Every year, millions of Americans suffer from chronic pain. Low back pain is the most common chronic pain. Low back pain can persist for 12 weeks or longer.
In a recent study, researchers find that placebo (i.e. inactive treatment) can reduce back pain, even when patients know they’re taking placebo.
The finding is published in PAIN, the official publication of the International Association for the Study of Pain (IASP).
Placebo is a medicine or procedure prescribed for the psychological benefit to the patient rather than for any physiological effect.
It can be a substance that has no therapeutic effect, used as a control in testing new drugs.
In the study, researchers recruited 97 adult patients with low back pain lasting at least 3 months. Patients were randomly assigned to 3 weeks of treatment on their usual pain medications alone, or on their usual medications plus placebo.
Importantly, patients knew they were taking a placebo. The researchers explained to patients about the “potentially powerful” placebo effect, and how the body may automatically respond to placebo treatments.
Measures of back pain and disability were compared between groups. 83 patients completed the study.
Researchers found greater reductions in pain for patients assigned to placebo. On a 0-to-10 scale, patients in the placebo group had a 1.5-point improvement in pain score, compared to no significant change for patients taking usual medications only.
In addition, the placebo group had nearly a 3-point reduction in back pain-related disability score, compared to no change for the usual-treatment group.
Overall, open placebo treatment reduced initial pain and disability scores by approximately 30%. Patients in the usual-treatment group had similar improvements after they started taking placebo pills.
Researchers suggest that open-label placebo can be a safe and effective adjunct to treatment for chronic low back pain. Patients have better improvement when placebo is added to pain medications.
Importantly, giving placebo pills in open fashion—including explanations of how the placebo effect may work—offers a way to overcome the ethical conflict of deceiving patients that they are taking an active medication.
Citation: Claudia C, et al. (2016). Open-label placebo treatment in chronic low back pain: a randomized controlled trial. Pain, published online. DOI: 10.1097/j.pain.0000000000000700.
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