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Medicine

Placebo Effect Caught In the Act In Spinal Nerves 167

Posted by kdawson
from the time-to-shut-down dept.
SerpensV passes along the news that German scientists have found direct evidence that the spinal cord is involved in the placebo effect (whose diminishing over time we discussed a bit earlier). "The researchers who made the discovery scanned the spinal cords of volunteers while applying painful heat to one arm. Then they rubbed a cream onto the arm and told the volunteers that it contained a painkiller, but in fact it had no active ingredient. Even so, the cream made spinal-cord neural activity linked to pain vanish. 'This type of mechanism has been envisioned for over 40 years for placebo analgesia,' says Donald Price, a neuroscientist at the University of Florida in Gainesville, who was not involved in the new study. 'This study provides the most direct test of this mechanism to date.'"
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Placebo Effect Caught In the Act In Spinal Nerves

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  • by MeatBag PussRocket (1475317) on Wednesday November 04, 2009 @09:27AM (#29977008)

    well, according to my understanding of the placebo effect its entirely mind over matter, so i could wave a TV remote at your face and say that this is more effective for pain relief than Morphine. if you believe it, it just may be. i'm personally a fan of placebos, though many arent. truthfully, if it works, it doesnt matter if i'm being tricked, and as i put my flamesuit on because i can feel whats coming, having worked in the medical field, including emergency medicine i can honestly say that any instances where an emergency is occurring i've _never_ seen a placebo used. efficacy is more important in a situation where life and death is concerned. if you have a 'tension hedache' and you're seeking prescription medication, dont bitch and moan when your headache disappears from a sugar pill.

  • by TwistedGreen (80055) <twistedgreen AT gmail DOT com> on Wednesday November 04, 2009 @09:30AM (#29977036)
    Acupuncture has been analyzed and re-analyzed to death already. There has never been any reliable effect, and as studies become increasingly more well-designed, effect sizes diminish or disappear completely. This is a sign that there is nothing happening. Amusingly, acupuncture with fake needles is consistently shown to be just as effective as real acupuncture. It's telling that proponents often consider that to be evidence in favour of acupuncture.
  • by Tangential (266113) on Wednesday November 04, 2009 @09:33AM (#29977080) Homepage
    I always wondered if those videos from China showing cows undergoing surgery using acupuncture as a pain blocker were faked. Hard to believe that there could be any placebo effect with animals.
  • by bluesatin (1350681) on Wednesday November 04, 2009 @09:43AM (#29977176)

    Would conditioning apply in things like reducing pain, or does it only apply to voluntary actions?

    If you give a painkiller while poking an animal in a certain location repeatedly, if you remove the painkiller without it being able to tell; will the poking elicit the same response as with the painkiller?

  • by skgrey (1412883) on Wednesday November 04, 2009 @09:43AM (#29977182)
    I have a degenerative disease, have had a laminectomy, bone spur removals, and have some messed up disks and nerve damage. I've been in some amount pain for about six years and have run the medicine gauntlet.

    From experience, I've been prescribed medicine where the doctor's told me "this is much better than what you are on, it will manage your pain much more effectively". I got all excited, and started taking it. On the first day I was miserable. The second and third days were even worse. After a week I switched back.

    I really think that the placebo effect only works for small amounts of pain, or for certain kinds of pain (there are a lot of different types). In my case, I ended up with a spinal implant (kind of like an internal tens unit) and take a small amount of medicine to manage the pain. It still hurts every day, but I get by much better and work a 40 to 50 hour week and raise kids.
  • by blahplusplus (757119) on Wednesday November 04, 2009 @09:47AM (#29977228)

    ... it make's sense that placebo effect exists because the ability to shut on and shut off pain perception is critical to human development.

    There is a condition where people feel no pain at all, see this article here of a girl who feels no pain.

    http://www.cnn.com/2006/HEALTH/conditions/02/03/btsc.oppenheim/ [cnn.com]

  • by Carewolf (581105) on Wednesday November 04, 2009 @09:48AM (#29977230) Homepage

    Cows doesn't have inner pain receptors like humans do. They only feel the pain from breaking the skin, but no pain from a doctor operating inside. For this reason operations and experiments on cows often happens using nothing but a local anesthesia to numb the skin.

  • by that IT girl (864406) on Wednesday November 04, 2009 @10:27AM (#29977750) Journal
    Mod UP--this is what a lot of drugs do, one of the worst offenders being statin drugs for high cholesterol. In addition to causing muscle-degenerative problems after long-term use, artificially lowering the cholesterol in the bloodstream does not solve the actual problem, which is the reason it was there to begin with. Long story short, cholesterol is what 'patches up' holes in the vessel walls caused by wear and tear, foreign particles in the blood, or (big one here) inflammation. And some of the biggest things that cause inflammation in general are refined sugars, foods one has an allergy or sensitivity to (dairy and wheat being big ones), "bad" fats (omega-6 rather than omega-3) and of course smoking. Getting rid of the cholesterol doesn't get rid of the inflammation, and in fact makes your body unable to repair the damage as well. Fix the underlying problem and the amount of cholesterol will go down.

    Sorry to go off on a tangent, but this is something I've done a lot of research on lately, and it's something that seems to get ignored by the mainstream. I'm guessing it's mostly because curing the source of a problem means the drug companies can't make money off someone as long, perpetually suppressing the outward symptoms while the real issue continues to fester. It's like continuing to spray air-fresheners and light scented candles around the garbage can instead of just taking the stinking bag out.
  • by Anonymous Coward on Wednesday November 04, 2009 @10:38AM (#29977894)
    I took part in a study on depression. After a few days on medication the change was dramatic. Friends remarked on it. At the end of the study I was told I was on a placebo. Couldn't believe it as the changes were so dramatic. Felt it must have been a mistake, and the doctor I told this to accepted my response. It is only years later that I've entertained the thought that yes, maybe it was a placebo. So strange that something that I felt (and I mean that quite literally) had an effect on my brain could be attributed to spinal nerves.
  • by Culture20 (968837) on Wednesday November 04, 2009 @10:39AM (#29977910)

    The researchers who made the discovery scanned the spinal cords of volunteers while applying painful heat to one arm. Then they rubbed a cream onto the arm and told the volunteers that it contained a painkiller, but in fact it had no active ingredient. Even so, the cream made spinal-cord neural activity linked to pain vanish.

    According to this, there's no way to tell whether it was the cream or the brain. The doctors didn't rub cream on anyone without telling them anything and/or rub cream on anyone saying that it contained suspended HCL? Tell people they were rubbing a pain killer powder on their skin? There was no control group? This wasn't a well planned experiment. Just having a soothing balm on the skin might be enough to lower heat pain. Speaking of which: did they try any other types of pain? Heat pain feels quite a bit different from impact pain.

  • by Hurricane78 (562437) <deleted.slashdot@org> on Wednesday November 04, 2009 @11:16AM (#29978494)

    Yeah, way to go, mixing up two time scales, just to bash kdawson again.
    While I agree that he may not be the greatest story poster, this time, you was way over your head.

    Because what he meant, is that when you apply the placebo, then because one expects the effect of a medicine to diminish after a certain time, the body simulates that for placebos too.
    And what you meant, is that placebos nowadays work better than they worked e.g. decades ago.

    These are two totally different time scales.
    Imagine it as taking a big structure that looks like this: /|
    And putting lots of these tiny structures that look like this on its slope: |\
    The first one is yours. The second one is his.

    No conflict at all. Just a knee-jerk reaction.

  • by Lord Ender (156273) on Wednesday November 04, 2009 @11:20AM (#29978572) Homepage

    i'm personally a fan of placebos, though many arent. truthfully, if it works, it doesnt matter if i'm being tricked

    The problem is that the people who practice placebo treatment never just sell themselves as providing pain relief; they sell magical cures for real medical problems which need real medicine.

    I would be happy if the FDA allowed "alternative pain management" to be sold and regulated, so long as they threw everyone claiming their hocus-pocus cured diseases into prison. Can you imagine how wonderful it would be to see chiropractors, homeopaths, and faith healers behind bars?

  • by plague3106 (71849) on Wednesday November 04, 2009 @11:33AM (#29978836)

    Whoa, careful there on the "bad" fats label.

    We NEED saturated fats. Men use it to produce testosterone. It's also used to repair tissue. In fact, new research shows its the carbs doing the damage, as men which replaced bad carbs with "bad" fat LOWERED their bad cholesterol. Sounds like more research is needed.

  • by adamchou (993073) on Wednesday November 04, 2009 @11:39AM (#29978942)

    if you don't believe it exists, you're less likely to experience it

    well, in that same sense, is it possible that the headache is only there because you believe it to be there? with all due respect, i don't know your medical background. just throwing out food for thought.

  • by ubermiester (883599) * on Wednesday November 04, 2009 @12:16PM (#29979660)

    Hardly mind over matter, simply a bio-chemical organ that can be induced to produce a range of neurotransmitters and hormones based upon psychological states

    How are the two different exactly? The "bio-chemical" organ you refer to is, I suppose, is the brain? If that's the case, most experts - such as yourself - say the brain is where most people keep their mind (though new research suggests many male subjects keep their mind in a different organ closer to the waist). And the "range of neurotransmitters and hormones" produced based on "psychological states" would appear to be the mind interacting with that oh so squishy matter we call our central nervous system. So why do you strain so much to "debunk" the mind over matter truism.

    The placebo effect relies in no small part on the "faith" effect, which we use every day to overcome our physiologically limited ability to comprehend the world. Faith does not (necessarily) allow people to walk through walls or levitate, but it does allow us to do all kinds of important things, including and not limited to the discovery of new knowledge.

    For example, your well founded faith in the scientific method allows you to maintain focus while facing mysteries often seem to defy not only experimental observation, but the very intuitions upon which those observations are based.

    Do you have faith that we will figure out what's inside a black hole? Will we'll figure out where and what all that missing mass and energy is? Will we ever know why the photon goes through both holes at the same time? The scientific method has attained considerable momentum because of it's ability to shed light on mysteries we have long thought unknowable. That does NOT mean it will always succeed. The uncertainty principle, for example, claims that it has already failed in at least one important case (i.e., Schrodinger's cat). Knowing something about the state of an atom means affecting that atom, which also means we cannot always make "objective" observations. We can only make extremely well-educated guesses and hope that we're not wrong that often. This realization put a HUGE hole in the scientific method, but our faith allowed us to continue working and make ever more important discoveries.

    So when you tell someone that the pill they took was just sugar, why is it a surprise that their faith is undermined and the unconscious processes that resulted in pain relief (or whatever) are also undermined?

  • by raygundan (16760) on Wednesday November 04, 2009 @12:43PM (#29980212) Homepage

    I doubt you'll find a doctor who would prescribe these drugs without first suggesting you get off your arse and do some exercise. Nobody does this, of course, so prescriptions for these drugs get handed out as the next best thing when a patient won't do what is needed for themselves. It's not some huge profit conspiracy, although there is certainly profit involved-- but if you end up on statins without having given a serious effort at altering diet and exercise, it's your own fault.

  • My Anecdote (Score:2, Interesting)

    by pwagle (13408) on Wednesday November 04, 2009 @01:16PM (#29980838)
    When I was 15, I had a bicycle wreck where I received major road-rash on my entire left side. Unable to tolerate the pain that evening enough to sleep, I went to the emergency room, where I was given codeine. That helped a lot. The next morning, I had to take a shower. Expecting that to hurt a lot, I, for some reason, decided to see if I could "shut off" the pain while exposing the road-rash to the running water. Somehow I did some mental twist that completely shut off the pain. My interpretation/guess at the time was that the codeine taught my brain a technique to shut off the pain. This would be interesting if true. I've been able to repeat this several times since then, but not with headaches. Took neural anatomy years later, where I found out that facial nerves don't come from the spine. I also found out that the spine itself has controllers that control muscles. The brain controls those controllers. My interpretation/guess is that I need the spinal controllers to control pain, and I don't have those for facial (sinus?) pain. I'm uncomfortable calling this "placebo" effect. Seems like its something else. But maybe that's because here I have a mechanism, and I prefer to label only the mysterious as "placebo".

I bet the human brain is a kludge. -- Marvin Minsky

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