Could taking a placebo, a pill which contains nothing but ground rice, really help cure back pain?
To find out, Dr Michael Mosley with experts from the University of Oxford embarked on Britain’s largest ever trial to investigate the placebo effect on chronic pain. 117 volunteers, all suffered with bad backs for years and felt their conventional medication, painkillers from Tramadol to morphine, gave no substantial relief.
Some were asked to act as a “control” group. The rest were told that they were taking part in a study – where they might receive the placebo or a powerful new painkiller.
What they weren’t told was that they would ALL get placebos, capsules containing nothing but ground rice.
The pills were authentic looking and based on years of research. They were blue-and-white-striped, because that has been shown to have a greatest painkilling effect. They came in bottles, carefully labelled, warning of potential side effects and reminding patients to keep out of the hands of children.
After three weeks, the volunteers went through another round of tests and questionnaires. Nearly half of the volunteers reported a medically significant improvement in their back pain from taking the pills – even though they were fake.
Additionally, the time they spent with the doctor had a substantial effect on the outcome, with people benefitting from having a longer consultation with their GP.
The power of the mind.
Studies show that the placebo effect is more than just a medical curiosity. The brain is actually capable of producing its own drugs which can be more powerful than prescription painkillers.
The characteristics of back pain sufferers who responded best to placebo treatment, found those who were most “aware” and “open to new experiences” had the most benefit.
The researchers also carried out brain scans and found anatomical differences in the “responders” and “non-responders”.
Among other things they found subtle differences in areas of the brain, like the amygdala, which controls emotion and reward.
What exactly this means, no one quite knows.
But University of Oxford’s Prof Irene Tracey says: ” . . . just because a placebo contains no active chemicals, does not mean the effects of taking it are not real.”
“The average person thinks that placebo is something that’s a lie or some fakery, something where the person has been tricked and it isn’t real. But science has told us, particularly over the last two decades, that it is something that is very real, it’s something that we can see played out in our physiology and neurochemistry.”
Research has shown that taking a placebo can trigger the release of endorphins – natural painkillers that are similar in structure to morphine.
Where does this leave modern medicine?