The placebo effect is a well known but often misunderstood phenomenon. The word placebo comes from the Latin meaning ‘I please’. The implication being that the doctor gives the placebo to the patient when there is nothing really wrong - just to keep him or her happy and presumably off the doctor’s back.
However in the past couple of decades western medicine has developed a greater understanding of how the mind can affect physical health and this has led to increased interest in the placebo effect.
The Placebo in History
It has been said that before the advent of scientific medicine most medical treatment was either useless or positively harmful. This is not entirely true – many traditional herbal remedies were no doubt effective for some problems as was massage and manipulation. But the reason most people recovered from their illness is because of the body’s own self-healing mechanisms.
What the healer or doctor was doing, at least some of the time, by an incantation or potion was encouraging the sick person to believe that something was being done for his illness. This put the patient in a more positive frame of mind and so helped him recover. Professional medical people would have suggested that those who recovered from this placebo treatment would have gotten better anyway.
Until fairly recently it was common for family doctors to give pills made of sugar as a placebo. The doctor was either convinced that there was nothing really wrong with the patient or that he was going to get better anyway. And at least the sugar pill wasn’t going to do the patient any harm. It was known that the more elaborate the placebo treatment then the stronger the placebo effect. For example, injections of sterile water produced a greater effect than a pill in many people.
Placebos are not used in today’s medicine (except in research) with its emphasis on complete transparency in the doctor/patient relationship – most likely any doctor prescribing a placebo would be sued for misleading the patient. In some ways this is a shame because medical science is now beginning to understand just how powerful the placebo effect is.
The Placebo Effect Today
The placebo is used in very many trials of medical treatment – particularly trials of drugs. Typically, patients with a particular illness are randomly assigned to one of two groups. One group is given the active drug and the other a placebo indistinguishable from the drug. Neither patients nor researchers are aware of who has been given the drug.
This method is not comparing the active drug with no treatment, it’s comparing it to another sort of treatment – the placebo. The effect of simply giving the patient a pill (even an inactive one) is beneficial to the patient’s health.
Studies showing that psycho/emotional states influence the body’s functions are numerous. The effect of relaxation and positive thinking on such conditions as high blood pressure and cancer – to name a few – is well known.
Placebo Effect and Surgery
Placebo is usually associated with medication but its effects manifest in other forms of treatment as well. A study by JB Moseley et al reported to the Annual Meeting of the American Academy of Orthopaedic Surgeons in 2001 examined the placebo effect on surgery.
The study looked at the results of arthroscopic (keyhole) treatment for knee osteoarthritis. Patients were divided into three groups: group 1 underwent arthroscopic debridement – cutting away loose tissue in the knee. Group 2 had the knee washed out with no cutting. Group 3 had the placebo – where only the skin openings were made.
After a 2 year follow-up there were no differences in patient satisfaction or clinical outcome between any of the groups.
The fascinating implication from the placebo effect is not that we can be fooled by some sham treatment, it’s that, through training our thoughts and emotions, we can have a marked beneficial effect on our body processes.
Resource
Arthroscopic treatment of the knee: a randomized double-blind trial. Moseley et al. 68th Annual Meeting of the American Academy of Orthopaedic Surgeons; February 28 –March 4 2001.
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