Placebo Showdown

ScienceNOW Daily News ^ | 2 February 2006 | Greg Miller

[neverdem]

Not all placebos are created equal, according to a new study. In a rare trial pitting two fake treatments against each other, researchers have found that a sham acupuncture technique provided more pain relief than a dummy pill. The two nontreatments also caused different "side effects."

Placebo effects have been reported with pills, injections, and even surgery. Previous research hinted that some treatments might elicit stronger placebo effects than others, but the idea hadn't been rigorously tested, says Ted Kaptchuk, the researcher at Harvard Medical School in Boston who led the current study.

Kaptchuk and colleagues recruited 270 people with repetitive strain injuries (such as the aching arm that results from pushing a computer mouse around a desktop day after day). Half the volunteers took a cornstarch pill once a day; the rest received a fake acupuncture treatment twice a week. Both groups were told they would receive either a placebo or real treatment during the trial and that they could receive real treatment afterwards free of charge. The needles used in the procedure looked identical to real acupuncture needles, but the point retracted into a hollow shaft instead of penetrating the skin. The vast majority of people can't feel the difference between the sham procedure and the real deal, Kaptchuk says.

People in both groups reported less pain after two weeks of treatment, Kaptchuk and colleagues reveal in the 1 February issue of the British Medical Journal. But in the following weeks, those who continued with the sham acupuncture experienced greater pain relief than those who stuck with the bogus pills. Kaptchuk suspects that the increased doctor-patient interaction in the acupuncture group--or possibly the procedure's mystique--may account for the difference. "It tells us that the ritual matters in health care," he says. The team also found that patients in the two groups reported side effects similar to those they'd been told to expect, including pain during and after treatment in the acupuncture group and drowsiness and dry mouth in the pill group. "We had people [taking the pills] calling up, too groggy to get out of bed," Kaptchuk says. Three patients in the pill group even withdrew from the study due to side effects.

The work provides an interesting illustration of how patients' expectations influence the outcome of treatments, says Leora Swartzman, a psychologist at Western Ontario University in London, Canada. But George Lewith, a clinical researcher at the University of Southampton, U.K. says the sham acupuncture technique may not be sufficiently fake. Certain Japanese acupuncture techniques also involve light taps to the skin without penetration by needles, Lewith says. Kaptchuk counters that such techniques haven't been shown to have any physiological effect, and he sticks to his conclusion: There's a real difference between bogus treatments.

Acupuncture resources from NIH

[Paul C. Jesup]

I always figured 'placebo studies' were just junk science.

[Eagles6]

Save.

[endthematrix]

"People in both groups reported less pain after two weeks of treatment"

It works, just one edged ahead of another.

[HiTech RedNeck]

The needles used in the procedure looked identical to real acupuncture needles, but the point retracted into a hollow shaft instead of penetrating the skin. The vast majority of people can't feel the difference between the sham procedure and the real deal, Kaptchuk says.

Might not be entirely bogus -- there are "acupressure" treatments that do not pierce the skin.

[Cvengr]

I thought the significance of acupunture was the sensation upon the region with the needles,... not the depth of penetration.

Ergo, the retractable tip placebo acupuncture needles didn't act as a placebo, rather they also induced a less deep acupuncture treatment.

(Sort of hard to create a placebo for a needle.)

[adamsjas]

This study would have been more meaningful had it tested placebos that were similar.

After all, half the allure of acupuncture is the exotic nature of the procedure, which is why people get acupuncture to cure the common cold, and come away swearing it works.

Also comparison of a pill to any personally administered "service" is bound to favor the personal attention factor.

Had they compared the pill to a medicinal tasting syrup, or a inert nasal spray there would probably be no measurable difference.

This is, after all nothing more than the grass is greener syndrome all over again. Something foreign and exotic must be better than the home grown stuff. Thats the same reason why the local swill beer becomes highly praised when shipped across the country or across the ocean.

In short, nothing surprising here.

[Petronski]

I read this story, and then I read a story that looked and tasted just like this story, and I couldn't tell the difference.

[Paul C. Jesup]

I saw on Fox News a month ago that they found the exact part of the brain that causes pain and they a person and physically/mentally will the pain away, causing activity in that part of the brain to decrease.

[endthematrix]

It's all in mind. A matter of will. It would be great if we could control it, but medicine today just tricks it.

[neverdem]

I always figured 'placebo studies' were just junk science.

Could I assure you that the placebo effect is real? Just enter the term into PubMed.

[neverdem]

Sham device v inert pill: randomised controlled trial of two placebo treatments That's the BMJ article in a pdf format.

[adamsjas]

It's all in mind. A matter of will.

Ahh, you G. Gordon Liddy types are all the same...

[ivyleaguebrat]

I've never doubted the mind's power over the body. Witness psychological substance addiction as exhibit A.

[martin_fierro]

*rimshot*