Tag Archives: placebo

Treating the parts that real medicines cannot treat – a place for placebos

As a skeptic I have a shameful confession to make: I once had an imaginary condition miraculously cured by a placebo treatment.

Some conditions have symptons but not signs. Symptoms are felt and reported by patients, signs can be detected using some form of test. Headache and nausea are symptoms of migraine, vomiting and pallor are signs.

About 10 years ago I went through some high-stakes changes and made a career-move which required full-on keyboard use.  But I developed Repetitive Strain Injury which affected my hands to the extent that I experienced pain up to my shoulders.  Lawyers have a field day with RSI, because some repetitive strain injuries such as Carpel Tunnel Syndrome have signs, but others are just painful with no measurable physical changes. The long and the short of my story is that I bought a wrist magnet and strapped it on my right arm. Within half an hour my right arm was considerably less painful than my left and over the next few days the pains disappeared completely. I was able to take up my new job with no problem at all.  A miracle cure! For a condition my doctor had been powerless to treat! Woo hoo!

Doctors are often exasperated by patients who turn up with functional conditions (ie ones which have symptoms but not signs) because there is nothing concrete to treat and no objective way to measure outcomes. In the worst case, they consider the patient to be a malingerer and even in good cases trust between paient and doctor break down and create a space for kindly Alternative Medical practitioners to step into. Functional conditions are for Alt Med of course because the intervention needed isn’t medical. It’s in the realm that Terry Pratchett’s Granny Weatherwax calls “headology”. The wrist magnet really did cure my RSI.  It worked, not because it improved the flow of fluids in my body, but because I thought it improved the flow of fluids in my body.

Placebos are a side-effect free way to treat conditions which can’t be treated using evidence-based medicine. Let’s be clear here: these conditions are honestly experienced by people of integrity. Just because their minds and bodies are lying to them, doesn’t mean they are lying to the doctors. But there are no symptoms that can be measured and treated so the medical model and the patients’ experience simply don’t overlap. This creates a gap in the market which alt med happily and sometimes effectively fills. But not all alt med is innocent and all of it is expensive and based on false models and premises. We need medical science to admit there is something going on here that needs treating, rather than dismissing functional conditions as hysterical, imaginary or psychosomatic.

Unfortunately, medics who accept that placebos may indeed be appropriate for these conditions cannot bridge gap by prescribing them, even if they will work where “real” treatments fail. Doctors consider it unethical to lie to patients, and I think most patients would agree with them. So at the moment there is indeed a place for alt med in providing these interventions.  Alt Med has no place in treating pathological conditions of course (ie “real” ones): flower drops and sugar pills cannot treat cancer, and magnetic bracelets can’t cure Carpel Tunnel Syndrome.

Exercise and the placebo feel-good factor

I had an epiphany about exercise this morning. About length 16 it was. I spent the remaining 14 lengths, (or maybe the remaining 12 lengths – I tend to lose count around length 23), thinking about it.

My rather damp epiphany is that half the vaunted benefits of exercise are in fact just placebos and I am immune to them. This is the reason why lycra-clad gym-bunnies assume that I am being stupid, mad, stroppy or all three when I tell them that, no, exercise does not make me feel good.

I can only manage swimming for half an hour if I approach it as a meditation practice and concentrate on doing the perfect stroke. And then the next one. And then the next one. The mindfulness of swimming. Feel the water around your nostrils and on your upper lip. Etc.

  • No. I don’t have more energy afterwards. Placebo.
  • No. I don’t need less sleep. Placebo.
  • No. It does not put me in a better mood. Placebo.
  • No. I don’t enjoy it at the time. Placebo.
  • No. I don’t enjoy it afterwards. Placebo.
  • No. I have never ever found myself getting addicted to it. Placebo.
  • Or even used to it, really.
  • No, no, NO it is NOT – heaven spare us all – fun. Place-ee-frotting-BO. OK?

I swim with gritted teeth and go to the gym in a state of desperation crossed with Calvinist bloody-mindedness because you don’t see fat people in their 50s, because my mother disabled herself through sustained inactivity, because (and only because) it is Good For Me.