Thursday Thoughts: Non-Specific Effects

apparently this guy is Non-Specific Action Figure - he approves this post

What happens when you read literature that says your favorite manual treatment or exercise has non-specific effects? Do you get upset? Do you roll with it and keep on doing the same? Maybe you question what you have been doing all along.

I'll tell you what has non-specific effects

• joint mobilization/manipulation
• soft tissue work
• corrective exercise
• repeated motions

It certainly does not mean that just because any of these have been tested "the right way to do them" versus sham, and hopefully with a control, that you should not be using them as treatments. What it does mean is that the intention of making a change, and giving the nervous system novel input will restore a homeostasis to the area applied.

This means if

• you wiggle a joint
• scrape some skin
• needle it 
• use some PNF to get the area moving

that if there are muscles that are faciltated, they will have tone reduction. Muscles that are inhibited, will have increase in tone. Yes, it's convenient.

One more thing, regular readers will know my passion for pain science education, and how it is promoted in all my evaluations and treatments along with my courses. However, we see sham pain science education working daily in clinics all over the world. Patients get explanations that certain exercises are going to reduce discs, strengthen their core, reposition their pelvis, or any other type of biomechanical explanation. They buy it, placebo occurs, and they get better. When delivered by an interactive, charismatic, compassionate practioner, sham pain science also works to reduce fear avoidance. Has this ever been studied? Not that I am aware of, but I believe since it happens clinically, it would also happen under controlled conditions. 

Are you a better clinician for moving away from pathoanatomy and using modern explanations of treatment, movement, and pain? You know my thoughts. What about yours? Chime in below on on the facebook page.

Keeping it Eclectic...