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HOW DO PLACEBOS RELIEVE PAIN?

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Posted by abeodbart January 27, 2012 at 8:07 am

“Scientists and doctors have been studying placebos for more than half a century. These inert “sugar pills” remain highly controversial, yet they are widely used in clinical treatment today—especially in the area of pain management. So-called “placebo analgesia” has been observed again and again not only in the pain clinic, but also in the neuroscience lab, where scientists have documented a placebo response in the brain’s pain pathways.

Despite this evidence, nobody really understands the psychological processes involved in placebo analgesia. Presumably the power of these inert substances has something to do with the expectation of relief, but how do expectations translate into basic cognitive processes, like attention and thought? One possibility is that when sufferers expect relief, they are able to redirect their attention away from their pain, creating an analgesic effect. If that’s the case, then expectation itself might actually act as an agent of cognitive control, and the mind’s executive powers might be the link between expectation and relief. Imaging studies have revealed placebo-related activity in a brain region involved in executive function—bolstering this theory.

But this brain imaging evidence is merely suggestive, and the theory has never been tested directly. A team of psychological scientists, headed up by Jason Buhle of Columbia University, decided to investigate this explanation for placebo analgesia. The brain has a limited supply of cognitive power, so if indeed placebo analgesia requires executive attention, then performance on a demanding cognitive task should interfere with pain relief from a placebo, and vice versa. One kind of executive power is working memory, and in previous work Buhle and colleagues have shown that performing a difficult working memory task itself reduces pain, presumably by distracting sufferers. So in a new experiment, they tested whether this same cognitive task interferes with the relief offered by a placebo drug, as one would expect if they are using the same cognitive mechanisms. If not, then the evidence would suggest that sugar pills and distraction have independent analgesic effects.”

Read more at Psychological Science (Thanks Annette)

COMMENTS
January 27, 2012 at 8:14 am

They do relieve pain, just as hypnosis does the subconscious mind is made to believe it cures something that it doesn’t so the body will react that way it was told to. Personally I think that hypnosis should be used instead it is just as powerful if not more.


January 27, 2012 at 8:21 am
Andrew C says:

I was on a trial at about 15-16 years old, 250 homeopathic “remedies” were given to Asthmatics, and 250 placebos which was just a powder of some form.

I went from being a severe asthmatic, suffering bad attacks which hospitalised me several times a year, to no asthmatic symptoms whatsoever and haven’t had for 12 years now (and stupidly I’m now also a smoker, but on the road to quitting).

I was on the placebo! Happy days, here’s to placebos and the wonders of the human brain.


January 27, 2012 at 8:28 am
Lindsey says:

I find this whole subject fascinating (I’m a nurse) and find the placebo effect isn’t just limited to analgesics, there’s strong evidence from my own practice with antipsychotics for example and antidepressants that suggests the ‘placebo’ effect occurs – again just as with analgesic placebo, my question is why would this be?


January 27, 2012 at 8:30 am
Jon says:

I do think that whilst “alternative” medicine’s claims should be taken with a salt mountain, we dismiss the potential benefits through the placebo which as mentioned, can be real. If we could only seperate the effect from the money garnering potential, perhaps?


January 27, 2012 at 10:03 am
Kev says:

I always thought that when you were taking a placebo, it was just the passing of time that made you feel less and less pain. Because the body (when wounded) is in a constant state of self repair.
I tend to get prescribed a little brown pill a lot for muscle pain and pulls called declofenic. But I’m convinced this is a placebo, because, YES I’m getting better. But no more so than if I was just letting it heal day by day.


January 27, 2012 at 1:29 pm
roz says:

no drug can come close to the possibilities of the human mind.


January 27, 2012 at 6:17 pm
Jonny O. says:

Hummm… I like this article.

There is much we don’t know about placebo. Sometimes, when we count to ten and think about the numbers, the pain will go away.

Regards,

Jonny from Norway


January 27, 2012 at 7:56 pm
nick says:

Placebo’s and working memory may use different aspects of executive power/ cognitive function.

(subjectively you would imagine a different process is going on when taking a “relieving substance” and “remembering a phone number”), but this isn’t about subjectivity.

The effects on reducing pain are additive, therefore the processes operate independently in relation to pain, either equally reducing a single well of pain (single well of pain model), or attacking different aspects of pain (multi well of pain model)

There are one or two cognitive processes involved in perceiving pain and at least two processes utilized in reducing it.

Its just doesn’t inspire the same curiosity as are the prime numbers random, or maybe it does, as we still don’t really know what we are trying to work out.


January 27, 2012 at 8:48 pm
nick says:

Bah, after buying some refreshments including some super hot chillies from a local and very well priced Asian food shop, I concede this article at the very least re highlights that THE PLACEBO EFFECT IS REAL, as real in certain tests as other active medication.

Expectation is the agent of pain relief, expectation is the agent of psychological progress, sure thumbs up to that one.

Sufferers can direct the attention of there mind onto subjects of their choice, including pain, thumbs up to that.

There are two processes :). Peace & love


January 27, 2012 at 9:54 pm
nick says:

Third time I have read this article, still wrestling with it, and the punchline is

SPOILER placebos and working memory have __pendent effects on pain.
(in the article).

But that doesn’t deter my initial impression, pain exists as a subjective reported experience in the brain, which part? Do we know yet? Executive function allows us to over ride basic primitive responses and have greater more meaningful experience, but we are looking for which specific part of the highly manoeuvrable frontal lobe helps us deal with pain by remembering things, and which specific part helps us deal with pain by setting the expectation to overcome it.

These processes are independent of each other.

We are still constructing the periodic table of psychology. It all looks confusing at present.


January 27, 2012 at 11:24 pm
Mags says:

It’s all about positive thinking… We havent discovered all the “power” of our brain yet…if we can influence others , we can probably influence ourselves as well ( even if at this stage we may not be aware of this )

p.s. I looooooove Darren ;)


January 27, 2012 at 11:30 pm
Shaun Banks says:

Pain is an emotive event that the logical cognitive processes of the executive function area of the brain cannot solve and as such this area of the brain maybe responsible for elevating and amplifying the pain alarm signals within the brain until the cause of the pain event is repaired and therefore solved . Preoccupying some of these cognitive processes with difficult working memory tasks (or even hypnosis) could help alleviate the pain by reducing the anxiety (emotional dis-ease) created by these logical cognitive processes trying to deal with the pain problem.

Amputees often suffer phantom pain which maybe the executive function area of the brain struggling to except the unnatural change to the persons physiology.

(I am no doctor though so it’s just a guest)

The placebo fools the executive function area of the brain by providing a possible solution for the pain.

There have been many cases of people having to cut of their own limbs which surely demonstrates that the mind is capable of extreme pain management, perhaps survival instinct over rides all of the cognitives processes in this area of the brain by disengaging any reasoning and focusing on the tsaks that need to be completed to survive.

Obviously this all depends on whether or not the executive function of the brain exists.


January 29, 2012 at 4:32 pm
Mark says:

Mind over matter? Something D could answer me thinks.


January 30, 2012 at 12:17 pm
Margaret Sinclair says:

I recently did my dissertation looking at placebo. There are lots of studies looking at fMRI’s and PET scans with interesting information coming out. Not all agree but there are some overlaps. What is interesting is what causes an increase in these ‘placebo’ responses. It usually comes down to perception and belief, both of the patient and practitioner. Amazing subject.


January 30, 2012 at 2:46 pm
alan says:

nobody really understands the psychological processes
If it is possible to experience an effect, relating to an extremity that has been removed. Then there is no true physical component concerned in that process. If feeling is being artificially generated, doesn’t that suggest the presence of a hub? At which point a signal can either be stimulated or erroneously generated? If some sort of conversion has to be performed, false triggering and/or overriding of that mechanism might also be possible.
Consider the stethoscope. Cut the tube at any point and the reality that is the sound will be released. When that reaches the ear it is converted into an electrical signal, which is a mere analogy of the original. So what we “hear” isn’t actual reality either.


February 4, 2012 at 9:15 pm
sailor says:

It may have a lot to do with anxiety. When we feel pain we tend to feel anxious and also out of control. This can exaggerate the pain. A placebo relieves anxiety and gives the feeling you are doing something positive so are in control. This lessens anxiety and stress thus not amplifying the pain, as they were before, and makes it feel better..


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