Healthy Living

Saturday, July 4, 2009

Pain: Is it all in your head?

A colleague just brought to my attention fascinating research in the British Medical Journal that investigated the placebo effect in patients with irritable bowel syndrome.

Researchers offered patients with IBS either no treatment (assignment to a waiting list), sham acupuncture (needles placed in the 'wrong' positions), or sham acupuncture plus interaction with a caring clinician.

Patients said they had greater pain relief with sham acupuncture than with no treatment at all. And they said the combination of sham acupuncture plus compassionate interaction alleviated even more pain!

Does this kind of placebo effect mean that it doesn't matter where we place acupuncture needles, because they don't really work anyway? No! Pain is about something much more profound.

Pain, and really all symptoms, are literally 'in your head' in the sense that the brain must interpret pain in order for you to feel it. No pain is false, because if you feel it, it's real. So no pain relief is false, either.

By breaking the placebo effect into component parts, this study helps to confirm what many experts already believe: That caring, human interaction is a vital component of good medical care and gives real hope to patients in pain. There is no substitute!

The best medical care treats the whole person, combining the therapeutic benefits of a specific form of treatment with the therapeutic benefits of hope. This kind of cure cannot be put into a capsule or syringe!

The mind and body are connected, and pain in one is pain in the other. Treatments directed only toward a condition or organ system may not affect the emotional issues a patient may experience. Placebos may miss the condition or organ system, yet provide relief, because they address the big picture--which in turn gives hope and support to the whole person, organs and all!

So here's to medicine that treats the condition and the person. Because all symptom relief is real.

Related Links:
This is Your Brain on Illness
World's Best Natural Cures
Inspiring Real-Life Health Success Stories

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From the Community…

Comments 1-2 of 2
  • skept79's Avatar
    Posted by skept79 Mon Apr 28, 2008 7:49pm PDT

    "Does this kind of placebo effect mean that it doesn't matter where we place acupuncture needles, because they don't really work anyway?" Actually yes, and studies have shown exactly that. There is some effect from acupuncture but it doesn't matter where you stick the needle (the effect size is the same whether you use real acupuncture or so called sham acupuncture). So the effect comes from something other then the acupuncture itself. Something like a placebo effect or a relaxation effect. A recent study using non-penetrating placebo needles found that it isn't even necessary to actually use real needles to get an effect, this strongly points to the effect being entirely a placebo effect.

    Pain is a very subjective thing and is therefore extremely difficult to study. It's important to remember that a placebo cannot take the place of real medical intervention. Usually pain is an indication of a more significant problem that needs to be treated. And imagine the damage to the doctor patient relationship if the patient realizes the doctor is treating them with a placebo. There are plenty of good reasons that "caring, human interaction is a vital component of good medical care" but I don't think a placebo effect is one of them. In the context of a medical study a placebo effect is anything besides the actually treatment that affects the patient's outcome. This includes things like the patient taking better care of themselves or adhering to medical advice when they think they're being treated, bias of the study administrators, patients reporting differences in subjective symptoms due to an expectation that they will improve, etc. A placebo effect is not an indication of a mind body connection, rather it is an indication of human biased.

    Compassionate medicine that gets the patient involved in their treatment is important to making a patient feel better and to getting them adhere to medical advice, but it is not a treatment in itself. We should not prescribe placebos, but that doesn't mean that doctors shouldn't focus on "compassionate interaction" with their patients, because doing so has other very real benefits.

    Acupuncture study:

    http://www.eurekalert.org/pub_releases/2007-09/eecc-adn092607.php

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  • carvergirl616's Avatar
    Posted by carvergirl616 Fri Oct 10, 2008 10:00am PDT

    Mind over matter is the most compelling argument! I've never tried acupuncture, so I'm not sure how it would work for me, but I've had lots of people swear by it. I think if you believe in its effects, then it will have a great benefit to you. For a great blog on how acupuncture helped this writer sleep, check out this link! I'm sure you'll be convinced!

    http://buzz.prevention.com/community/dina-o/sleep-evades-me-no-longer

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