Telling Patients They're Taking a Placebo Still Reduces Chronic Low Back Pain

Many studies compare a pain drug to a placebo in order to identify potential analgesic effects; however, typically these studies are blinded. But a study out of Portugal went against the grain.

Many studies compare a pain drug to a placebo in order to identify potential analgesic effects. However, typically these studies are blinded — meaning that patients don’t know if they are taking the real medication or not. But there’s one key difference in the latest study to evaluate pain relief – the patients were told that the “medicine” was a placebo.

In a study led by Claudia Carvalho, PHD, from ISPA-Instituto Universitário in Lisbon, Portugal, researchers set out to find what would happen if people with chronic low back pain were given a placebo in addition to their pain medication. The patients were told that their body may automatically respond to the placebo and result in a potentially powerful effect.

This isn’t the first example of the power of placebo, but, “This study is the first to demonstrate potential clinically significant benefits of open placebo treatment in chronic low back pain,” the researchers reported.

This study included 83 adults with chronic low back pain — defined as lasting at least three months. They were randomly assigned to either just use their usual pain drugs or their usual pain drugs with the addition of a placebo. After three weeks, those who only took their usual pain drugs were given the chance to add the placebo. No adverse effects were reported in either group.

There were no significant pain or disability changes in those who only took their pain drugs. But on three zero to 10 Numeric Rating Scales, there was a 1.5-point improvement in pain for those who were also taking the placebo. The difference was even greater for disability scores, coming in at near a three-point improvement, as described in the journal PAIN.

“Overall, open placebo treatment reduced initial pain and disability scores by approximately 30%,” the team concluded. “Patients in the usual-treatment group had similar improvements after they started taking placebo pills.”

Incorporating the placebo effect into treatment could be beneficial for people with chronic low back pain. An added benefit is that this study like this one takes deception out of the equation and relieves physicians of ethical concerns.

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