OBJECTIVE: To identify aspects of the delivery of placebo chiropractic treatments by using sham adjustments that may cause a treatment effect and that may affect the success of blinding. DESIGN AND SETTING: Two-period crossover design in a chiropractic college research clinic. SUBJECTS: Eighteen volunteer staff, students, and faculty of the chiropractic college who reported low-back pain within the last 6 months. INTERVENTIONS: Flexion-distraction technique was used to perform chiropractic adjustments, and a hand-held instrument (Activator adjusting instrument) with the pressure gauge set on the 0 was used to perform sham adjustments. The treatment period was 2 weeks, with a total of 4 visits. MAIN OUTCOME MEASURES: The visual analog scale (VAS) for pain and Global Well-Being Scale (GWBS). RESULTS: Although VAS and GWBS scores improved with both treatments, a somewhat greater improvement occurred in most cases with the active treatment. Eight of 14 patients interviewed believed that the placebo had a treatment effect. CONCLUSION: This study provided preliminary information that was useful in planning the protocol for a placebo chiropractic treatment in the randomized clinical trial for which it was designed.
Reprinted from the Journal of Manipulative and Physiological Therapeutics with copyright permission from the National University of Health Sciences.

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