As regular readers of this column will know I am firmly convinced that our minds have a big role to play in helping us control pain.
I was therefore delighted to see the BBC has, along with Oxford University, carried out a very important study to test how placebos work. This has screened on TV and can still be seen on Iplayer. I have been looking at this and believe it will give give heart to everyone out there who is living with chronic pain.
The programme explains the strange and still not well-understood, working of placebo. We have always known that a placebo can make a difference to pain, but we have not understood why very well. But we are now just beginning to really appreciate how much difference a placebo can make and why it is effective.
Over the past decade there have been numerous studies which have begun to unravel the mystery. Taking a placebo does have an effect. A real physical effect. Physical tests have shown many people have a rise in endorphins after taking a placebo. Endorphins are a natural pain-killer produced by our own bodies. Other studies have also shown changes in the structure of the brain in some people who have been given placebo. Yet more research has investigated people’s psychological outlook. This indicates that an open outlook on life, especially being willing to try out new things, is a predictor of how well people can learn to control their pain. https://www.nature.com/articles/s41467-018-05859-1
Horizon’s amazing findings
Here is what has been happening for this programme. The Horizon documentary team carried out an audacious experiment. It wanted to see what would happen if a group of people, all of whom suffer from back pain, were given a placebo. Would their pain lessen even though they were not receiving any drugs? This trial differed from an average clinical trial in that there was no ‘real’ painkilling drug involved. Everyone got the placebo and only the placebo.
On hundred people were involved, they each got the same pill (it was made of ground rice and had blue and white stripes – blue and white stripes say ‘pain killer’ to the greatest number of people, apparently). All the participants were told that they were participating in a classic clinical trial. They were informed that some people on the trial would be given a strong new type of pain killer and some would be given a placebo. In fact, there was no strong painkiller. Every participant was given the placebo.
The test group was divided into two. One group was given a lot longer to discuss their pain with their doctor, the other was rushed through in the usual ten minutes for the average GP consultation. This made a difference, the group which got longer to speak with a GP was more likely to report lessening of their pain later in the trial.
There are other factors involved as well, some of which we do not fully understand yet. But it seems from this trial that, where people trust the medical professionals looking after them, they are more likely to experience a lessening of their pain.
A virtuous circle: lessening pain and better lifestyle choices
Another important thing I noticed from the study is how a perceived lessening of pain enabled people to make better lifestyle choices and this improved their mood and further reduced their pain.
The quality of people’s lives improved and this seemed to lessen their pain and make it easier for them to do things which gave them pleasure and enjoyment. One participant, a 71-year-old man called Jim had been wheelchair-bound and taking high doses of morphine just to get up in the morning before the trial. After three weeks on the blue striped pills he reported he had not had any pain and was able to do things which had been impossible to him for years.
There are other examples of these sort of transformations in the film. People whose perception is that their pain has lessened begin to do things which further reduce the pain. They began to socialise again, to move more, to get out of the house. And then their pain decreases even more. It is a virtuous cycle which needs to be kickstarted, but once it gets going can have the most marvellous effects.
One very interesting, and very encouraging discovery was that, even when people were told they had been receiving a placebo their pain stayed down. Again, it is not exactly clear why this happened, but I suspect that once the mindset is changed and the lifestyle improvements are made the effects can be long-lasting and even permanent.
Hypnotherapy for pain can kick-start the changes
The placebo seems to have acted to kick-start this process of improvement. This feels familiar to me. I work to kick start this process in a different way in my pain management for hypnotherapy clinics in Milton Keynes and Bedford. I often start off with a session of hypnotherapy. This is a marvellous way of helping people to reset their own perceptions of what they can do. Once they can envisage a changed attitude to the pain, it is much easier to achieve this in reality. It is all about perception.
I will be using the Horizon story of the placebo in my clinics from now on. It is a great way to show people the power of the mind and how this can be used for good.
We are still in the early stages of understanding how to harness our powerful minds in the control of pain. But we have made enough of a start to make a real difference to the lives of everyone who suffers from chronic pain.
So, if you are living with pain, give me a call or contact me by email. I can point you to the sort of resources which will help you. There is no need to suffer any more.