07/05/2025
New Webinar!
https://register.gotowebinar.com/register/8779066430526761568?source=p
Giacomo Rossettini ¦ Contextual Effects in Musculoskeletal Pain - Insights and Uncertainties
Contextual effects are complex psycho-neurobiological phenomena that produce neurobiological, physical, perceptual, and cognitive changes. These changes arise from various contextual elements within the therapeutic environment, including specific healing rituals and cues such as the clinician’s and patient’s characteristics, the patient-clinician relationship, treatment rituality, and the broader healthcare context.
Evidence indicates that contextual effects can influence more subjective outcomes in musculoskeletal care through mechanisms like expectation, learning, neurotransmitter release, and neural activation. Positive contextual elements, such as empathetic communication, therapeutic rituals, and trust in treatment, enhance outcomes via placebo mechanisms. In contrast, negative factors, including uncertainty, mistrust, or a perceived lack of care, can exacerbate symptoms through nocebo mechanisms. Understanding these processes is crucial to optimize care and minimize adverse effects.
Despite advancements, significant challenges persist. These include distinguishing contextual effects from confounding factors like natural disease progression and regression to the mean, assessing their long-term impact on musculoskeletal conditions, and examining their influence across diverse populations varying in ethnicity, culture, and age. Addressing these challenges demands a multidisciplinary effort involving neuroscience, psychology, physiotherapy, medicine, nursing, osteopathy, and chiropractic.
Moving from this premise, this masterclass will deliver an in-depth exploration of contextual effects in musculoskeletal care. It will review current evidence, critically evaluate research limitations, and identify priorities for future research.
Dr. Giacomo Rossettini has authored over 110 publications in peer-reviewed scientific journals in the fields of physiotherapy and rehabilitation. He has delivered more than 60 presentations at universities, conventions, and both national and international conferences.
