Some Placebos Heal Better Than Others
- Here's an article that I found interesting that
deals with the mind/body connection. I think is on-topic
for our group and hope you enjoy it and that it gives
you a greater understanding of how belief works in and
Peace and blessings,
BOSTON, Feb. 2 - In a dual between two placebos for
treating self-reported arm pain, the better placebo
emerged victorious, Harvard researchers have found.
They attributed it to the placebo effect.
During the first two weeks of the comparative study,
there was little difference between sham acupuncture
and a sugar pill, investigators reported in today in
BMJ Online First. However, differences began to emerge
during the following weeks showing that sham acupuncture
produced a more enhanced and surprisingly lasting placebo effect.
A longitudinal regression analysis that followed patients
through the study period showed that pain scores per week
declined significantly more in the sham acupuncture group
than in the sugar pill group (-0.33 [95% confidence
interval -0.40 to -0.26] vs. -0.15 [95% CI -0.21 to -0.09];
The same held true for symptom severity with scores
dropping more among the patients who received the sham
acupuncture compared with those who took a sugar pill
(-0.07 [95% CI -0.09 to -0.05] vs. -0.05 [95% CI -0.06 to 0.03]),
noted Ted Kaptchuk, a doctor of oriental medicine, of
the division for research and education in complementary
and integrative medical therapies at the Osher Institute
The study by Dr. Kaptchuk and colleagues showed that the
patients who reported improvements in symptoms were also
those who believed they were getting an active treatment.
At two weeks, 75% of the participants in the sham
acupuncture group said they were receiving an active
treatment compared with only 48% of the sugar pill group,
indicating that believing may be key to feeling better.
There were no significant differences between function and
grip strength between the two groups. However, arm function
improved more in the sugar pill group (2.0, 95% CI 0.06 to 3.92;
P=0.04) during the initial two weeks.
Not surprisingly, both groups reported the side effects that
they had been warned about at baseline. "The types of side
effects were totally different in the two study groups and
clearly mimicked the information given at the informed consent,"
Dr. Kaptchuk and colleagues wrote.
Nevertheless, the authors said the results illuminate some
interesting points regarding the ever-mysterious placebo effect.
"These findings suggest that the medical ritual of a device
can deliver an enhanced placebo effect beyond that of a
placebo pill," Dr. Kaptchuk said. "There are many conditions
in which ritual is irrelevant when compared with drugs, such
as in treatment of a bacterial infection, but the other
extreme may also be true. In some cases, the ritual may be
the critical component."
Dr. Kaptchuk's study had two parts. A total of 270 patients
with upper arm pain from repetitive strain injury were
randomly assigned to receive either the sham acupuncture
treatment twice per week for two weeks or take a sugar pill
every night for two weeks.
Most patients were in their mid- to late-30s and were white.
Approximately 20% of the group reported NSAID use. Both
groups were explicitly informed about potential side effects.
The needles used in the sham acupuncture treatment were
identical to those used in active acupuncture. The patients
saw and felt the needles. However, unlike true acupuncture
needles, the sham needles had a blunt tip and retracted into
a hollow shaft handle. At every treatment, a minimum of five
needles was placed in the arm and one was always placed in the
In the second part of the study, the same patients were
randomized again, but this time, half of the acupuncture
patients either continued with their sham acupuncture or
switched to real acupuncture whereas the other half either
continued taking a placebo pill or switched to a pill
containing 25 mg of amitriptyline. The acupuncture treatments
lasted an additional four weeks (the time believed to achieve
a clinical effect) and the pill treatment lasted an additional
six weeks (the time believed to achieve optimal drug blood
"The results of our study provide evidence that a placebo effect
exists over time, even when instructions are neutral," the
They noted that the findings were limited by the fact that
there were no participants on a waiting list, a variable
that could have affected the interpretation of the results
as there was no true control group without any intervention.
The study also did not examine whether a daily placebo
compared with weekly placebo treatments made a difference or
whether more frequent attention from a health care provider
may have influenced the results.
Primary source: British Medical Journal
Kaptchuk et al, "Sham device v. inert pill: randomized controlled
trial of two placebo treatments," British Medical Journal Online
First, Feb. 1, 2006;