The Power of Placebo

With Tim Wright - Gower Acupuncture (Swansea)

Acupuncture has a long history of some naysayers dismissing it as no more than an elaborate placebo. It’s less commonplace nowadays with GPs using acupuncture for pain management and the National Institute for Health and Care Excellence recommending acupuncture for migraine and headache treatment. However the question remains… is acupuncture no more than placebo? And what is placebo anyway?

What is Placebo?

The Latin “placebo” roughly translates to “I shall be pleasing or accepting”. Looking at the dictionary definition gives a more precise translation “a medicine or procedure prescribed for the psychological benefit to the patient rather than for any physiological effect”. This definition separates illness or disfunction of the mind from illness or disfunction of the body. With knowledge of modern day maladies this distinction between mind and body seems a little archaic.
Take a modern day illness, reaching almost epidemic proportions – stress. Browsing through the NHS website the symptoms of stress include headaches, muscle tension, pain and dizziness. Clearly a case of the psychological insult of stress manifesting in physical symptoms.
So changes in emotional environment can affect the physical body negatively. If so how can positive emotional suggestions affect the physical body? Just how powerful can the suggestion of placebo be?

Placebo and Surgery

Surely the placebo effect couldn’t be at play in surgery? Prof Andy Carr, an orthopaedic surgeon at Oxford University Hospitals, claims there is evidence that in certain types of surgery the improvement could be explained by the patients strong belief that their symptoms would improve, i.e. placebo. These types of trials with surgical interventions are not extensive but there is proof that surgery for arthritic knee, spinal cement injections for vertebral fractures, some gastric balloon procedures for obesity and certain forms of endometriosis are no better than placebo. The placebo in these cases is usually rather elaborate. The patient will be put under general anaesthetic and typically come round with a small scar, but no surgery will have taken place.

Placebo – The Mindset Responsible For Weight Loss In Chambermaids

This study by Harvard Psychologist Elleen Langer a decade ago illustrates the massive power of mind over body. The job of a chambermaid is a physically demanding job. So Langer surveyed a population of chambermaids to find out how many of them considered that they do any exercise in a week. 67% reported that they didn’t do any exercise despite the fact they exceeded the US surgeon generals recommendation for exercise.
So she took a group of 84 chambermaids. Forty two, in group I, were told that they were burning a lot of calories and that the amount of exercise exceeded the US surgeon generals advice. The other 42, in group 2, were given no information.

One month later she returned and found a reduction in weight and drop of 10% in blood pressure in group 1– all attributable, she claimed to a change in mind-set only.

Placebo Is A force For Good

Prof Irene Tracey is a professor of anaesthetic sciences at the University of Oxford. She is a proponent for placebo. Her research shows that positive expectations can hijack the brain systems involved in pain perception and produce powerful effects. Rather than being considered deception and fakery she recommends placebo is embraced and incorporated into treatment.

The point I’m trying to make is that the placebo effect is neither trivial nor should it be ignored.

So Acupuncture Is Placebo?

Having sung the praises of placebo, I’m now going to say no – acupuncture is not placebo. Of course there is an element of placebo in any therapeutic intervention. A patient comes to me, they want, and in many cases expect, to get better. This mindset improves a patients likelihood of healing.
But there is a lot more at play with acupuncture. A few pioneering neuroscientists are monitoring acupunctures effects on the brain.

   Richard Harris, a neuroscientist at the University of Michigan, Ann Arbor, and colleagues used brain scans to investigate whether acupuncture triggers an endorphin hit in the same way that placebo (sham) acupuncture does. Interestingly placebo and real acupuncture offered similar levels of immediate pain relief. However, brain imaging equipment showed changes in activity suggesting real acupuncture worked in a different way to actually affect a cure rather than just alleviating symptoms.

Further work by Vitaly Napadow at Harvard Medical School has shown that whilst placebo (sham) and real acupuncture both reduce pain levels for sufferers of carpal tunnel, those that received real acupuncture (in this case electro-acupuncture) showed increased speed of nerve transmission. Nerve impulses at the wrist travel slower for patients with carpal tunnel. In addition to improved nerve transmission the real acupuncture group maintained reductions in pain levels 3 months after a course of treatment, versus the placebo group.

Acupuncture Works

Whatever your belief of how acupuncture works, my experience is it works…and works very effectively for a variety of symptoms. To see if it can help you feel free to contact me by phone or email.

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