Placebo Really Does Kill Pain
Sales of prescription pain killers like codeine, morphine, oxycodone, and hydrocopone increased 90 percent in the US in less than a decade between 1997 and 2005. Those sales represent enough prescription pain medication to supply 300 milligrams to every person in the country. Now add in $2 billion in sales of over-the-counter pain killers like aspirin, Tylenol, and ibuprofin every year, and you have an incredible amount of people taking painkillers. But what are they getting for their money? The consumers who keep popping pain pills must feel that they get some relief, but a new study raises the question of just what causes that sensation of relief after all.
The study, conducted by Dr. Falk Eippert of the University Medical Centre Hamburg-Eppendorf in Germany, inflicted pain in the form of heat on 15 subjects, who indicated when their pain threshold had been reached. The researchers told the subjects that they were testing a new pain-killer cream, and that as part of the test they also would be using a placebo cream. In fact, neither the "real" nor the "control" cream contained any pain-killing ingredient, but the subjects reported 26 percent less pain when using the "supposed" real pain-killer. Meanwhile, the researchers took MRI scans of the subjects. They found that when the subjects used the cream that they believed contained no painkiller, their MRIs showed increased neural activity in a spinal area called the dorsal horn. This area plays a role in controlling sensory perception. When the test was repeated with the fake painkiller cream, the pain signal disappeared. Plus, as already mentioned, the subjects said they felt 26 percent less pain.
And so, for the first time, scientists observed that the placebo effect actually causes changes in the pain-signaling mechanism in the body. In other words, it's not just "all in your head." A few years ago, a study by Jon Karr-Zubieta out of the University of Michigan found that, in fact, the brain increases production of endorphins after receiving a placebo medication. He said at the time, "[The system] is there to ensure the survival of the organism. The placebo effect is acting through these mechanisms. But exactly how it does this remains a mystery."
The new research sheds a little light on that mystery. Dr. Eippert believes that the results show that the brain triggers the release of pain-killing endogenous opioids when it expects to receive relief. These opioids then reduce the neural activity in the spine, thus reducing the sensation of pain experienced by the individual. And Dr. Eippert asserts that the effect is very powerful because, "It is deeply rooted in very, very early areas of the central nervous system. That definitely speaks for a strong effect."
Eippert suggests that his research "opens up new avenues for assessing the efficacy and possible site of action of new treatments for various forms of pain, including chronic pain." Surely pharmaceutical companies will see an opportunity here to concoct some drug that will dampen the neural activity in the dorsal horn, intensifying pain relief action. Ahh! But how will we know they're not just marketing placebos? Now, from the natural health point of view, the research opens a real opportunity to direct techniques such as hypnosis, acupressure, magnetic therapy, visualization, and so on to more effectively relieve pain, by focusing on the dorsal horn area.
Even Dr. Eippert realizes this possibility. He says, "It will be interesting to see whether opioid-dependent activation of the descending pain control system is a common feature of different forms of pain modulation such as hypnosis and attentional distraction, which share some common neuroanatomical features."
Meanwhile, public reliance on over-the-counter and prescription pain medications continues to escalate and to cause myriad problems. The number of deaths caused by painkiller abuse escalated by 160 percent during the five years between 1999 and 2004. Basically, no pharmaceutical or over-the-counter painkiller on the market comes without side effects. Aspirin can cause stomach bleeding and Reyes Disease. Tylenol can cause liver damage. Ibuprofen has been linked to kidney failure, heart attacks, and hypertension. These are just the tip of the side-effect iceberg. The picture gets bleaker with prescription painkillers which can trigger strokes, heart attacks, hallucinations, addictions, psychological disturbances, respiratory collapse, asthma, severe constipation, COPD, impaired breathing, and death.
Certainly, if less invasive and risky treatments reduce pain, they beat the pharmaceutical interventions hands down. Already, approaches using herbs, homeopathic remedies, and natural techniques such as acupuncture, Reiki, massage, and chiropractic provide an alternative. If the new research points to a way to make these approaches even more effective, perhaps those who stash painkillers in drawers wherever they live and work will find a reason to toss them in the trash.