Single Placebo Injection Improved Chronic Back Pain for 1 Year: Study

By Huey Freeman

Researchers have found that openly prescribed placebos can rival prescription drugs, steroid injections, and even surgery in providing relief for chronic back pain sufferers. The twist? Patients knew they were receiving a placebo—and it still worked.

While the concept of placebos providing pain relief is not entirely new, this study breaks ground by informing participants they were receiving a placebo—a departure from the common practice of concealing this information.

“To our knowledge, the brain mechanisms of an OLP (open-label placebo) treatment in a patient population have never been investigated,” according to the researchers. Open-label placebos are those that are honestly prescribed.

The research team set out to uncover the mechanisms by which placebos alleviate back pain. Traditionally, the effectiveness of placebo treatments has been thought to rely on deceiving the patient by presenting a false narrative of an actual treatment.

“Yet research has upended this belief by investigating open-label (OLP) treatments, which are disclosed to both patients and clinicians as placebo,” the researchers reported.

The trial, published Wednesday in the Journal of American Medical Association Network Open, involved 101 adult participants with chronic back pain aged 21 to 70. The findings suggest that honest placebo treatments “can confer meaningful clinical benefits to patients with chronic back pain” by engaging brain pathways linked to pain regulation, according to the authors.

Half of the participants received a single saline injection to their back. The other half did not receive additional treatments.

Saline does not provide health benefits, Yoni Ashar, assistant professor of neuroscience at the University of Colorado Anschutz Medical Campus and first author of the study, told The Epoch Times.

Participants who received saline were told that they received a placebo. They were also told that a placebo could have health benefits.

The researchers found that those who received the placebo had reduced pain intensity for one month and that the single injection “provided benefits lasting for at least 1 year posttreatment,” they wrote.

Beliefs Advance Healing

“The placebo effect is part of every treatment or procedure that advances healing, including exercise,” Ashar said. “If you believe exercise will help you, it’s more likely to do that.”

The participants were recruited from the Boulder, Colorado area in 2017 and 2018. They had suffered back pain for at least half the days during the previous six months.

The placebo group underwent a treatment program that included the injection and an “empathic, validating clinical encounter” with a physician from the research team. Through conversations and videos, participants were informed that:

• The placebo contained no active ingredients
• Placebos can have powerful effects
• Placebos can work even when inert by engaging “nonconscious pathways” that automatically trigger natural healing responses

The control group, comprising half the participants, were told to continue their usual ongoing care treatments and not start any new treatments. They did not receive any treatment from the research study team.

To investigate the brain mechanisms, functional magnetic resonance imaging (MRI) compared the placebo group with the usual care group. The placebo reduced chronic back pain intensity one month after treatment compared to usual care.

“Through 1-year follow-up, pain relief did not persist, although significant benefits were observed for depression, anger, anxiety, and sleep disruption,” the researchers wrote.

Brain responses to back pain were more pronounced in the placebo group than in the usual treatment group in several areas. Participants reported no adverse effects from their placebo injections.

The Power of Suggestion

Ashar cited a 2007 study, as an example of how a different kind of placebo can have a positive effect.

In that study, female hotel maids were told that their work of cleaning rooms constituted good exercise, satisfying the Surgeon General’s recommendations for a healthy lifestyle. The control group was not given this information. Four weeks later, the group that was told they were exercising enjoyed numerous benefits, including weight loss, lower blood pressure, and reduced body fat, despite no noticeable change in behavior.

In this case, the placebo is not a physical treatment but a procedure creating a connection between the mind and body. The placebo effect is defined as believing a treatment or procedure will work.

Ashar emphasized that, similarly, his team’s study demonstrated the power of the human psyche. “Our results point to the power of healing rituals, even when people know the ritual is essentially a ritual,” Ashar said.