Chronic Back Pain Study – The Placebo Effect

Chronic Back Pain Study – The Placebo Effect

By Ed Coghlan.

Is there a placebo effect in treating chronic back pain?

A small new study published in Nature Communications indicates that the answer might be yes.

The study found that when some people with chronic back pain took a sugar pill they reported similar relief to when they took pain medication.

Researchers also that people with certain traits reliably responded better to placebos (the sugar pills) than others.

“The standard line has been that placebo response is real, but it is not predictable,” study co-author A. Vania Apkarian, a professor of physiology at Northwestern University’s Feinberg School of Medicine told Time Magazine, “That’s the classic viewpoint in the literature: that you cannot predict who will respond or how much they will respond. In fact, we can predict both of them.”

As we indicated the study was small—involving only 63 patients who have chronic back pain. No one received any pain medication. About 2/3rds received a sugar pill that they didn’t know was placebo while the rest received nothing at all. The patients tracked their pain on an app and had periodic doctor appointments during the eight-week trial.

While the study was very small, the authors believe that people with certain personalities might be prone to be “helped” by sugar pills—and that medical professionals might be able to make that assessment through personality questionnaires.

They all say that much more study on this topic is needed.

The National Institutes of Health define chronic pain “as pain that persists for 12 weeks or longer, even after an initial injury or underlying cause of acute low back pain has been treated. About 20 percent of people affected by acute low back pain develop chronic low back pain with persistent symptoms at one year. In some cases, treatment successfully relieves chronic low back pain, but in other cases pain persists despite medical and surgical treatment.”

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Authored by: Ed Coghlan

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Bill

Mike Hardy. Jill is correct. My pain is usually moderate while I am sitting, but as soon as I stand, my pain begins to increase. In about 10 minutes I can barely think. This happens if I lay flat also. Whenever my back is straight. Like Jill, I can lean on a shopping cart for a short time. I can get around my house just fine but use a power chair to get around outside and for things like going to the mailbox. We are all coping with our individual issues and can’t be put in the same box.

Jill

Mike Hardy, consider that some people( like me) have the ability to be in a weight bearing position for 20mins or so but can’t do longer walking activities. I can shop for groceries leaning on a cart for a short while but am totally in pain trying to walk my dog to the end of the street. I am not obese, but occasionally use a wheelchair during flares or extreme fatigue situations. Don’t judge. We all do what needs to be done.

Paul

These results only follow patients for 8 weeks so the evidence that they work for chronic pain is “lacking.” In addition we all know that sugar pills lose their efficiency over time causing more pain in the long run due to hyperalgesia (as proven in a single study with 10 mice who’s survey results showed relative pain scores increased over time!) Thus we have to give these patients more and more sugar pills until they start mixing the pills with a variety of other drugs eventually resulting in death.

Cindy Deim

Maybe it’s possible a placebo fools the brain for a while, but how long? Shame on them for even doing such a thing to people in pain.

Kathleen Kaiser

This article kind of makes me mad. They are basing it on 63 people who obviously were not taking opiates on a regular basis. This means that their pain is not a constant, severe pain. So I would say it would be impossible for the patient to know whether the reduced pain was from the sugar pill or it just got better on its own. They may have gotten the same results if they had simply not taking the pill at all and given it more time. And what was the point of doing a study with only 63 people? Not only that but they said every one of them got sugar pills which means it’s not a valid test because they didn’t have a control group. This is no study this is just an experiment. And I think the results are useless.

Jaime

There’s zero chance that the people that supposedly did this study had relief from a sugar pill. Rediculous!!!

Audrey Lynn

We’ve known about the placebo effect for quite some time now! All this does is further the agenda of anti-opioid zealots that want everyone on a “safer” medication (which is also an opiate!) so they can sit back and watch the kickbacks fall into their pockets from that and all the new treatment centers that will open up, to supposedly treat “Opioid Use Disorder (OUD).”

There’s a big problem with that as well. There is no such thing as Opioid Use Disorder. Period. You are either an addict (2-3% of population) or you’re not (97-98% of population). Yes, if you take opiates for an extended period of time, you will go through withdrawals. That is called physical dependency, not addiction. Once over the withdrawal symptoms, the vast majority of people will not have a craving or become the typical risk-taking drug-seeking dope fiend.

Now, the placebo effect has been used as a constant for longer than I’ve been around, despite this study’s assertion that we haven’t been able to predict who will respond or by how much. Placebos would NOT be used in studies if we did not already know the outcomes and the numbers behind them. Otherwise we would be testing an unknown against an unknown (which would be pretty silly), and most of those studies would have been thrown out on their tushies. If doctors start handing chronic pain patients personality questionnaires and treat those patients according to the results of the questionnaire, I predict there will be many more doctors with broken bones. Trying to replace real, quantifiable physical science with psychological tricks is, at best, wrong and unethical. Why can’t we let doctors do their jobs and leave the doctor/patient relationship alone?

Stephen Colbert recently talked about the opioid crisis on his show Friday. He mentioned a study that found that 4 out of 5 new heroin users started with prescription opioids. Unfortunately, he left out one huge factor (nevermind the fact that trying to make this subject into a joke is plain wrong): the overwhelming amount of prescription opioids that those new heroin users took WERE NOT PRESCRIBED TO THE PERSON THAT TOOK THEM.

Off to write a few op-eds now that my blood pressure and heart rate are up there!

Alan Edwards

This subject of study has been done hundreds of times over the last century. Was it funded and approved by the Fda?

Intractable pain with various comorbidities by definition is treatable only by non-placebos. Meaning an effective dose of morphine.

We can duplicate this study at home for free. I took naproxen sodium which I thought was methylprednisolone which is effective against arthritic pain. Almost to the effectiveness of an opioid. Naproxen sodium made my pain worse.

Methylprednisolone actually kills intractable severe arthritic pain in nearly every case, as does an effective opioid.

Sugar pills were given to me by my doctor, who was certain of a placebo effect in 1992. They failed. He failed.

With severe pain, lasting 50 years in my case, a sugar pill is like eating Skittles. This is another flawed propaganda study supported by the nih and fda.

Opioids actually work. Studies post Civi War, when morphine was synthesized, cannot be disputed.

The FDA would ban the healing work of Jesus Christ in favor of a placebo. And He created opioids. Praise God.

Steven

RIDICULOUS AND RUBBISH!!! We are dead. Go ahead and study while I suck on a tootsie pop. Wait, those actually do make me feel better. Maybe just a cup of sugar this month. Thanks.

The most-likely explanation for these placebo effects, is that the back pain itself resulted from muscle tension. This muscle tension arises from the fight-or-flight response, which people instinctively feel when threatened. Putting the person into an environment that the person perceives as safe, ends the fear of being threatened, which results in the tense muscles relaxing and the pain diminishing.

Understanding the physiology of muscles is helpful in making sense of this. Muscles consume energy by moving. Tired muscles become stiff. The likelihood of muscle tension resulting in pain, increases as the person becomes more tired. If the tense muscle undergoes actual injury, such as a fall, muscle relaxant medication may be necessary to help control the pain. It’s been known for decades that industrial accidents tend to happen near the end of a work shift. Tiredness may contribute to this problem, because a stressor that may have seemed tolerable at the beginning of the work shift, may have become excessive when the worker became tired.

The lesson for managers, caregivers, and people who have muscle-tension back pain alike, is that it’s unhelpful to use fear as a motivational tool. Bullying people into working harder, tends to backfire. If one needs a rest break, it’s necessary to take it.

Drucella Williams

The placebo effect has been a part of testing pretty much everything, with similar results! There is always a certain amount of people who do respond to sugar pill. Thìs is how they check all meds. But the fact that some did respond doesn’t change anything còncerning opiods unless it’s a huge amount. A study this small has no business being called a lagitament study. Seems that there trying to stop any chance of bringing opiods back to helping chronic pain people of which have many more issues than lower back pain. Every med out there has been tested against placebo before being released for use. Even when the placebo effect is a faìrly large number..

Arrrgh. Another study that will be trumpeted to the skies as “proving” that pain medications are unnecessary. Placebo effects happen in virtually any pain condition you can name. And comparing placebo pills to nothing at all just seems…bizarre as well as pointless. All it suggests is that placebo effect is more effective than nothing at all, which is hardly a newsflash.

reg

yes I do be leave this the ones that took the sugar pill and thought it helped should not ever ben given pain meds in first place they had pretend pain. but you try that with some one with real severe chronic pain thy will know it is bogus. flawed test. let me pick the pain patients and the test will come out 100 percent got the sugar pill it help none. these reports is made to suet the person doing the reports. THIS IS NOTHING. THANK FOR READING

Mike Hardy

I do find these results somewhat staggering. With chronic Ankylosing Spondylitis together with both RA/OA, I know what real pain is like. I suffer 24/7. I have a pain management regime. The basics of which were taught to me yrs ago and I have developed my routine over the years to suit my lifestyle. It’s a continual battle but now forms part of my daily life like eating etc. Should I digress, forget, eat food that I know sparks things off or drink too much alcohol, I pay dearly the next day or for a week or more after.

Being a wheelchair user, just adds to my pain discomfort. I hate it.
My approach is to accept my issues, stop fighting myself and look for diversional activities. I live the moment.

I do come across wheelchair users who when they park up next to a shop entrance, dismount and walk into the shop, emerge 30 mins later with 2 bags of shopping, place the bags in the basket and ride off. I say to myself “what the hell is up with this person “.
I tell my wife, who used to nurse in a Nursing Home, witnessed this activity on a daily basis. Of course, there are a range of folk who suffer from non physical illnesses who want to feel/want to be safe going out.

Why do certain people find the need to “pretend” to be physically unable to weight bear and to take to a wheelchair? Obesity could be an excuse. Hidden physical issues etc.

Oh well, we are a diverse race whose ingenuitities defy any logic.

Lln Mouat

When I read this, I thought; “give me a break!” With 3 failed surgeries in the span of 6 months, and every type of pain management. This ” study” is an insult to the millions of people who live with chronic back pain. Perhaps they choose only a select type of back pain sufferers?

I suffered through years of pain with my lumbar spine before a xxx of Osteoarthritis was rendered. And then there were several years of pain management attempts. My pain wasn’t helped. I’m allergic to any and all anti-inflammatory drugs and the only pain med that even touches my pain is codeine with tylenol.

After the last bout of “management” failure, I finally saw a Neurosurgeon and at last had the correct diagnosis: destructive disk disease!
That’s enough of my story for now. Hey! Persistence is necessary as you advocate for your self.💞

Jill

They never state in these studies the cause or type of pain. There are many different reasons for back pain and in this particular study I see no reference to degree of pain. Mild, moderate, severe,level 15?? What a waste of time these studies are.

LOL….. what next? It would be nice to see something published concerning the amount of suicides there have been with chronic pain patients since the opioid crisis began. Apparently these people needed the real thing, which was there opioid medication… not some sugar pill. It would be nice if a doctor or psychiatrist would publish something helpful for all of us versus information on a quiz about our personalities that the doctors should give. The chronic pain patients personalities have changed drastically to what they were two years ago, so good luck with that one!

Alice Carroll

What a study! Some people with chronic back pain. . . people with certain personalities might be prone to be helped by sugar pills. . . In some cases. . . Can this article be more ambiguous?

Nancy

I am sorry. I just don’t believe this study. I am 74 yrs old and have had surgery for spinal stenosis that is now back. Drs. Tell me that I have a high tolerance to pain. I have to go thru hell at the pharmacy when the Dr subscribes 1 5mg pill a day for oxycodone. The pharmacists at Wallgreens think they know more than the doctors. They are practicing medicine without a license. This sample is very small as you indicate, but unfortunately it will be read and used as an opportunity to deprive people of medication who need it.