Placebos have been used for centuries both knowingly and unknowingly. A review of the literature on placebo effects shows at there is a complex response to placebos, potentially affecting one in three patients. The effects of the placebo are physiological and powerful over a wide range of subjective symptoms. Yet the true mechanisms of action are unclear being a combination of external and internal milieu. The application of the placebo in musculoskeletal management/ clinical practice has not been previously addressed.