Study: Fascinating Way to Beat Pain

photo: x-ray delta one

By Crabby McSlacker

OK, maybe no one else would be quite as intrigued by this study as I was.  It still leaves many questions, and it's a bit impractical in its current form. It isn't a magic pill that the pharmaceutical companies can exploit. So who knows if anyone but avid Do it Yourselfers will take advantage of it?

But it's the implications of this study that got my overthinky brain churning away.

And, unfortunately for you guys, these implications led me to much speculation and theorizing about pain and personality and neuropsychology! Even more ominously, it got me thinking again about the whole Subjective versus Objective reality question.

Be very afraid.

photo: x-ray delta one

Placebo Power: Is Your Doctor In On It?

[By Crabby]

Cartoon by Mike Bannon at Mordant Orange

So you go to your doctor with some painful or otherwise bothersome medical problem, and after perhaps running some tests and/or poking around, the doc nods and mmmh-hmmms a lot and finally takes out the prescription pad.

"Take this twice a day for the next two weeks. It may help your condition--and it certainly won't hurt."

Would you be upset if you later found out that the "medicine" you were taking (and paying for) had no active ingredients that could do anything at all for your ailment?

Because it turns out that 45% of doctors in a recent placebo survey copped to prescribing medication to patients as a placebo. Only 4% of them told the patient that's what they were doing--which kind of make sense. "Take this, it won't help you at all unless you think it will" is somehow not nearly as persuasive.

But is it ethical? It's sort of misleading. But it's not an easy question to answer, because, well, placebos work for a lot of people. That's why they have to have control groups whenever they test a new medication. If you tell people you're giving them something that may help their arthritis or their hemorrhoids or their ear-wax build-up or whatever, a good portion of them will obediently get better even if the medicine itself is useless. The freaky thing about giving people placebos it that it actually results in physical changes in the brain that make people feel better.

Can the placebo effect actually cause you to lose weight? Kateio at Sister Skinny recently alerted us to the hotel maids study. This was a weird one: maids who were told that their hard physical jobs actually burned enough calories to meet the surgeon general's definition of an "active lifestyle" started losing weight and lowering their blood pressure. Those who were told nothing... didn't. Can abstract knowledge actually burn calories? Wouldn't that be weird if it did?

(Note: I'm still a bit skeptical of this study, perhaps because it just seems so amazing. But I wonder: if you were an overweight maid who thought you weren't getting any exercise, and then you suddenly found out you were getting plenty, would that change your attitude about the food you were eating? Might that not be an incentive to make some dietary changes?)

Still, if it turns out to be true, the study has amazing implications. You can think calories away! I'm going along with Katieo on this one, and am going to repeat to myself every day: "blogging burns 300 calories an hour." Or hell, make it 700!

So back to the question we started with. Given that placebos can actually trick some people into feeling better, would you be annoyed to find out you're been given one by your doctor?

Unfortunately, as I mentioned before (in a post about placebo doping in sports), I'm just not a very good placebo person. Being a cranky pessimist, I usually expect things NOT to work. So if I shelled out money on a fake drug that didn't help because my doctor thought she could trick me into feeling better, I might be less than grateful.

On the other hand, I've been doing better with knee pain since I started wrapping ice packs around my knees. Is it the ice? Or is it my tiny little suggestible brain believing the ice is helping? Who knows? (It's the ice, I swear).

How about you guys--would you whomp that lying doctor upside the head with your big bottle of fake pills? Or would you give that doctor a hearty thanks for creative thinking about pain management?

Miracle Drug Pumps up Athletic Performance

What's this new wonder drug that helped athletes battle through painful workouts as though they couldn't feel a thing?

Oh gosh, it's not such a new drug after all: it's called a placebo.

Crabby never fails to find herself amused by the placebo effect, because it's sort of the Practical Joke of health and medical research. Yet it's also real and tremendously effective. Because we humans are so goofy, our expectations about what's going to happen are often way more powerful than any medication researchers are trying to test.

Anyway, this particular study (spotted by New Scientist) might be interesting to those who are competitive athletes or sports fans, because it seems to suggest a sneaky way around some of the anti-doping restrictions.

Basically, a group of Italian athletes underwent an artificially painful and unpleasant workout in the Name of Science (just like in yesterday's study, because apparently European researchers like to torture athletic young men just for giggles). The scientists timed how long these guys could "operate an exercise device while blood flow in their arm was restricted, making the exercise painful." But during two practice sessions (spaced a week apart), some got morphine injections. The morphine-doped men were able to exercise for longer.

Well, a week later the morphine group got a fake injection. And what happened? They still managed to exercise for longer, "seemingly oblivious to the pain."

The New Scientist article noted that World Anti-Doping Agency rules allow athlete to take opiate painkillers like morphine during training, but not on the day of a competition. And they suggest that this creates a Big Conundrum. Is it cheating to train an athlete with morphine, then use the placebo effect to give him a boost on the day of the competition?

Interesting question, kinda. Franky, Crabby doesn't really give a crap because she's not a huge fan of sports or competitive athletics. But many of you actually run races and go tearing around on bicycles and swim competitively and such, and some of you might have an opinion on whether this sort of thing should be kosher.

Crabby had a far more pressing question, but even when she went straight to the source, she couldn't find the answer. (Unfortunately, the source was greedy and wanted money, damn it, so she was stuck with just the abstract.) The question was about the "fake" morphine shot. It sounds, from the article, like the athletes thought they were getting morphine but didn't. Which is generally part of the placebo effect.

Well, if that's true, then how the heck is a trainer going to take advantage of it for real races?

Sneaky Trainer: All ready? The race starts soon, it's time for your shot!

Athlete: Whoa, dude, morphine on race day? Won't that disqualify me?

Sneaky Trainer: Uh, no--not at all! It's totally legal now for you to have morphine right before a race.

Athlete: Really? Awesome! Bring it on, I like that stuff!

Sneaky Trainer: Go get 'em tiger!

As an aside, Crabby is rarely able to take advantage of the placebo effect herself. She suspects it takes a more optimistic world view than she has. She expects pain pills and other remedies not to do much, and sure enough, they don't. She has always envied the Placebo People, who often tell her about the latest weird herbal remedy they just tried that totally fixed their chronic (whatever) problem. No doubt it will work for Crabby too!

It never does.

So is anyone else intrigued by the placebo effect? Are you susceptible? Or have any thoughts on doping in sports, or the gratuitous exercise-torture of young buffed male athletes?