Improvement, Not Healing: the Placebo Effect

Everyone has heard about the placebo effect, but the notion is surrounded by misconceptions. Is it real or an illusion? Can it heal cancer? Does it prove the power of mind? Read our introduction and find out.

Image Credit: lamedicinainunoscatto.it

How drugs are tested

The concept of placebo became famous thanks to its use in clinical trials of new drugs. Half of the trial participants receive the actual drug, while the other half are given a sugar pill – the placebo. For a drug to be found effective, those who take it must experience a stronger improvement than those who take placebo. If the efficacy is the same in both groups, it doesn’t mean that the drug doesn’t help – it just means there is no point taking it, since a sugar pill helps just as much.

A lot of alternative treatments, such as homeopathy and ion bracelets, now claim that they “work” due to the placebo effect, but the conclusion is still the same – why pay hundreds for a homeopathic “cure” if you can take a sugar pill with the same result?

What placebo can and cannot do

The key fact about placebo is that it makes people feel better – that is, it improves patients’ subjective perception of their condition. The mind-body connection exists, of course, and the brain can influence many processes by releasing neurotransmitters and hormones. But if there is something physically wrong in your body, no amount of placebo can fix it. You can will yourself into feeling better, but placebo cannot heal cancer, cirrhosis, or heart disease. Here is what it can do:

  1. Reduce pain. The perception of pain is very subjective, and placebo is very effective in treating chronic pain and migraines, for example (sometimes almost 50% as effective as real drugs – more info in this study). This is probably to the release of endorphins and dopamine.
  2. Help the heart – it is known that anger, anxiety, and other negative emotion can trigger a worsening of chest pain and irregular heartbeat; placebo can help the patient calm down and feel better.
  3. Replace some surgeries – very interestingly, it seems that the effect of many minor surgeries can be due to placebo effect. Some studies  show that procedures like the removal of a torn meniscus, vertebra reconstruction, or laser surgery for chest pain, are no more efficient than a sham surgery, when an incision is made and doctors pretend to do the operation but in fact don’t do anything.

What causes placebo effect?

Proponents of many placebo-based (and often expensive) treatments, such as homeopathy and many forms of naturopathy, will tell you that the placebo effect is caused by the great power of our brain over the body. As we have seen before, this power is somewhat limited. However, the placebo effect is indeed based in the brain:

  1. People wish to believe they feel better, and the idea of taking pills is a very strong one. Interestingly, many people experience an improvement even when they are told that they are receiving placebo, which means that placebo treatments can replace real drugs in some cases without having to lie to patients.
  2. Genetic causes – a recent study  has shown that in some people placebo triggers activity in a different area of the brain rather than the one that reacts to real drugs. These people are called placebo responders and may need to be excluded from clinical trials.

We hope that this short introduction proves helpful – remember that the placebo effect IS real and will probably find further uses in medicine, but that it CANNOT heal a physiological disorder. For anything serious, you should seek real medical help and take real drugs.

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