A new novel study examined whether the addition of placebos to usual treatment would have an effect on individuals suffering from low back pain, if they were aware that the pills provided lacked any active medicinal ingredients. The findings of the study indicate that the addition of open-label placebos had a clinically significant effect on the reduction of pain and pain-related disabilities experienced by these individuals.
Low back pain is one of the most common medical conditions experienced by people all over the world; in fact, it is the number one cause of disability globally. There are numerous causes of low back pain, ranging from injury or overuse, to pressure on nerve roots. As such, symptoms can range from a simple aching feeling and grow into a much more severe stabbing sensation that can make standing or walking difficult. As a result of its commonness, many researchers have started looking into ways that can help reduce the pain. One avenue of exploration has led to the study of placebo pills and their effect when added to usual treatment. As prior research has suggested, engaging in routines around pill taking, even when those pills are placebos, can help to reduce pain symptoms. Therefore, the researchers of this study wanted to examine the effect of the addition of placebo pills to usual treatment in individuals suffering from low back pain. However, in order to avoid deception, the participants were made aware that the pills provided lacked any active medicinal ingredients, in other words, they knew they were taking placebo pills.
This novel study, published in Pain, looked at a total of 83 individuals that participated in this 3-week long trial. The participants were chosen if they were 18 years of age or older, and had been suffering from low back pain persistently for at least 3 months as determined by a registered nurse and a pain specialist. Furthermore, participants were excluded from consideration if opioids had been used within the last 6 months, or if candidates had cancer, lower back surgery, disk degeneration, or were pregnant. Once selected, these individuals completed questionnaires, which acted as baseline measurements regarding the intensity of their pain, as well as if their pain caused any difficulties in completing everyday activities, also known as pain-related disability. They were then randomly divided into two groups, the first of which would receive the placebo pills, and the second which did not. Individuals in the first group were instructed to take the placebo pills twice daily in addition to their regular medications. On day 11 and day 21 all participants were required to complete follow-up questionnaires that would then be compared to baseline measurements. The findings of the study indicate that individuals taking the open-label placebos reported a significant reduction in their usual pain levels, specifically a 30% reduction, in comparison to those in the second group which only experienced a 9% reduction. Additionally, the experience of pain-related disability decreased by a total of 29% in the placebo group, in comparison to only 0.02% in the usual treatment group.
These findings suggest that the addition of open-label placebos to the treatment plan of those suffering from low back pain can have a large beneficial impact. While this may seem like a safe option to reduce pain symptoms, there are some drawbacks to this study that must be considered before its implementation. Firstly, the sample size was limited to 83 individuals, which means that the results may not be generalizable to a wider population. In addition, the duration of this trial was 3 weeks; therefore long-term outcomes still need to be identified. Lastly, this study relied on answers from participants and therefore, the results may be open to bias.
Written By: Sonia Parmar, BSc