The power of the placebo effect

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London - A doctor who simulated surgery on patients suffering from back pain says they recovered as well as those who underwent the operation.

Dr David Kallmes conducted a trial to see if vertebroplasty – a procedure in which patients are injected with a type of medical cement – was any more effective than a placebo.

He concluded that there was no statistically significant difference in pain relief or improvement in function between the patients who underwent the operation and those who did not. This may be because the mind believes the pain to have gone – allowing time for the damaged vertebra to heal naturally.

In recent years, evidence has built up to suggest that placebos, including dummy pills and fake acupuncture, can be highly effective – particularly in treating pain, depression, and even alleviating some of the symptoms of Parkinson’s disease.

The key is simply that you think it might help you.

Dr Kallmes, a radiologist at the Mayo Clinic in Minnesota – one of the world’s leading hospitals and where the Presidents of the United States often get treated – has been treating patients with damaged backs for 15 years.

He decided to carry out the experiment after some patients seemed to get better even after their operations were unsuccessful.

All of the 130 patients he studied were prepared for their “operation” in the same way, including being wheeled into theatre and given a local anaesthetic in their back, but only half actually underwent the operation. Dr Kallmes said his team had a “script” that they followed if a patient was placed on the placebo list.

“We pressed on the back and said okay ma’am, the cement is going in now, everything’s going fine, things are going well, a few more minutes here, okay we’re all done,” he said.

One patient, Bonnie Anderson, 76, was active again shortly after her fake operation. “Within a week I was able to play golf,” she said. “I took it a little easy, but I was able to play golf almost every day.”

Dr Kallmes said: “There was no statistically significant difference in degree of pain relief between the patients who had undergone vertebroplasty and placebo.

“And more importantly, there was no statistically significant difference in improvement in function between the patients who underwent vertebroplasty and placebo.”

He said that the assumption is that it worked because it relieved patients of their pain long enough for the bone to then heal naturally.

His findings form part of a BBC Horizon documentary that investigates the healing power of the mind.

Another scientist who carried out a similar study in Australia found that patients who experienced vertebroplasty or the placebo both got better than if they received no treatment at all.

A recent Finnish study also concluded that one of the world’s most common orthopaedic operations – arthroscopic partial meniscectomy of the knee – is no more effective than “sham surgery”. - Daily Mail

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