilized CAMs—osteopathy and chiropractic care—over the past 25 years, focusing on their biological plausibility, clinical effectiveness, and potential mechanisms of action. Our analysis of current research and clinical studies reveals that osteopathy and chiropractic are based on concepts such as “somatic dysfunction” and “vertebral subluxation”, which lack robust empirical validation. While these therapies are often presented as credible treatment options, studies evaluating their effectiveness frequently exhibit serious methodological flaws, providing insufficient empirical support for their recommendation as first-line treatments for musculoskeletal conditions. The effects and mechanisms underlying osteopathy and chiropractic remain poorly understood. However, placebo responses—mediated by the interaction of contextual, psychological, and non-specific factors—appear to play a significant role in observed outcomes. The integration of therapies with limited biological plausibility, whose effects may primarily rely on placebo effects, into healthcare systems raises important ethical dilemmas. This review highlights the need for rigorous adherence to scientific principles and calls for a more comprehensive investigation into biobehavioral, contextual, and psychosocial factors that interact with the specific effects of these interventions. Such efforts are essential to advancing our understanding of CAMs, enhancing clinical decision-making, promoting ethical practices, and guiding future research aimed at improving patient care in musculoskeletal disorders.
format Artículo
Artículo
publishedVersion
author Mamud Meroni, Lucas
Tarcaya, Germán E.
Carrasco Uribarren, Andoni
Rossettini, Giacomo
Flores Cortes, Mar
Ceballos Laita, Luis
author_facet Mamud Meroni, Lucas
Tarcaya, Germán E.
Carrasco Uribarren, Andoni
Rossettini, Giacomo
Flores Cortes, Mar
Ceballos Laita, Luis
author_sort Mamud Meroni, Lucas
title "The dark side of musculoskeletal Care” : why do ineffective techniques seem to work? a comprehensive review of complementary and alternative therapies
title_short "The dark side of musculoskeletal Care” : why do ineffective techniques seem to work? a comprehensive review of complementary and alternative therapies
title_full "The dark side of musculoskeletal Care” : why do ineffective techniques seem to work? a comprehensive review of complementary and alternative therapies
title_fullStr "The dark side of musculoskeletal Care” : why do ineffective techniques seem to work? a comprehensive review of complementary and alternative therapies
title_full_unstemmed "The dark side of musculoskeletal Care” : why do ineffective techniques seem to work? a comprehensive review of complementary and alternative therapies
title_sort "the dark side of musculoskeletal care” : why do ineffective techniques seem to work? a comprehensive review of complementary and alternative therapies
publisher MDPI Multidisciplinary Digital Publishing Institute, Suiza
publishDate 2025
url https://hdl.handle.net/20.500.14340/2061
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