Is One of Your Medications a Placebo?

Almost half of doctors use placebos to treat patients, but only 4% are up front with patients about it, according to an American Medical Association article. Having doctors admit that they dance around the truth to get patients to agree to a medication they don’t know is a fake is troubling. It also poses ethical questions about patient-provider relationships. But…

Placebos have an important role in medical treatment. I’d be thrilled if one did the trick for me. Telling the patient that they’re getting a placebo undermines the placebo effect, thus negating the potential benefit. I wouldn’t want to know if my doctor prescribed a placebo for me — at least not at first. However, I also expect my doctors to be honest with me.

The phrases physicians used were:

  • “[It is] a substance that may help and will not hurt. “34%
  • “This may help you, but I’m not sure how it works.” 33%
  • “It is medication.” 19%
  • “It is medicine with no specific effect.” 9%
  • “It is a placebo.” 4%

The article Doctors Use Placebos But Don’t Tell Patients describes the study and the American Medical Association’s response to it.


This week on Free my Brain from Migraine Pain

It has been a quiet week at Free My Brain From Migraine Pain, but I hope you enjoy these posts:

And an older one just for fun:

Megan Oltman, a migraine management coach, has volunteered to keep The Daily Headache running while I’m on vacation. Be sure to check out her blog, Free My Brain From Migraine Pain for more thoughts, tips and techniques on managing life with migraine. -Kerrie

Some posts you may find interesting over at Help My Hurt

Hi folks, here’s a weekly round-up of some posts from Help My Hurt that you may find interesting or helpful:

Video: Yoga for Your Pain

A helpful tip – taking night time pills

Study Finds Oral Cannabis (Marijuana) Ineffective In Treating Acute Pain…

Can children get CRPS?

Call for Artistic Submissions for Creativity and Pain Exhibit

People with arthritis not taking their medications – and a poll

How to find free health/medical care in your area

6 tips for taking medications

Migraines – myth or fact?

Marijke has volunteered to keep The Daily Headache running while I’m on vacation. An RN turned writer, her excellent blog is called Help My Hurt. -Kerrie

Surgery for Migraine and Headache: Does it Work?

Nerve stimulation, nasal surgery/septum repair, cutting muscles in the forehead and PFO closure are the surgeries commonly mentioned as headache treatments. A lot of press coverage doesn’t necessarily equal efficacy. They are all still in early phases of clinical trials. Recent opinions I’ve come across aren’t encouraging.

I’ve had two of the four — an occipital nerve stimulator and nasal surgery — and don’t intend to try a surgical treatment again. Neither surgery was effective for me and I sometimes wonder if the nerve stimulator made my migraines worse.

Surgery is so commonplace that it is normal to consider it as a remedy for so many illnesses. No matter that general anesthesia is always risky and there’s a potential for complications — including that it may worsen the condition. Not to mention that its expensive and invasive and may not even work.

I’m not saying that because my surgeries were unsuccessful yours will be too. I do caution you to take it slowly. Research the procedure as much as you possibly can. Ask your doctor every question that you have, no matter how silly or small it may seem. This is your body. The doctor may have the expertise, but you are the only one who really knows yourself.

If you have the slightest inkling of discomfort with your doctor, find someone else. If he or she tells you in your first appointment that surgery is just the thing for you, find someone else.

Although surgery may feel like your last hope, it rarely is. Few people have truly tried everything. If multiple doctors say you’ve tried everything, it’s time to get on the internet and learn what else is out there. Online forums are a great place to start. (I’m partial to The Daily Headache’s online support group and forum, but there are lots of good ones.) Maybe you’ll discover that you have tried everything; maybe you’ll find a not-so-well-known treatment works for you.

Placebo Effect: In the Brain, Not the Mind

Many of us learned in high school biology that the placebo effect is when you think that a treatment is effective even though the treatment or medication is an inactive form of treatment. You think you will feel better, so you believe that you are better.

High school biology was wrong. Studies using sophisticated brain scanning equipment have shown that when participants believed a medication would ease pain, the brain releases endorphins and opioids, the brain’s natural painkillers.

PET scans turned up differences in brain activity. Those who reported pain relief after taking the placebo showed increased activity in parts of the brain associated with modulating pain. A radioactive tracer also revealed that binding occurred at receptors for naturally occurring pain-fighting endorphins.

“If somebody believes something will work,” says Zubieta, “that positive expectation by itself, through different connections in the brain, activates mechanisms that suppress pain. We saw a linear relationship between how people reported pain and how their brains released opioids.

People Need Both Drugs and Faith to Get Rid of Pain is an excellent article explaining current and past placebo research and understandings.

Recent Posts on Free my Brain from Migraine Pain

Some recent posts on Free My Brain From Migraine Pain include:

  • Face, Meet Floor!: Virus, fever and Migraine together can have nasty consequences, including passing out and hitting the deck.
  • Feverish Thoughts: When you cannot take analgesics, you can have the surreal experience of life with an untreated fever and head pain.
  • Exercise for Migraine Prevention: Daily exercise can help calm the nervous system, reducing Migraine frequency.
  • Migraine? Where do I Start?: An introduction to a free resource for learning about and coping with Migraine disease, an e-course on managing life with Migraine.

Megan Oltman, a migraine management coach, has volunteered to keep The Daily Headache running while I’m on vacation. Be sure to check out her blog, Free My Brain From Migraine Pain for more thoughts, tips and techniques on managing life with migraine. -Kerrie

This week at Help My Hurt