One More Time – The Placebo Effect

Way back in early 2012, I first brought up the placebo effect – the tendency of the body to heal itself when belief in the cure is strong. How it works is still a mystery but that it does work is indisputable.

The example I used over 6 years ago was a $30 performance wristband, one endorsed by famous athletes and touted to improve athletic performance. In a test people were given the advertised wristband and exposed to some physical performance and balance tests. The before and after results showed some improvement. Then they were given a similar-looking one-dollar replacement band and told it was also special, performance on physical and balance tests improved comparably. Conclusion: it wasn’t the band at all; it was the perception that they were getting some extra, outside help – mind over matter.

Since then I have mentioned the placebo effect in essays warning about vitamins, acupuncture, forest bathing, chiropractic, healing crystals, gluten-free diets, cryotherapy, homeopathy, ear candling, essential oils and a few other subjects. (Wow, that’s a lot of toes to step on in only six and a half years!)

The point is not to make people angry and defensive, but to make them aware of the difference between science and marketing, and how the placebo effect can lead to an erroneous conclusion that a treatment really works.

When a cure is proposed, competent scientists will split a relatively large group in two, randomly assigning one to test the treatment while giving the other a placebo. Both groups usually show some improvement due to the placebo effect. To validate the treatment however, the improvement of the treated group must be significantly better than that of the control group. Otherwise they declare the treatment “no better than a placebo,” that is, no better than no medicine at all.

The placebo effect explains many of the endorsements we hear from celebrities, friends and neighbors. They sincerely (and enthusiastically) believe whatever they are recommending has beneficial effects, but with no scientific evidence it may be “no better than a placebo.” When you buy one of these products, the money spent is money wasted. That’s why the small print in ads, where they explain how the FDA has not approved their magic formula, they often add something like “results will vary.”

That takes us to a health story from England where the BBC reported a pure placebo experiment. With help from University of Oxford, they tried to see if they could “cure real back pain with fake pills.”

One hundred people with severe back pain were asked to participate in a study of a powerful new painkiller. What they didn’t know is that everyone would be given realistic looking pills that were really placebos, “capsules containing nothing but ground rice.”

The blue-and-white-striped pills “came in bottles, carefully labeled, warning of potential side effects and sternly reminding patients to keep out of the hands of children” to further the impression that this was powerful stuff.

Three weeks later researchers found “nearly half of our volunteers reported a medically significant improvement in their back pain” and that those who spent a little more time with a doctor merely discussing the pills were more likely to improve. In one case, a man went off his morphine but continues to take the ground-rice pills.

Placebo effect is not a trick that works only on the gullible. Taking a placebo can cause the body to release endorphins, natural painkillers. And sometimes subjects improve even when they know they are taking a placebo.

But that doesn’t mean the gullible aren’t tricked. In the earlier case of wristbands, even after the people learned that there was no difference and the improvement in both cases was psychological, they still wanted to buy the $30-wristband over the equally effective $1 bands. It’s like when people think the same wine tastes better when the bottle has a higher price tag. 

It does no good to understand science when critical thinking fails to kick in.