How Do Placebos Affect Pain?
You’re a toddler. You’ve just learned to walk, and have started running a bit when Dad’s playfully coming after you to tickle you. And then the inevitable happens: you fall down. Except this time you’ve been going fast enough so that when you plunk down on your outdoor patio, you slide and scrape your knees. It’s the quiet shock before the storm, until you start crying that high-pitched cry toddlers make when in pain. And scared.
So who do you call for? Mom. She comes running, picks you up, and tries to calm you down. She asks if you want her to kiss your scrape. You say yes, she does it, and somehow, you start to feel better. The pain may still be there, but not as intense, and more importantly, the fear that something serious has happened to you has been reassured.
What happened exactly?
In a way, this process of reassurance by telling the child it’s OK and just a scrape, and by specifically locating the point of pain with a kiss, is similar to giving a trial patient a placebo. How do placebos work?
According to the Cambridge Dictionary online, a placebo is defined as, “a substance that is not medicine, but that is given to someone who is told that it is a medicine, used to test the effect of a drug or to please a patient.”
Placebos have long been used in medical trials known as a “randomized controlled trial”. They’ve been considered the “gold standard” for medical trials. If a new drug needs testing, researchers will often call on groups of participants for the trial. For our purposes, let’s say the drug is for a new pain medication. Randomized controlled trials are most often double-blind or single-blind. This means that the group of patients chosen at random may either be separated into two groups (double-blind) or merely one group (single-blind). Some of the patients are given the actual medication they’re testing, and others a placebo medication which has no activating ingredients, without the groups knowing which one is which: thus the term “blind.”
After the trial concludes, the patients are then interviewed and assessed about whether or not they received any benefits from the medicine. Surprisingly (though not as surprisingly to those who conduct these trials), many patients who were given the placebo medication comment that they do feel better than before, that their pain has since minimized after feeling the effects of the drug, even though no medication was given.
What are Placebo’s Benefit?
But is there, in fact, a benefit to placebos? It seems the answer is yes. The reason, however, is complicated.
There are many explanations why placebos make people feel better when it comes to pain and well-being, but the reality is what’s important: that the patient feels better.
What is the complex relationship we have with pain and the way we deal with it?
We must be careful, here. No one wants to hear that their pain is “all in their head,” meaning that they’re somehow “making it up” are psychologically delusional, and so on. That kind of misnomer delimits the complexity of our bodies and pain.
You know those magnetic and copper bracelets certain companies were touted as being a cure-all for health? Scientific research done on the bracelets have concluded, based on their controlled study, that there is no significant improvement in pain levels while using them. Yet, some individuals are convinced of their efficacy. Who are we to suggest they don’t feel improvement from them?
Pain is difficult for a doctor to ascertain in a patient because of the subjective nature of it. It’s also hard to quantify. When doctors ask from a range of 1-10 how bad the pain is, how do you answer? It hurts. How bad does it hurt? It hurts pretty bad. So you “guesstimate” and say it’s a 7. Perhaps what the doctor is really assessing is not some kind of objective standard of pain level, but rather how much pain the person perceives they are experiencing. And given that information, discuss treatment options.
Pain “thresholds” are hard to determine. For someone used to receiving a good amount of pain, say, and have trained themselves through repetition that the pain they feel is of no consequence, they may decide to focus on other issues (especially with professional athletes, who are often told to “play through the pain”). On the other hand, the pain threshold may be greater than those not conditioned to respond in this way. Does that mean those people with a lower threshold are not as “tough” as the others, and they just need to deal with it? No.
In fact, pain is an important indicator our brains use to tell our body when it’s in danger. Pain’s there to protect the individual from causing lasting physical damage, such as touching a hot pan and removing the hand before we even think of it. This is instinctual and usually don’t incur serious burns. There are those very sensitive to pain, and from a medical standpoint, rather than figuring out why that is, the doctor will often address the symptoms to relieve the pain the person is feeling.
Pain will always be a part of our lives. How we deal with it, and what step we take to address it, plays
an important factor in the quality of life during a painful time.
- Markus MacGill and Helen Webberley, What Is a Randomized Controlled Trial in Medical Research?, (Medical News Today), January 29, 2016, http://www.medicalnewstoday.com/articles/280574.php.
- Markus MacGill, Copper Bracelets: Do Copper Bracelets Help with Arthritis?, (Medical News Today), February 8, 2016, http://www.medicalnewstoday.com/articles/305500.php.
- ‘Placebo Definition in the Cambridge English Dictionary’, February 22, 2016, accessed February 27, 2016, http://dictionary.cambridge.org/us/dictionary/english/placebo.