Sugar Pills for Chronic Pain: A New Perspective
The influence of placebo in managing persistent pain conditions
A new study delves into the idea of giving sugar pills to some people with chronic pain as a potential solution for their symptoms. Scientists are exploring the individual differences that make certain individuals more susceptible to a placebo.
You might think a placebo is just a bogus treatment, but it's not that simple. A placebo is an interference with no healing power — be it a pill, injection, or even a sham surgery — that can surprisingly bring about real benefits.
The placebo effect refers to the actual advantages that ineffective interventions can offer. Simply ingesting a tablet or pill can make a person feel the benefits working. Although this isn't only a psychological phenomenon, it does have a biological basis.
Lyborne studies have demonstrated that a placebo can , proving it involves a genuine physiological response. However, the placebo effect is most common in conditions that depend on symptoms, such as anxiety, irritable bowel syndrome, and chronic pain.
In chronic pain trials, for example, the placebo effect is often just as remarkable as the response to the treatment being tested. In some instances, the response to a placebo can even surpass the response to conventional treatments.
Is a Placebo a Viable Option?
Considering that standard drugs for treating chronic pain can have significant side effects over time, the possibility of an inactive tablet aiding some patients is a topic of great interest. However, not everyone responds equally to the placebo effect.
Recently, a study aimed to tackle this issue: could it be possible to predict the size of someone's response to a placebo before they take it? The study's results were recently published in an esteemed journal.
Researchers at Northwestern University in Illinois investigated 60 individuals experiencing chronic back pain. They divided the group into two study arms: one took either the drug or placebo, while the other attended the clinic but underwent no treatment.
Each participant completed several detailed questionnaires covering their personality and pain experience, as well as four neuroimaging sessions. As expected, some individuals who took the placebo reported noticeable pain relief.
These individuals were further examined. The researchers found that those who responded to the placebo presented an asymmetry in their subcortical limbic system, a part of the brain associated with emotions. Specifically, this region was larger on the right side than the left in subjects who responded to the placebo. These individuals also had a larger cortical sensory area than those who did not respond to the placebo.
Interestingly, participants who had a strong placebo response also showed higher emotional self-awareness, an awareness of their surroundings, and sensitivity to painful situations.
No Need to Keep it a Secret
Study author A. Vania Apkarian, a professor of physiology at Northwestern University, believes that "[c]linicians treating chronic pain patients should consider the possibility that some will receive as much relief from a sugar pill as any other drug. They should use it and see the outcome. This opens up a whole new field."
While giving a patient a placebo can seem underhanded, it need not be for those with a strong response to the placebo effect. "You can tell them, 'I'm giving you a drug that has no physiological effect, but your brain will respond to it.' You don't need to hide it. There is scientifically proven biology behind the placebo response."
These results could potentially benefit people with chronic pain and other conditions, and they might transform the way some clinical trials are conducted.
The placebo effect has long been a headache for medical research — it's difficult to determine exactly which component of the treatment has relieved the symptoms, whether it's the drug or the placebo effect.
However, if researchers know which participants are likely to have a larger placebo response, they can screen them out initially, resulting in more reliable results in the long run.
As Prof. Apkarian explains, "Drug trials would need to recruit fewer people, and identifying the physiological effects would be much easier."
The more we unravel the intricacies of the placebo effect, the closer we get to treating illnesses with minimal, less toxic chemicals. "It's far better to give someone a nonactive drug instead of an active drug with the same outcome," Prof. Apkarian adds.
Although the placebo effect is full of mysteries waiting to be solved, understanding it brings us one step closer to treating certain conditions in a potentially gentler manner.
- The placebo effect, which is surprising in conditions such as anxiety, irritable bowel syndrome, and chronic pain, has shown to produce real benefits and even be just as remarkable as the response to conventional treatments in trials for chronic pain.
- A study conducted by researchers at Northwestern University investigated 60 individuals with chronic back pain to determine if it's possible to predict the size of someone's response to a placebo before they take it.
- The study found that those who responded to the placebo showed higher emotional self-awareness, an awareness of their surroundings, and sensitivity to painful situations.
- Understanding the placebo effect could potentially lead to treating certain conditions in a potentially gentler manner and even transform the way some clinical trials are conducted, making it easier to identify the physiological effects and conduct more reliable drug trials.
