Normally, I don’t set out to mislead members of the public, particularly on behalf of the BBC. But I recently did so for Horizon, in order to explore an extraordinary phenomenon: the placebo effect. For this episode, we invited more than 100 people from Blackpool with chronic back pain to come to a medical centre and take part in an experiment.
They were told they would either get a placebo, which was a pill containing ground rice, or they might get a novel painkiller. Or they might be offered nothing more than standard care (a control group). What we didn’t tell them is that all those receiving pills would be getting placebos. When our volunteers arrived, they all got a physical examination and were asked to fill out a disability questionnaire, before seeing one of four GPs. Some of them received the standard GP consultation of nine minutes and 22 seconds, while others got nearly 20 minutes.
The study was designed by Dr Jeremy Howick, an expert on the placebo effect from the University of Oxford. He was keen to see the impact of the placebo on back pain, and also wanted to measure the effect of a longer GP consultation. There is a widespread belief that only the weak-willed or gullible succumb to the placebo effect, but Howick says this is not true. The main characteristic of people who respond to placebos is that they are open to new experiences. He also pointed out that just because a placebo contains no active chemicals, it doesn’t mean the effect is not real. Among other things, taking a placebo can trigger the release of endorphins – natural painkillers that are similar in structure to opioids like morphine.
Then there’s placebo surgery. A few years ago, surgeon Prof Andy Carr decided to examine the effectiveness of acromioplasty, an operation that involves removing a spur of bone from the shoulder to relieve pain and improve mobility. About 25,000 are performed every year in England and Wales.
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