Knowingly taking placebos reduces pain

Scientists have shown that sufferers of chronic back pain report a reduction in pain when given pills they know to be placebos
20 October 2016


Pill capsule


Scientists have shown that knowingly taking sugar pills reduces chronic back pain by 30%.

In some drugs trials participants are split into two: one set is given the new drug to be tested and the other is given something which resembles a drug but contains no active ingredients, this is known as the placebo.  Patients receiving the placebo occasionally experience the placebo effect, the improvement of their symptoms even though no real medication has been given.  The expectation of being treated is enough to trigger partial recovery.  Any consequences of the new drug are compared against the placebo effect.

The placebo effect is only thought to work if patients think they are receiving a real drug and do not know it is a fake.

However, new research published in the journal Pain, challenges this theory.  Dr Irving Kirsch, from Harvard Medical School, has demonstrated that even knowingly taking a placebo can reduce your pain.

In this instance, patients with chronic lower back pain reported a 30% drop in discomfort after taking sugar pills for three weeks in addition to their normal pain medication.

Dr Kirsch postulates that "the belief or expectation or at least hope that this new or additional treatment might give some relief" is able to trigger the placebo effect even though patients have not been deceived.

The Harvard team studied 97 patients with lower back pain, which had lasted three months or more. Patients were told by researchers that placebos have no known medical properties but that previous studies have shown that placebos have been found to reduce lower back pain and can rival the effectiveness of taking known medications.

Kirsch and colleagues also explained to patients that "people who have been treated all their lives for various medical complaints have come to form an association between the ritual of taking the pill, for example, and getting a benefit from it," and "just the act of going through that ritual can trigger some of the person's self healing ability that the body has."

Once this was explained to patients they were split into two groups.  Both groups continued treatment as usual, which was non-steroidal anti-inflammatories, but half of the patients were also instructed to take two placebo pills twice a day for three weeks.

Patients reported their pain on a scale of 1-10, with 10 being the highest.

After three weeks, placebo patients reported a reduction of 1.5 in their pain score whereas non-placebo patients only showed a 0.2 decrease in pain.

Kirsch said that the "open label placebos [they are] using in [their] clinical trials are one way of harnessing and making use of the placebo effect ethically, without deception."

So, does this mean the NHS should abandon anti-inflammatories in favour of placebos?

The jury is still out on this, but Kirsch believes that this study provides the "possibility that the open placebo is something that may indeed be a tool that is added" to a clinician's medical arsenal to be used alongside more traditional pain management.


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