EDITORIAL
The art of medicine in treating osteoarthritis: I will please
Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
Correspondence to:
Professor J W J Bijlsma, University Medical Center Utrecht, The Netherlands; J.W.J.Bijlsma@umcutrecht.nl
Accepted 18 September 2008
| The first 150 words of the full text of this article appear below. |
The Latin word placebo literally means, "I will please". Until 1945 the placebo was a "morally" useful but innocuous management tool without curative or symptomatic consequences. When in the 1950s the double-blind randomised controlled trial (RCT) began to establish itself, the placebo was imbued with powerful therapeutic effects and its ethical use in clinical practice was being questioned.1 In a few years the placebo changed from what was called the "humble humbug" (a means of reinforcing a patient’s confidence in his recovery) to an entity with occult-like powers that could mimic potent drugs.
Nowadays placebo is primarily used within the RCT setting; use in clinical practice is generally considered unethical. In the current literature placebo is described as "inert", "inactive" or "non-specific" and as "dummy" or "sham" treatment in the context of a RCT. An "active" treatment not expected to be useful for the complaints at hand, however, might work
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