Knowingly taking placebo/fake pills eases pain – new study

Pain and disability in people with chronic low back pain was significantly reduced when they took a pill that they knew was a placebo, says research in Pain.

Until now the medical community has believed that the placebo effect depends on people thinking that they are taking something that is pharmacologically active.

But the new findings showed that those who knowingly took a placebo alongside traditional treatment for lower back pain saw more improvement than those given only traditional treatment.

The study

A total of 97 people with chronic lower back pain were screened and examined by a registered nurse practitioner and board certified pain specialist. All of the participants were given a 15-minute explanation of the placebo effect. The group was then split. Half were given treatment as usual while the others were given treatment as usual plus a placebo pill.

At the end of their three-week course of pills, the placebo group overall reported 30% reductions in usual pain and maximum pain, much higher than the treatment as usual group. The group taking placebo pills also saw a 29% drop in pain-related disability; people receiving treatment as usual saw almost no improvement by that measure.

The implications

“These findings turn our understanding of the placebo effect on its head,” explains senior author Ted Kaptchuk.”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.”

Claudia Carvalho, the other senior author, comments:

“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.”

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