During this morning live broadcast on Facebook of PodChatLive (and its on YouTube) we were discussing paediatric flatfoot and paediatric foot orthoses with Helen Banwell, a question from came in from Marc Barton that got me thinking.
But first, some context to the thinking: we have a learnt a lot in recent years about the importance of nocebic language and just how potentially harmful to outcomes can the choice of language be. The topic has come up in several of our previous PodChatLive’s. ‘Nocebo’ comes from the Latin nocēbō: “I shall harm”. Nocebo effects are considered as adverse events or more negative outcomes that are related to negative expectations. There is quite a body of literature developing around this concept.
Marc’s question came during the discussion on that perennial issue about the use of foot orthoses in the asymptomatic paediatric flatfoot and was “Is there a worry that if we prescribe an orthosis in asymptomatic the child will ‘rely’ on it and never give it up?“. Yes, that is a problem and an issue.
In that context of the use and potential harm of nocebic language, I came up with the term: “nocebic foot orthotic“. It got a laugh.
What say you?
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I’m not sure it can be called nocebic because ,in that case ,it wont be the orthotic that will cause the beliefs that the child body is weak but the explaination that justify why you prescribed that othotic.
But for sure the orthotic can increase this belief and create a therapeutic dependency because it’s a « proof » that the foot isn’t capable to function correctly by itself.