Scientists often use placebos in comparative drug studies. The point of a placebo is that the patient is unaware the placebo has no medicinal value. However, a new study shows that even when a person takes it knowingly, a placebo can reduce pain.
The decrease in pain for patients in the study was substantial, up to 30 percent, as compared to a 16 percent reduction for subjects who took only the regular treatment.
The senior author of the study, Ted Kaptchuk of Harvard Medical School and the Beth Israel Deaconess Medical Center, explained:
This new research demonstrates that the placebo effect is not necessarily elicited by patients’ conscious expectation that they are getting an active medicine, as long thought.
Taking a pill in the context of a patient-clinician relationship – even if you know it’s a placebo – is a ritual that changes symptoms and probably activates regions of the brain that modulate symptoms.
The researchers studied 97 people who suffered from chronic lower back pain (the number one cause of disability worldwide). They evaluated each participant individually and explained the placebo effect, then split them randomly into two groups.
One group continued normal pain medication; this group was known to the team as the “treatment-as-usual” (TAU) group. A second group was given a bottle of pills clearly marked as placebos; this was known as the “open-label placebo” (OLP) group.
Members of both groups were already taking non-opioid medications for pain, and all participants were instructed to continue their normal medications. However, the researchers had the OLP group take the placebo pills twice a day.
After three weeks, the researchers met with both groups to assess the differences in their pain levels during the course of the experiment. They were surprised to learn the OLP group reported a significant 30 percent reduction in both normal and maximum pain.
Conversely, the TAU group reported a nine percent reduction in normal pain and a reduction in maximum pain of 16 percent. In other words, the placebo group reported about three times less normal pain and half the maximum pain than did the TAU group.
Lead author Claudia Carvalho, of the Instituto Superior de Psibologia Aplicada (ISPA) in Lisbon, Portugal, explained:
Our findings demonstrate the placebo effect can be elicited without deception. Patients were interested in what would happen and enjoyed this novel approach to their pain. They felt empowered.
The researchers were unable to completely account for why patients did so well using the placebo, but Kaptchuk postulated the reason could be they were encouraged by the chance to participate in a new treatment approach. He said:
It’s the benefit of being immersed in treatment: interacting with a physician or nurse, taking pills, all the rituals and symbols of our healthcare system. The body responds to that.
You’re never going to shrink a tumor or unclog an artery with placebo intervention. It’s not a cure-all, but it makes people feel better, for sure.