When I was in the hospital recently, I basically demanded that anyone visiting me bring me a milkshake. For a solid week, the taste of cold, chocolate goodness instantly would make me feel better, often even more than the generous narcotics being offered.
That’s why it’s no surprise to me that Northwestern University researchers have found that sugar pills relieve pain for people with chronic pain. In the study, approximately 60 chronic back pain patients were randomly assigned to receive either a medication, nothing or a sugar placebo pill. Results were published in Nature Communications on Sept. 12.
Those whose pain decreased with the sugar pill generally had a larger right side of their emotional brain and a larger cortical sensory area than people whose pain was not responsive. The pain placebo responders also tended to be more emotionally self-aware, mindful of their environment and sensitive to painful situations. What that means is that their brains are already tuned to respond, says senior study author A. Vania Apkarian, professor of physiology at Northwestern University Feinberg School of Medicine.
“They have the appropriate psychology and biology that puts them in a cognitive state that as soon as you say, ‘This may make your pain better,’ their pain gets better.”
On average, the patients reported that their pain improved by 30%.
Even better, Apkarian says, healthcare providers can be honest with patients.
“You can tell them, ‘I’m giving you a drug that has no physiological effect, but your brain will respond to it,’ ” he said. “You don’t need to hide it. There is a biology behind the placebo response.”
This work has huge implications for the healthcare field, but especially in long-term care, where managing pain is a constant struggle.
Putting aside how much cheaper a sugar pill prescription is, think about the ability to give someone a non-active drug. Apkarian points out how most pain medications eventually are not only addictive, but have long-term adverse effects. Such effects would be eliminated with a placebo.
“Clinicians who are treating chronic pain patients should seriously consider that some will get as good a response to a sugar pill as any other drug,” Apkarian says. “They should use it and see the outcome. This opens up a whole new field.”
We obviously have a long way to go in understanding how the brain processes pain, and I’m not advising slipping a resident sugar pills over a prescribed medication. But I do hope Apkarian’s research eventually can lead us to an alternate path, one in which a homemade cookie is considered as important as Percocet.
Follow Senior Editor Elizabeth Newman @TigerELN.
