Portuguese researchers recruited 83 people with chronic back pain. They explained to them that a placebo was an inactive substance, like a sugar pill, that contained no medication. Then they randomly assigned the patients to either treatment as usual (in almost all cases, this was pain medication), or treatment plus the placebo. The pills were provided in a prescription medicine bottle marked “Placebo pills. Take 2 pills twice a day.” The study is in the journal Pain.More evidence for my theory that in many people back pain – or perhaps being disabled by back pain – is a response to overall misery rather than some particular injury.
At the start and end of the three-week trial, patients filled out questionnaires describing pain intensity and degree of disability.
The group that got their regular treatment had an average 9 percent reduction in usual pain and a 16 percent reduction in maximum pain. But the placebo group averaged a 30 percent reduction in both usual and maximum pain. The placebo group also reported a 29 percent reduction in disability, while the usual treatment group reported none.
Sunday, October 23, 2016
For Back Pain, Placebos Work Better than Painkillers
In this one study, anyway:
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Wait - what's going on here?
Firstly, why are they informing the patients that they're being given placebos? How do you have the placebo effect if the patient is aware the pill is worthless?
Secondly, where is the experimental control? There needs to be a group that doesn't receive any actual pain medication at all.
Thirdly, how are they measuring pain, and how are they equalizing data? Pain is a highly subjective sensation, and chronic back pain is a condition that covers a broad spectrum of intensities.
And what's stopping the variance in reported pain levels from being the product of random circumstance? What if by sheer coincidence they assigned individuals with more severe back problems to the non-placebo group, and thus those individuals saw smaller comparative reductions? Or how about individuals with greater or lesser degrees of pain tolerance? What about individual sensitivity or resistance to the painkillers being used? What about daily living conditions and individual exertion? Many studies like these just send people home to return to their daily lives for the duration, which might expose them to wildly variable conditions which might improve or worsen their conditions. There are just so many variable unaccounted for here!
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