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Placebo Effect Caught In the Act In Spinal Nerves

kdawson posted more than 4 years ago | from the time-to-shut-down dept.

Medicine 167

SerpensV passes along the news that German scientists have found direct evidence that the spinal cord is involved in the placebo effect (whose diminishing over time we discussed a bit earlier). "The researchers who made the discovery scanned the spinal cords of volunteers while applying painful heat to one arm. Then they rubbed a cream onto the arm and told the volunteers that it contained a painkiller, but in fact it had no active ingredient. Even so, the cream made spinal-cord neural activity linked to pain vanish. 'This type of mechanism has been envisioned for over 40 years for placebo analgesia,' says Donald Price, a neuroscientist at the University of Florida in Gainesville, who was not involved in the new study. 'This study provides the most direct test of this mechanism to date.'"

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167 comments

Acupuncture to be reanalysed (2, Insightful)

foobsr (693224) | more than 4 years ago | (#29976848)

Would be interesting to see if similar effects could be observed regards acupuncture which is rated to be in the realm of placebo by 'old school' medicine.

CC.

Re:Acupuncture to be reanalysed (4, Interesting)

MeatBag PussRocket (1475317) | more than 4 years ago | (#29977008)

well, according to my understanding of the placebo effect its entirely mind over matter, so i could wave a TV remote at your face and say that this is more effective for pain relief than Morphine. if you believe it, it just may be. i'm personally a fan of placebos, though many arent. truthfully, if it works, it doesnt matter if i'm being tricked, and as i put my flamesuit on because i can feel whats coming, having worked in the medical field, including emergency medicine i can honestly say that any instances where an emergency is occurring i've _never_ seen a placebo used. efficacy is more important in a situation where life and death is concerned. if you have a 'tension hedache' and you're seeking prescription medication, dont bitch and moan when your headache disappears from a sugar pill.

Re:Acupuncture to be reanalysed (1)

Shikaku (1129753) | more than 4 years ago | (#29977184)

Probably something only semi-related, but there is a way to harness such a thing for your own use. It isn't the placebo effect per se, but the causes are the same: you can make yourself believe you can make your pain go away, and it does. I use pain-killers like once every few months because of this.

Re:Acupuncture to be reanalysed (1)

maxume (22995) | more than 4 years ago | (#29977796)

You may just be healthy and/or have a high tolerance for pain. I don't really get headaches, and am a little bit crazy, so far this year I have only taken 3 ibuprofen (to help deal with a sprain), but I'm not sure I would attribute it to thinking the pain away.

Re:Acupuncture to be reanalysed (1)

TheLink (130905) | more than 4 years ago | (#29980814)

In the past number of years, I've mainly only had pain killers for surgery and tooth extraction. I don't find paracetamol useful for me - it doesn't seem to make severe pain go away much, and I can cope with minor pain. I'd be happy to take the placebo effect for pain if it works well enough for me.

There's a lot of signals the brain sends OUT. Hence the brain may be telling the spinal nerves - "That's not important, don't bother us now OK?".

After all you hear of people with very severe injuries who manage to do heroic feats and not feel any pain. They only start screaming in pain once they're done with their task.

Re:Acupuncture to be reanalysed (4, Insightful)

rtb61 (674572) | more than 4 years ago | (#29977354)

Hardly mind over matter, simply a bio-chemical organ that can be induced to produce a range of neurotransmitters and hormones based upon psychological states. Don't be fooled though, whilst reactions might be controllable and the negative impact that stress and tension has upon recovery can be alleviated when a supportive environment is provided, it will not change the nature of the ailment itself. So a placebo is not really a placebo but a psychological treatment to assure the patient and alleviate stress and tension, which allows natural healing processes to function more effectively.

Note dependent upon the background of the patient this can also include religious support as long as the belief is there and of course the illness falls within scope of natural healing processes which would otherwise be circumscribed by fear and stress. No mind over matter, no miracle cures although of course genetic diversity and probability allows for luck to cure the most lethal of ailments, you know one in a million don't bet on it though as you far more likely to end up in the 999,999 group.

Re:Acupuncture to be reanalysed (2, Interesting)

ubermiester (883599) | more than 4 years ago | (#29979660)

Hardly mind over matter, simply a bio-chemical organ that can be induced to produce a range of neurotransmitters and hormones based upon psychological states

How are the two different exactly? The "bio-chemical" organ you refer to is, I suppose, is the brain? If that's the case, most experts - such as yourself - say the brain is where most people keep their mind (though new research suggests many male subjects keep their mind in a different organ closer to the waist). And the "range of neurotransmitters and hormones" produced based on "psychological states" would appear to be the mind interacting with that oh so squishy matter we call our central nervous system. So why do you strain so much to "debunk" the mind over matter truism.

The placebo effect relies in no small part on the "faith" effect, which we use every day to overcome our physiologically limited ability to comprehend the world. Faith does not (necessarily) allow people to walk through walls or levitate, but it does allow us to do all kinds of important things, including and not limited to the discovery of new knowledge.

For example, your well founded faith in the scientific method allows you to maintain focus while facing mysteries often seem to defy not only experimental observation, but the very intuitions upon which those observations are based.

Do you have faith that we will figure out what's inside a black hole? Will we'll figure out where and what all that missing mass and energy is? Will we ever know why the photon goes through both holes at the same time? The scientific method has attained considerable momentum because of it's ability to shed light on mysteries we have long thought unknowable. That does NOT mean it will always succeed. The uncertainty principle, for example, claims that it has already failed in at least one important case (i.e., Schrodinger's cat). Knowing something about the state of an atom means affecting that atom, which also means we cannot always make "objective" observations. We can only make extremely well-educated guesses and hope that we're not wrong that often. This realization put a HUGE hole in the scientific method, but our faith allowed us to continue working and make ever more important discoveries.

So when you tell someone that the pill they took was just sugar, why is it a surprise that their faith is undermined and the unconscious processes that resulted in pain relief (or whatever) are also undermined?

Re:Acupuncture to be reanalysed (4, Insightful)

Anonymous Coward | more than 4 years ago | (#29977448)

The problem is when someone mistakes treating symptoms for treating causes. If you feel better, but you're still dying, then you're still dying.

Re:Acupuncture to be reanalysed (4, Interesting)

that IT girl (864406) | more than 4 years ago | (#29977750)

Mod UP--this is what a lot of drugs do, one of the worst offenders being statin drugs for high cholesterol. In addition to causing muscle-degenerative problems after long-term use, artificially lowering the cholesterol in the bloodstream does not solve the actual problem, which is the reason it was there to begin with. Long story short, cholesterol is what 'patches up' holes in the vessel walls caused by wear and tear, foreign particles in the blood, or (big one here) inflammation. And some of the biggest things that cause inflammation in general are refined sugars, foods one has an allergy or sensitivity to (dairy and wheat being big ones), "bad" fats (omega-6 rather than omega-3) and of course smoking. Getting rid of the cholesterol doesn't get rid of the inflammation, and in fact makes your body unable to repair the damage as well. Fix the underlying problem and the amount of cholesterol will go down.

Sorry to go off on a tangent, but this is something I've done a lot of research on lately, and it's something that seems to get ignored by the mainstream. I'm guessing it's mostly because curing the source of a problem means the drug companies can't make money off someone as long, perpetually suppressing the outward symptoms while the real issue continues to fester. It's like continuing to spray air-fresheners and light scented candles around the garbage can instead of just taking the stinking bag out.

Re:Acupuncture to be reanalysed (1)

that IT girl (864406) | more than 4 years ago | (#29977838)

To save you all the trouble of pointing it out--I realise this was poorly worded. I'm at work and trying to do too many things at one time. I apologise, and I hope some of the phrasing doesn't take away from the message I was trying to convey.

Re:Acupuncture to be reanalysed (1)

blackest_k (761565) | more than 4 years ago | (#29978050)

Thanks its something to think about, my cholesterol has been lowered with statins to 3.7 yet my health seems worse.
I just had to be stented for the 2nd time in less than 4 months.

I think I need to research more myself.

Re:Acupuncture to be reanalysed (1)

MikeURL (890801) | more than 4 years ago | (#29980744)

IMO Statins really should only be used for people who have a genetic disorder that caused their cholesterol to go to insane levels. For generic "elevated" cholesterol I think that diet and exercise can go a long way. Supplementing with quality fish oil (I like the one from Swanson's) as well as using supplemental fiber can help. Diet does not have much impact on levels as far as I can tell but for some people it does seem to matter a lot.

Also, the ratio is supposed to matter and that is what you posted. If I'm not mistaken 3.7 is pretty good but OP is right in that it may not help you IF it is low simply due to statins. Please consider exercise, fish oil and supplemental fiber. In particular that last one can really have a dramatic impact on your cholesterol level because fiber literally "sucks" cholesterol out of your system.

Re:Acupuncture to be reanalysed (2, Interesting)

plague3106 (71849) | more than 4 years ago | (#29978836)

Whoa, careful there on the "bad" fats label.

We NEED saturated fats. Men use it to produce testosterone. It's also used to repair tissue. In fact, new research shows its the carbs doing the damage, as men which replaced bad carbs with "bad" fat LOWERED their bad cholesterol. Sounds like more research is needed.

Re:Acupuncture to be reanalysed (2, Interesting)

raygundan (16760) | more than 4 years ago | (#29980212)

I doubt you'll find a doctor who would prescribe these drugs without first suggesting you get off your arse and do some exercise. Nobody does this, of course, so prescriptions for these drugs get handed out as the next best thing when a patient won't do what is needed for themselves. It's not some huge profit conspiracy, although there is certainly profit involved-- but if you end up on statins without having given a serious effort at altering diet and exercise, it's your own fault.

Re:Acupuncture to be reanalysed (2, Interesting)

Lord Ender (156273) | more than 4 years ago | (#29978572)

i'm personally a fan of placebos, though many arent. truthfully, if it works, it doesnt matter if i'm being tricked

The problem is that the people who practice placebo treatment never just sell themselves as providing pain relief; they sell magical cures for real medical problems which need real medicine.

I would be happy if the FDA allowed "alternative pain management" to be sold and regulated, so long as they threw everyone claiming their hocus-pocus cured diseases into prison. Can you imagine how wonderful it would be to see chiropractors, homeopaths, and faith healers behind bars?

Re:Acupuncture to be reanalysed (1)

plague3106 (71849) | more than 4 years ago | (#29978720)

Can you imagine how wonderful it would be to see chiropractors [snip] behind bars.

Ya, well, I was refered to one by my doctor for an injury. I fully expected it not to work and to be back at the doctor saying as much, and to be in surgery shortly after.

Re:Acupuncture to be reanalysed (1)

plague3106 (71849) | more than 4 years ago | (#29978770)

Opps... I had more and cut it by mistake. It did work and the pain is greatly reduced.

Re:Acupuncture to be reanalysed (1)

Lord Ender (156273) | more than 4 years ago | (#29978970)

Not all chiropractors are crooks; he may provide help for pain. But chiropractic is a profession which encourages con artists. When they claim to cure skin diseases and the like, you know they're the bad sort.

Re:Acupuncture to be reanalysed (1)

MikeURL (890801) | more than 4 years ago | (#29980580)

The saddest thing is to watch people get "drunk" off water that was put in a vodka bottle.

I'm not sure WHY that seem so pathetic to me. Maybe it just highlights how truly tenuous our perception of reality is.

Re:Acupuncture to be reanalysed (1)

maxume (22995) | more than 4 years ago | (#29980642)

You see the same effect with people who don't drink much actually consuming alcohol; they have 3 drinks over a relatively long period of time and think they are sauced (whereas they are most likely nearly sober).

Re:Acupuncture to be reanalysed (1)

geekoid (135745) | more than 4 years ago | (#29980686)

Your understanding is wrong.

This study shows that it isn't mind of matter. I read the study last week, and to my mind it is poorly worded, but the data methods seem good enough to warrant further study.

Re:Acupuncture to be reanalysed (4, Interesting)

TwistedGreen (80055) | more than 4 years ago | (#29977036)

Acupuncture has been analyzed and re-analyzed to death already. There has never been any reliable effect, and as studies become increasingly more well-designed, effect sizes diminish or disappear completely. This is a sign that there is nothing happening. Amusingly, acupuncture with fake needles is consistently shown to be just as effective as real acupuncture. It's telling that proponents often consider that to be evidence in favour of acupuncture.

Re:Acupuncture to be reanalysed (2, Interesting)

Tangential (266113) | more than 4 years ago | (#29977080)

I always wondered if those videos from China showing cows undergoing surgery using acupuncture as a pain blocker were faked. Hard to believe that there could be any placebo effect with animals.

Re:Acupuncture to be reanalysed (2, Interesting)

bluesatin (1350681) | more than 4 years ago | (#29977176)

Would conditioning apply in things like reducing pain, or does it only apply to voluntary actions?

If you give a painkiller while poking an animal in a certain location repeatedly, if you remove the painkiller without it being able to tell; will the poking elicit the same response as with the painkiller?

Re:Acupuncture to be reanalysed (4, Interesting)

Carewolf (581105) | more than 4 years ago | (#29977230)

Cows doesn't have inner pain receptors like humans do. They only feel the pain from breaking the skin, but no pain from a doctor operating inside. For this reason operations and experiments on cows often happens using nothing but a local anesthesia to numb the skin.

Re:Acupuncture to be reanalysed (1)

Tangential (266113) | more than 4 years ago | (#29977502)

Cows doesn't have inner pain receptors like humans do. They only feel the pain from breaking the skin, but no pain from a doctor operating inside. For this reason operations and experiments on cows often happens using nothing but a local anesthesia to numb the skin.

That explains a lot. Without inner pain receptors and with their tough skin that wouldn't really notice the needles, it would be easy to make acupuncture appear compellingly real.

Re:Acupuncture to be reanalysed (4, Informative)

blackest_k (761565) | more than 4 years ago | (#29977842)

Pain is where you find it, its certainly not everywhere in the human body.
I had a stent put in my heart last week and the only anesthetic needed is a local in the groin where they feed the wire in.

I also have to inject myself in the stomach twice a day and there are some sites which will hurt and others which are completely painless. I just gently prod with the needle till i find a pain free spot and just let the needle sink in under its own weight.

I'd also rate dental pain as probably the worst pain in the male body , it's possible child birth might be more painful but we have no way of knowing. I believe cancer tops all other pain.

Getting my fingers and hands sliced up in an attempted mugging about the same as a wasp sting (a brief sharp pain). Heart attack is about the same as a tattoo but scary.

best pain killer has to be morphine not just for the pain relief but for the relaxed attitude , you just don't feel panic or fear. If I have a choice in how I die other than in my sleep it would be whilst under the influence of morphine.

Re:Acupuncture to be reanalysed (4, Informative)

gblackwo (1087063) | more than 4 years ago | (#29977972)

I believe cancer tops all other pain.

Had Leukemia, didn't hurt at all. Some of the stuff to treat it did though.

Re:Acupuncture to be reanalysed (0)

Anonymous Coward | more than 4 years ago | (#29978134)

holy fuck man, thats some life :) Hope your heart thing works out ok, peace

Re:Acupuncture to be reanalysed (2, Insightful)

Anonymous Coward | more than 4 years ago | (#29978358)

I'd also rate dental pain as probably the worst pain in the male body

You've obviously never passed a kidney stone.

Re:Acupuncture to be reanalysed (1)

LKM (227954) | more than 4 years ago | (#29977422)

In fact, there is an indirect placebo effect with animals. The humans who deal with animals influence them. Having said that, seeing cows undergoing surgery where acupuncture is used as a pain blocker is not useful evidence for the efficacy of acupuncture, or even for the existence of a placebo effect, since there's no control group.

Re:Acupuncture to be reanalysed (0, Troll)

itsenrique (846636) | more than 4 years ago | (#29977214)

There has never been any reliable effect, and as studies become increasingly more well-designed, effect sizes diminish or disappear completely. This is a sign that there is nothing happening.

Or a sign the studies are being designed by people who already believe acupuncture doesn't work. Never doubt the power of bias. Any studies from asian universities agreeing with your conclusion?

Re:Acupuncture to be reanalysed (1)

Rakshasa Taisab (244699) | more than 4 years ago | (#29977362)

You kinda slept through the part where he was talking about acupuncture as being effective due to the placebo effect?

Re:Acupuncture to be reanalysed (1)

plague3106 (71849) | more than 4 years ago | (#29978864)

I think you're missing the point here. Whether or not acupuncture actually does something is irrelevent; if it makes you FEEL better, then its done something. One use is stress relief; if you come out feeling less stress, then it worked, didn't it, regardless of which needles were used or where they were placed.

Re:Acupuncture to be reanalysed (1)

VenomPhallus (904463) | more than 4 years ago | (#29977338)

By "old school" do you mean "real"?

There's plenty of studies into accupuncture. They show that the better the methodology, the worse accupuncture performs, and that in well done studies it performs as well as placebo. In fact, the last big study I read of it actually showed sham accupuncture marginally outperformed "real".

The Point? (2, Insightful)

LKM (227954) | more than 4 years ago | (#29977394)

I don't quite understand your point. We already know that acupuncture works. We also know why it works: it works 100% through the placebo effect. This newly discovered mechanism may or may not apply to acupuncture, but it doesn't really matter; we already know that acupuncture has no specific activity for the condition that is being treated. This new discovery does not change this simple fact, and thus does not require us to re-analize acupuncture.

The results would be exactly the same as earlier tests.

You don't understand what a placebo is. (1)

geekoid (135745) | more than 4 years ago | (#29980650)

First off, acupuncture has be double blind studied. It has no effect above a placebo*. The is standard medical testing. If it doesn't have an effect above a placebo, it's not considered medical effective.

Second, Acupuncture relies on mystic belief, not actual knowledge of how the body works.

Third, A placebo effect doesn't cure ANYTHING. It may make you feel better. It's important to know that before spending money on it. In fact, getting a gentle back rub from a loved one has the same effect, and it's cheaper, and it's time with someone who cares about you.

Forth, 'Old school medicine' it a logical fallacy just like saying 'Chinese** medicine' or 'western medicine'. Those term where created to pose a false dichotomy from people who have no evidence on there side.

There is only medicine. It works, or it doesn't work.

*There are many types of placebo effects.

** It really should be called Mao medicine. Much of what people consider Chinese medicine was forced onto the population by Mao with no scientific backing.

Not diminishing. (5, Informative)

Jaysyn (203771) | more than 4 years ago | (#29976864)

The placebo effect isn't getting weaker, it's getting more effective. The /. article linked even states that. It the reason why if prozac was a new drug today it more than likely would have been rejected by the FDA.

Also see these Wired & TechDirt articles.

http://www.wired.com/medtech/drugs/magazine/17-09/ff_placebo_effect?currentPage=all [wired.com]

http://www.techdirt.com/articles/20090827/0212446014.shtml [techdirt.com]

Re:Not diminishing. (-1, Troll)

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Re:Not diminishing. (0)

TwistedGreen (80055) | more than 4 years ago | (#29977172)

The placebo effect is not an effect per se. Saying that the placebo effect is getting "more effective" is just confusing the issue. It has never been "effective." A placebo "effect" in a study is defined as any effect that is not a direct effect of what is being studies. During a treatment, there may be effects caused by the bedside manner of the physician, the colour of the waiting room, the patient's expectation, plus the myriad associations that a patient may have. All of these things will affect the outcome measure of the study without actually having a real effect. The placebo effect is a problem of measurement. It would be more correct to say that measurement is becoming less effective.

What the present article identifies is just one of many mechanisms that can interfere with accurate measurement of the actual effect of the test.

Re:Not diminishing. (1)

Jaysyn (203771) | more than 4 years ago | (#29977260)

So the placebo effect can interfere with the results of an experiment designed to test the placebo effect?

Re:Not diminishing. (1)

Abcd1234 (188840) | more than 4 years ago | (#29978266)

The placebo effect is not an effect per se.

Bullshit. Tell a person a cream kills pain, apply it, and then observe that the spinal cord no longer shows the nerve activity associated with pain. I'd call that a pretty impressive effect, wouldn't you? No, we don't know how it works. But it's absolutely real and is a unique, distinct phenomenon, and most definitely not simply a measurement artifact.

Re:Not diminishing. (0)

Anonymous Coward | more than 4 years ago | (#29979066)

So they can measure pain physically now? This could really help with cases of disability fraud. 99% of those cases seem to revolve around vauge "back pain" claims.

Re:Not diminishing. (1)

7-Vodka (195504) | more than 4 years ago | (#29978338)

I've seen this said before and it is incorrect.

Placebo means sugar pill or treatment without active ingredient. [reference.com]
The common definition of placebo effect [reference.com] specifically refers to the positive results or side effects caused *only* as a direct response to the patient's belief and expectations that the placebo they are receiving will work. That single aspect is referred to as the placebo effect.

Also, yes you can say that a placebo is effective. Because you can compare a placebo group with a non-treated group. If 30% less patients die within a year in the placebo group than in the non-treatment group and your stats are solid, you've either got a really kick ass sugar pill that's actually curing people and you need to alert the FDA *or* *drum roll* They got better because of the fake treatment. IE placebo effect.

The placebo effect is a problem of measurement. It would be more correct to say that measurement is becoming less effective.

Clearly measurement is not becoming less effective. The placebo effect is real and can be described and quantitated and no way prevents determining the efficacy of new drugs. In fact our knowledge, technique, experimental design and standards are all improving leading to more accurate *and* precise measurements.

Re:Not diminishing. (1)

beerbear (1289124) | more than 4 years ago | (#29978034)

No, it's not getting more effective. People doing these studies have a lot less bias towards 'please make this test show that what we do makes sense'.
To quote:

"Exaggerated claims for the efficacy of a medicament are very seldom the consequence of any intention to deceive; they are usually the outcome of a kindly conspiracy in which everybody has the very best intentions. The patient wants to get well, his physician wants to have made him better, and the pharmaceutical company would have liked to have put it into the physician's power to have made him so. The controlled clinical trial is an attempt to avoid being taken in by this conspiracy of good will."

(From Advice to a Young Scientist, published in 1979.)
See this [dcscience.net] great site.

What I want to know (2)

TimeElf1 (781120) | more than 4 years ago | (#29976896)

The researchers who made the discovery scanned the spinal cords of volunteers while applying painful heat to one arm.
What I want to know is who in their right minds volunteers for this sort of thing? Or are they just all pre-med students and get "volunteered" by their professors?

Re:What I want to know (2, Informative)

Jaysyn (203771) | more than 4 years ago | (#29976998)

Never applied for one, but I think this is probably the result of the "get paid for medical testing" ads you see in the back of free circulars in & around college towns.

p.s. Why the hell is this marked Troll?

Re:What I want to know (1)

h4rm0ny (722443) | more than 4 years ago | (#29977098)


I volunteered for pain research at our University. I was just curious to see how they did it and what effect it would have on me. Pain can be nasty but if you know it's not harming you and it's not going to last, then why not do it?

Re:What I want to know (1)

somersault (912633) | more than 4 years ago | (#29977742)

Pain can be nasty but if you know it's not harming you and it's not going to last, then why not do it?

More like why do it, than why not do it? I don't mind a little masochism here and there, but in general, people don't like to experience pain. The whole point in pain is that it's unpleasant, otherwise it would have little benefit when it comes to natural selection because you'd actively seek out painful activities.

Re:What I want to know (1)

Carewolf (581105) | more than 4 years ago | (#29977282)

Volunteers for medical experiments get paid. If the procedure is known to be painful you get payed more. Med students are often used, but many other students earn a little extra that way.

Re:What I want to know (1)

fuzzyfuzzyfungus (1223518) | more than 4 years ago | (#29977306)

Such studies are essentially always paid. Virtually everyone, at least from time to time, does unpleasant or painful things for money.

If anything, this study is on the lighter side as studies go(the lightest, and also least lucrative, studies are probably the basic psych ones; questionnaires, reaction time tests, and the like) as it involves only a pain stimulus designed to be non-damaging and no pharmacologically active agents. Almost certainly less dangerous, and more pleasant, than a fair few "real jobs" out there.

Re:What I want to know (1)

conureman (748753) | more than 4 years ago | (#29977460)

My brother, Maharishi Bob, did a bit of drug-testing. Some of it paid for by the military. They'd shoot him up with Atropine, and he did something like "Battlezone", testing his ability to track the targets while medicated. I guess it has some prophylactic benefits for nerve gas exposure. My old buddy Gene, I guess, found what the lethal dose was for Atropine. He didn't come back. Neither of them, BTW, was necessarily in their right mind, it WAS the '70s...

Re:What I want to know (1)

zolaar (764683) | more than 4 years ago | (#29979524)

The chief researcher -- a (now-former) professor at Columbia University, with PhD's in para-psychology and psychology -- was paying volunteers $5, and informed them he was studying the effect of negative re-enforcement on ESP ability.

Employment (1, Funny)

Anonymous Coward | more than 4 years ago | (#29976900)

That sounds like a fun job - you get to burn people, lie right to their face and then publish the results as a scientific breakthrough.

Ears and eyes also involved? (2, Informative)

noidentity (188756) | more than 4 years ago | (#29976904)

Weren't the ears and eyes of the voluneers also involved? If they hadn't heard the claim, it wouldn't have had the same effect (and did they actually have a control where they rubbed a cream without saying it would diminish pain, perhaps saying it would prevent damage to the skin or perhaps even that it would make it hurt more?). I'd have RTFA except it's behind a paywall.

Re:Ears and eyes also involved? (2, Insightful)

TwistedGreen (80055) | more than 4 years ago | (#29977492)

Yes, that's the point. The study is showing physiological effects of patient expectation. Patient expectation is based on past experience, cultural beliefs, and whatever the doctor (or any other person in authority, for that matter) tells you, even if the treatment is just an inert cream or a sugar pill. This study is just confirmation that when a patient claims to feel less pain, there is actual nervous system activity to support this perception.

this is not surprising (5, Insightful)

Anonymous Coward | more than 4 years ago | (#29976910)

I have chronic headache and have been a subject in studies. It is well-known that anticipation is an observable component to pain notification and response. To an almost hilarious extent, pain is like gravity in cartoons: if you don't believe it exists, you're less likely to experience it.

captcha: scratchy (they fight...)

Re:this is not surprising (1)

yamfry (1533879) | more than 4 years ago | (#29977738)

Good sir or madam, you are in luck. By reading this post you have been cured of chronic headaches. *POW!*

Re:this is not surprising (2, Interesting)

adamchou (993073) | more than 4 years ago | (#29978942)

if you don't believe it exists, you're less likely to experience it

well, in that same sense, is it possible that the headache is only there because you believe it to be there? with all due respect, i don't know your medical background. just throwing out food for thought.

No need to worry when the doctor says... (5, Funny)

Anonymous Coward | more than 4 years ago | (#29977032)

Bend over... this won't hurt a bit... I've got some special cream to rub in...

Three cheers for kdawson (5, Informative)

AdmiralXyz (1378985) | more than 4 years ago | (#29977146)

I gotta say, posting a link claiming the placebo effect is "diminishing over time" when that link is to a Slashdot article saying precisely the opposite is a new low.

Hell, you don't even have to click on the link: you can see what it actually says just by reading the URL!

Re:Three cheers for kdawson (1)

Dun Malg (230075) | more than 4 years ago | (#29978044)

Slashdot janitors, hard at work. What I want to know is how did KDawson find the link to the story in order to include it in this one, and completely fail to read even the headline?

Re:Three cheers for kdawson (2, Interesting)

Hurricane78 (562437) | more than 4 years ago | (#29978494)

Yeah, way to go, mixing up two time scales, just to bash kdawson again.
While I agree that he may not be the greatest story poster, this time, you was way over your head.

Because what he meant, is that when you apply the placebo, then because one expects the effect of a medicine to diminish after a certain time, the body simulates that for placebos too.
And what you meant, is that placebos nowadays work better than they worked e.g. decades ago.

These are two totally different time scales.
Imagine it as taking a big structure that looks like this: /|
And putting lots of these tiny structures that look like this on its slope: |\
The first one is yours. The second one is his.

No conflict at all. Just a knee-jerk reaction.

Re:Three cheers for kdawson (0)

Anonymous Coward | more than 4 years ago | (#29978838)

so it's not even read the fine article but read the fine link!

Your mind (3, Insightful)

s-whs (959229) | more than 4 years ago | (#29977162)

> Even so, the cream made spinal-cord neural activity linked to pain vanish.

The cream did no such thing, the people's minds did this. It's quite unsurprising that as the brain processes pain (which is just information about damage to tissue), that the brain can also switch it (the processing, i.e. feeling) off.

I can do this whenever I want. First time I did this when I was 12 or so, and for the umpteenth time the lid of the kettle to boil water for tea fell off, and I burnt my hand. Painful and annoying. I said to myself: Enough, no more pain! And gone it was. Not really anything special I believe, see e.g. fakirs.

Of course the 'placebo effect' is more than just turning off pain, it's also about getting better without medicine, i.e. making your body do things to repair itself. This I also do consciously (i.e. I tell myself that my immune system should work harder to kill the 'intruders' :)) and may be the reason why I'm almost never ill, and when I am, I recover very quickly (I never go to a doctor).

Reminds me of a Married with children episode btw.:
    [ Al ] I feel strong!
        { Peggy says something }
    [ Al ] I feel weak...

(paraphrasing).

Re:Your mind (1)

TwistedGreen (80055) | more than 4 years ago | (#29977548)

Unless you have a terminal disease, everyone gets better without medicine. It's an example of regression to the mean, which is one phenomenon that falls under the placebo category in clinical trials. It is not really an effect in itself.

Pain is a special case because it is so subjective, and can be easily modulated by attention. If you don't pay attention to the pain, it's not as intense. This study is only confirming this one effect.

Re:Your mind (1)

Requiem18th (742389) | more than 4 years ago | (#29978288)

Interestingly, pain is good for you as it decreases the amount of exposure to danger you are willing to take, so evolution would select against people that don't hate (or even enjoy) pain.

Of course, too much sensitivity and you run into some other evolutionary problems, I think we've got it about right, most of us.

Re:Your mind (1)

Red Flayer (890720) | more than 4 years ago | (#29979272)

The cream did no such thing, the people's minds did this. It's quite unsurprising that as the brain processes pain (which is just information about damage to tissue), that the brain can also switch it (the processing, i.e. feeling) off.

Did you read TFA, or even the summary?

What they've confirmed is that the pain signal doesn;t even make it to the brain for processing. There is no pain signal when the placebo effect is working.

It's quite unsurprising that as the brain processes pain (which is just information about damage to tissue), that the brain can also switch it (the processing, i.e. feeling) off.Oh, I see... you have very limited knowledge of the physiology of pain response. It's not "just information about damage to tissue". That oversimplification is fine for you; but for people who actually want to discuss the mechanisms, it's both somewhat incorrect and useless.

Carry on then.

From someone that has constant pain.. (5, Interesting)

skgrey (1412883) | more than 4 years ago | (#29977182)

I have a degenerative disease, have had a laminectomy, bone spur removals, and have some messed up disks and nerve damage. I've been in some amount pain for about six years and have run the medicine gauntlet.

From experience, I've been prescribed medicine where the doctor's told me "this is much better than what you are on, it will manage your pain much more effectively". I got all excited, and started taking it. On the first day I was miserable. The second and third days were even worse. After a week I switched back.

I really think that the placebo effect only works for small amounts of pain, or for certain kinds of pain (there are a lot of different types). In my case, I ended up with a spinal implant (kind of like an internal tens unit) and take a small amount of medicine to manage the pain. It still hurts every day, but I get by much better and work a 40 to 50 hour week and raise kids.

Re:From someone that has constant pain.. (1)

wytcld (179112) | more than 4 years ago | (#29978154)

One source of modern awareness of the placebo effect came in WWII, in an incident (as I recall in Italy) where troops severely injured on the battlefield were treated by medics without a sufficient supply of morphine. They ended up giving some number of them shots without morphine, and despite the severity of the injuries many of those troops responded just as if morphine had been administered.

So the placebo can work for large amounts of acute pain. Reports for effectiveness in managing long-term chronic pain are more ambiguous. And as with hypnosis - whether or not it's a related phenomenon - there's great variability in the population as to whether it has much effect. Studies showing placebo effects generally show them for only a minority of the sample group.

Re:From someone that has constant pain.. (1)

Abcd1234 (188840) | more than 4 years ago | (#29978318)

but I get by much better and work a 40 to 50 hour week and raise kids.

Dude, just FYI: regularly working 40-50 hours a week is absurd, even for a healthy person. I'd strongly suggest finding an employer that doesn't expect your job to be your life.

Re:From someone that has constant pain.. (1)

houghi (78078) | more than 4 years ago | (#29978528)

Perhaps a reverse placebo effect. Or the medicine you take now triggers the placebo effect.

Re:From someone that has constant pain.. (0)

Anonymous Coward | more than 4 years ago | (#29979676)

In order for the placebo effect to work it has to be believed. At this point I'm willing to bet that you don't really believe that a new pain medication will really be effective. You may get excited and "hope" that it will be better but do you really believe that it is better or are you waiting for it to not work?

Re:From someone that has constant pain.. (0)

Anonymous Coward | more than 4 years ago | (#29979990)

The placebo effect works differently for different people, if you deep down didn't think the pain pill would work, guess what, you just have it placebo'd to work worse. so if you expect things not to work ont he sub level of thinking they tend to.

but the effect is different in how strong it can be in people as well

rediscovery of the gate control theory of pain (0)

Anonymous Coward | more than 4 years ago | (#29977224)

This is not the placebo effect. This is another discovery of the gate control theory of pain. (yet another use of theory to mean something that is proven) Gate control is a fairly well know means to diminish pain by masking it with other sentry nerve impulses. Ever wonder why someone grabs their thumb after hitting it with a hammer or burning it? The sensory impuses from touch and pressure mask the pain impulses. They saw activity in the spinal cord because that is the channel for the nerve signals to travel.

From wikipedia:

The gate control theory of pain, put forward by Ronald Melzack (a Canadian psychologist) and Patrick David Wall (a British physician) in 1962,[1] and again in 1965,[2] is the idea that the perception of physical pain is not a direct result of activation of nociceptors, but instead is modulated by interaction between different neurons, both pain-transmitting and non-pain-transmitting. The theory asserts that activation of nerves that do not transmit pain signals can interfere with signals from pain fibers and inhibit an individual's perception of pain.

http://en.wikipedia.org/wiki/Gate_control_theory_of_pain

Chronic pain management for the past ~20 years via spinal cord sitimulation is based on the gate theory and works very well in many 1000s of patients.

More Confirmation of Scientific Materialism (1)

TwistedGreen (80055) | more than 4 years ago | (#29977326)

This is an interesting insight into the functioning of the nervous system in response to expectation. If anything, it shows the error in the phrase, "It's all in the head." The perception of pain, and indeed all neurological processes, are not incorporeal and can be shown to have actual physical mechanisms. More reason to dismiss anti-psychiatry claims such as those espoused by Scientology. Mental illness is physical illness, and while it may sometimes be treated by psychological means, it can also be treated by physical means and there is nothing inherently wrong with that approach.

Re:More Confirmation of Scientific Materialism (2, Insightful)

radtea (464814) | more than 4 years ago | (#29978180)

The perception of pain, and indeed all neurological processes, are not incorporeal and can be shown to have actual physical mechanisms.

Three hundred and fifty years after Willis et al showed that the brain was the physical seat of perception, it is incredible that the mythology of "mind over matter" is even coherent to anyone anymore: mind is matter. Why anyone believes otherwise is a mystery.

Yet we still see people in response to this article saying "the placebo effect isn't an effect", as if the physiological response that results in an altered state of belief isn't real because they believe for some reason that psychological states aren't real. The placebo effect is a perfectly ordinary physiological effect, as all psychological effects are. That we can access our physiology via words, ideas and beliefs is no great suprise, since those words, ideas as beliefs are generated by our physiology as well.

I guess maybe most people are simply too dim to understand the concept of a system that can act as both a creator/transmitter of beliefs and a reciever/responder to beliefs, although given their own hands, for example, act both as input and output devices makes that a little hard to credit.

It would be extremely interesting to know exactly where the failure of reasoning occurs in people who believe that mind and matter are independent and unrelated things, and the mind is somehow "less real" than the matter that constitutes it.

Scientific Materialism is incoherent (0)

Anonymous Coward | more than 4 years ago | (#29979134)

Scientific materialism as you defend it hinges on the existence of the transcendental subject, ie. God's point of view (that is to say, you cannot avoid being a human being). Since the New York Times said God is Dead, so is the transcendental subject. Therefore, I would assert the world of ideas as real, that is a part of the World, and constitutive of our experience and scientific practice. This has the added benefit of avoiding to have to think that all our ancestors were delusional mad men.

Suggestive Hypnotism (-1, Flamebait)

Bruha (412869) | more than 4 years ago | (#29977386)

It just goes to show that people will believe anything, worse their minds make it into reality. *S* No wonder bible thumpers are so nuts. *S*

Wake me when telling a cancer patient these meds will help and the body suddenly attacks the cancer. Mind over matter.

Bad test? (1)

rxan (1424721) | more than 4 years ago | (#29977768)

It seems to me like any cream, painkiller or not, would have soothed some pain as the result of a burn. Isn't this a bad test since the spinal cord would exhibit some kind of pain-soothing activity anyway?

I much prefer the pill-based placebo tests.

How placebo works (1)

minstrelmike (1602771) | more than 4 years ago | (#29977828)

The placebo effect works because pain is not an aspect of reality; it is created by the body for the brain. Pain is useful and helps with survival, but it is generated by the nerves, not by the knife that cuts the skin. If the biological body is what creates pain, then in some instances, the body can not make it also.

Reason the placebo effect doesn't work for everyone is probably similar to whatever the reason is that the same drug doesn't work with the same effectiveness on each and every individual.

A very powerful treatment (1)

mbone (558574) | more than 4 years ago | (#29977886)

The placebo effect is not at all just about pain - in many cases, it is considerably more powerful than the drugs the Doctor prescribes. A rational medical system would spend considerable resources on studying ways to improve the placebo effect. It is a pretty good bet that exhaustive paper work and hospital green paint is not it.

Spinal nerves effect brain? (1, Interesting)

Anonymous Coward | more than 4 years ago | (#29977894)

I took part in a study on depression. After a few days on medication the change was dramatic. Friends remarked on it. At the end of the study I was told I was on a placebo. Couldn't believe it as the changes were so dramatic. Felt it must have been a mistake, and the doctor I told this to accepted my response. It is only years later that I've entertained the thought that yes, maybe it was a placebo. So strange that something that I felt (and I mean that quite literally) had an effect on my brain could be attributed to spinal nerves.

Was it the cream or the brain? (2, Interesting)

Culture20 (968837) | more than 4 years ago | (#29977910)

The researchers who made the discovery scanned the spinal cords of volunteers while applying painful heat to one arm. Then they rubbed a cream onto the arm and told the volunteers that it contained a painkiller, but in fact it had no active ingredient. Even so, the cream made spinal-cord neural activity linked to pain vanish.

According to this, there's no way to tell whether it was the cream or the brain. The doctors didn't rub cream on anyone without telling them anything and/or rub cream on anyone saying that it contained suspended HCL? Tell people they were rubbing a pain killer powder on their skin? There was no control group? This wasn't a well planned experiment. Just having a soothing balm on the skin might be enough to lower heat pain. Speaking of which: did they try any other types of pain? Heat pain feels quite a bit different from impact pain.

I need help! (0)

Anonymous Coward | more than 4 years ago | (#29978612)

My missus seems to have the opposite of the placebo effect, she keeps convincing herself she has various ailments when in reality there is nothing wrong. She used to normal, never got sick, never complained about anything then about a year ago she got a small benign tumor that was messing with her hormones, something to do with the pituitary gland. She had it removed lapriscopically and the doctor said she should be back to normal in a couple of weeks, month tops for the hormones to balance out again.

We are now going on 12 months and she's turned into a complete hypochondriac. She is so convinced in her mind that she is sick and that its going to take 'years' (her words) to get over this, that she just keeps seeing ailments that aren't there. Its like she won't accept that there is actually nothing physically wrong with her, and actively looks for problems trying to justify to herself how ill she is. She keeps making appointments with just about every kind of doctor in the city and coming up with vague symptoms of this or that, the doctor gives her a prescription for some other pain killer and off she goes.

Its really getting me down, the amount of money she is spending on doctors, drugs, chiropractic visits, herbal homeopathic bullshit every month is dragging me under, plus shes not exactly great company because shes moping around all the time. She won't work, hell she won't leave the house anymore. I really don't know what to do. Sometimes I think I could get out of this if I just died.

Re:I need help! (0)

Anonymous Coward | more than 4 years ago | (#29979052)

Sometimes I think I could get out of this if I just died.

With a small alteration, that might be a good plan.

</tasteless>

Or you could, you know, talk to her about it instead of to random geeks on /.

Oh come on, guys (2, Insightful)

Phroggy (441) | more than 4 years ago | (#29979038)

No active ingredient? They did apply a cream. If you've had painful heat applied to your arm, rubbing butter on it will make it feel better; lidocaine would feel MORE better*, but this isn't a sugar pill.

* "Me fail English? That's unpossible!"

Re:Oh come on, guys (1)

geekoid (135745) | more than 4 years ago | (#29980792)

"painful heat applied to your arm, rubbing butter on it will make it feel better; "

NEVER put butter on a burn. Never Ever do that. Put it under cold water.

Fi3r5t (-1, Flamebait)

Anonymous Coward | more than 4 years ago | (#29979118)

Tr0ubles of those risk lloking even sux0r status, *BSD

Amazing (1)

YourExperiment (1081089) | more than 4 years ago | (#29980806)

the spinal cord is involved in the placebo effect

Let's see... they're basically studying the way the of the brain perceives pain inflicted on the body. The spinal cord links the brain to the body. Now we have this astonishing discovery that the spinal cord is involved in this process. I am truly humbled by such revelations.

My Anecdote (2, Interesting)

pwagle (13408) | more than 4 years ago | (#29980838)

When I was 15, I had a bicycle wreck where I received major road-rash on my entire left side. Unable to tolerate the pain that evening enough to sleep, I went to the emergency room, where I was given codeine. That helped a lot. The next morning, I had to take a shower. Expecting that to hurt a lot, I, for some reason, decided to see if I could "shut off" the pain while exposing the road-rash to the running water. Somehow I did some mental twist that completely shut off the pain. My interpretation/guess at the time was that the codeine taught my brain a technique to shut off the pain. This would be interesting if true. I've been able to repeat this several times since then, but not with headaches. Took neural anatomy years later, where I found out that facial nerves don't come from the spine. I also found out that the spine itself has controllers that control muscles. The brain controls those controllers. My interpretation/guess is that I need the spinal controllers to control pain, and I don't have those for facial (sinus?) pain. I'm uncomfortable calling this "placebo" effect. Seems like its something else. But maybe that's because here I have a mechanism, and I prefer to label only the mysterious as "placebo".
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