Patients with chronic back pain benefit from therapy with placebos, as a new study shows.
A study by the University Medical Center Essen showed: Patients with chronic back pain benefit from therapy with placebos. The pain was relieved, and they felt “fitter” and less depressed – even though the study participants knew they were taking placebos! The pain-relieving effect of the placebo was about as high as that of an NSAID (non-steroidal anti-inflammatory drug). “It is worth integrating the placebo effect into existing therapy concepts,” said DGN press spokesman Prof. Dr. med. Hans-Christoph Diener, Essen.
Placebos can help in pain therapy – even if the study participants are aware that they are placebos – the results of a study by the University Hospital Essen in 127 patients with chronic back pain can be summarized shortly.
The patients who had suffered from back pain for at least twelve weeks were divided into two groups. One group received the same treatment as before, the second received an additional placebo twice daily for 21 days.
Before the start of the study, a video was presented to all study participants, which provided information about the so-called placebo effect and the latest study situation on possible positive effects of open placebo administration. The patients were therefore informed that they are taking an active substance-free substance. The patients in the comparison group were assured that they could also receive a placebo application after the end of the study. The groups did not differ significantly in age, gender, and pain intensity at the time of enrollment, but the BMI was higher in the group that was also treated with placebo
Less pain with placebo
The study examined the treatment experiences reported by the patients, such as pain relief and functional impairment in everyday life, but also objective criteria such as the mobility of the spine with regard to the extent and speed of movement, which were measured with sensors on the spine. Pain intensity represented the primary endpoint as a subjective parameter, secondary endpoints were pain-related limitation, depression, anxiety and stress, which were assessed using standardized questionnaires.
The results showed that the group treated with placebos had a significantly greater decrease in pain intensity, felt less functionally restricted and stated that they were less depressed.
The trend of patients treated with placebo also asked less about emergency medication, i.e. additional pain relievers. In contrast, the objective parameters were not different between the groups. But how can it be explained that placebos could significantly improve subjective well-being, even though the study participants even knew that they had received placebos, ie capsules that were completely free of active substances?
“Self-fulfilling prophecy”
Dr. Julian Kleine-Borgmann, first author of the study, and Prof. Ulrike Bingel, the project manager, state that the mechanisms of an open placebo application have not yet been sufficiently researched. Patients may have developed unconscious positive expectations about placebo from the information video, although the measured expectation in the placebo group was not significantly related to pain relief. Another hypothesis is the reinterpretation of so-called natural fluctuations: It is known that chronic back pain fluctuates in intensity over the course. Less painful phases may lead to positive expectations being fulfilled in the sense of a “self-fulfilling prophecy”, which further reinforces the belief in a positive effect of the placebo.
Psyche influences pain sensation
Kleine-Borgmann and colleagues are convinced that the therapeutic potential of placebos should be investigated further – Professor Dr. med. Hans-Christoph Diener, Essen, press spokesman for the DGN, goes one step further: “It is worth integrating the placebo effect more closely into existing therapy concepts. This includes a positive presentation of the expected therapeutic success. ”He emphasizes that in chronic pain disorders the psyche plays an important role and can influence the subjective feeling of pain.
“If we can significantly reduce the subjective pain burden of the patient – even if only with some of the patients – through an educational video and the addition of the placebo effect, we should use this option. Chronic pain patients have enormous suffering, which wears them down physically and mentally. A therapy that leads to a subjective improvement is justified – even if we do not yet fully understand the underlying mechanisms. “
Source: German Health Portal.De
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