As far as the body is concerned, a placebo is nothing—a sugar pill, a sham treatment, an inert compound. But try telling that to the brain, as scientists led by Daniel Cherkin of Group Health Center for Health Studies in Seattle recently saw. They assigned 638 adults with chronic lower-back pain to receive either standard acupuncture therapy, customized acupuncture (tailored to the individual, such as by using nonstandard acupuncture points), sham acupuncture (toothpicks in acupuncture-needle guide tubes that mimic the feel of real acupuncture) or standard back-pain care, such as anti-inflammatory drugs and massage.
As the scientists reported this month in Archives of Internal Medicine, pain diminished significantly for 60 percent of the people in all three acupuncture groups—but for just 39 percent of patients receiving usual care. On average, both fake and real acupuncture reduced pain more than twice as much as standard care. Weirdly, this is being spun as “acupuncture is better than standard medical care for back pain!” I say “weirdly” because the key finding is that sham acupuncture delivered as much benefit as real acupuncture. And the most parsimonious explanation for that finding is inescapable: it is possible to think yourself out of pain.
In fact, the power of thought to relieve pain has been known since 1978, when neuroscientists began studying placebo responses in earnest. Now they have even mapped the brain processes that underlie it. When people expect their pain to diminish, typically because a doctor tells them that a little pill or other treatment will do so, that mere expectation produces activity in the prefrontal cortex, site of higher mental function, which in turn activates other regions to release the brain’s own homemade opioids, says Fabrizio Benedetti of the University of Turin Medical School, a pioneer in placebo research. (A big advance in understanding placebo was showing that a drug that blocks the effects of opioids also blocks the placebo effect on pain, prima facie evidence that the brain’s endogenous opioids are in play.) The higher the expectations, the greater the pain relief, too. When scientists led by Dan Ariely of Duke University gave volunteers identical dummy pills before and after an electric shock, and told some of their human guinea pigs that the pills were analgesics costing $2.50 and others that they cost 10 cents, more of those getting the expensive placebo than the cheaper one reported pain relief (85 percent vs. 60 percent).
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Lol, it is true. Pain can be hurtful, or both the pain AND your response to the pain can hurt. Placebo = more controlled response to the pain.
But I doubt any Psychological trickery can hold back against initial reactions. What happens AFTER, however, is very much up for grabs.
i wish there was a way for me to ask my doctor if i could try a placebo. i know that sounds stupid, but i’m willing to try anything. i’m sure asking for it, and knowing about it, would make it ineffectual. maybe i should ask if there’s any “experiments” and whatnot going on i could be part of.
good to know drugs can hinder placebo effects tho, i think thats interesting.
This whole subject confuses me….I had 3 attempted epidurals during childbirth, all of which failed, but if the placebo effect is real then surely I’d have felt a little less like I was dying and that sooo wasn’t the case!!
If I were a scientist, I’d study the physical mechanics of stimulation of the skin by pointy objects. Tissue changes caused by acupuncture needles can now be observed as well as the resulting chemical changes in the brain. Perhaps it doesn’t matter so much exactly where the needles or toothpicks go, but the stimulation itself may have an impact that is being overlooked. The placebo effect is present for any medical intervention, but it doesn’t appear to explain everything.
Some army guys who were captured and tortured for months managed to train them selves into enjoying pain, so it just felt nice rather than painful. It’s surprising what the mind can do.
With acupuncture i think it’s a combination of placebo and the effect of having someone fuss over you for an hour or so that makes some folks feel better afterward. Another study showed that the treatment, either traditional or sham, only worked when it was administered by a purported professional in a clinical setting. If you took the needles home and did it yourself, e.g., you wouldn’t get the same result.
also reminded of the scene in Lawrence of Arabia where Peter O’Toole is burning himself with matches and says (approximately) “Of course it hurts. The trick is in not MINDING that it hurts.”
Another question could be – is pain actually pain?
Example: say you put the point of a knife on your arm very lightly, then gradually press in until you feel “pain”. At what point does it become pain? Is all ‘feeling’ just a lower threshold of pain like gripping the mouse of your computer?
But hey … the effect of regular medicine or the real thing can be plainly in the mind as well …. no matter what they saw in their results …(well, in a way it is always all in the mind ofcourse ..).
Giving placebo\’s to people in a study is one thing, giving them to people who went to a doctor .. nope, should not be legal. The insight of lots of doctors is not that immense I\’ve noticed (you have to tell them the diagnose quite often and then they at times till dont see it .. even not when it is written in their journals already ……….makes you wonder huh? Took a little too much of their own drugs? Ofcourse it\’s easy to explain how they got there .. but they are clearly not in the right job .. that as well).
Oh, and placebo\’s wont work in all people. Only in those who will indeed open up on the inside .. put their trust in the placebo and have something that should be cured but is being triggered by something else.
But only in a few cases.
In studies they often use a group who gets placebo\’s whereas the others get the real thing. To rule out any possible psychological effects. Which is ofcourse not all possible. I myself dont see the point of those type of studies. Waste of time. And also, they so dont check the so called healthy group thorough enough .. in a way all projects with volunteers involved vs patients are never 100%. And one patient is not the other.
Bla bla bla ..
But hey, you have to start somewhere .. (them, the scientists). I know.
Maybe a nice gesture .. swop placebo with the real medication and dont tell the first team of scientists that will diagnose the results … Also in them .. there might be another effect at work now and then. They have a focus … they start always with a certain focus. In case of doubt … not difficult to see which side they will choose quite often. Not all .. but hey …
Science .. not a 100% proof either. Hardly. Only if you narrow your vision and the field and even then …
Life .. I think it is a placebo …
Had a Placebo album once… it was a blank CD.
Sorry, I’m a bit late with this, but I’d love to see Derren do some work with chronic pain patients. My boyfriend has been suffering from chronic upper back pain for 15 years and it seriously impacts on our lives.
Unfortunately, he also thinks of Derren as ‘weird’ and ‘creepy’, so you’ll need to find yourself another guinea pig, I’m afraid…