Problems with placebo

[W_cheape]

Here is a section from White & Cummings (2008) on the difficulty in using double blind placebo-neutal trials to measure acupuncture outcomes.

A placebo must be indistinguishable from the real treatment, but it must
be inert. Unfortunately, there is no placebo for an acupuncture needle: anything that feels like a needle inevitably has a physiological effect. For many years, researchers have displayed great invention in trying to find inactive controls, but it is now clear that any stimulus on the skin, even just pressure with the blunt end of a needle, can have profound effects on the limbic system when it is being used in a therapeutic context, i.e. pretending to be a real treatment (Pariente et al 2005). While it is true that a sharp, penetrating needle has a greater effect than blunt pressure on the skin the fact remains that the blunt pressure will have treatment effects of its own through widespread activation of the limbic system: a blunt needle is not an inactive placebo.

This creates a problem, which is that the effect of the blunt needle is
almost as large as the effect of the real needle. The difference
between the two is often much smaller than the difference between a drug and a placebo drug. Therefore, acupuncture studies that are too small, or not very carefully designed, will fail to reveal this small difference. Studies like this could be interpreted as showing that acupuncture has no real effect, when in fact the acupuncture has an effect, but more patients are required to show the effect. This is known as a type 2 error – the failure to reveal an effect that does actually exist, because of inadequate statistical power, usually because the number of subjects is too small.

 

[Elizabeth Bones]

Placebo: An inactive pill. This is sometimes called a “sugar pill.” In some studies, participants may be assigned to take a placebo rather than the study medication. Ask the researcher if this is a possibility for the study that interests you.

Even the fact of using a placebo in trials is still a relatively unmeasurable outcome because it itself has yet to be measured.

Placebo is the most powerful form of self healing that should not need to be explained.

I love the effect of this!..... you know.... when you are ill and a phone cal to the doctor instantly makes you feel better.

Your injury suddenly lessens when you book that appointment to attend treatment.

What a wonderful and unexplainable organism the human body is!

Placebo could be seen as a complete smental and physical shift in energy where the decision at the point in time is made by YOU to make yourself better, or even except the fact that something MUST change.

When the revelatory moment happens our own healing system kicks in and begins the process of healing. By all means it seems it is not able to complete the cycle but it definately get s the ball rolling

So if this may be the case, how can someone taking a 'physical' pill, lotion, etc. have that same connection in this process?

A 'physical' placebo is still a very 'external' format. Which is measurable on the power of mental outcome which is a very westerm medical point of veiw.

(Saying that....inserting a needle into a 'contained' polar magnetic system bridges the gap between macrocosm and microcosm, the outer magnetic atmosphere and the rest of this big atom )

 

[Bone Idle]

i thought the idea of placebo in acupuncture relates to missing the points slightly, rather than blunt needles. i don't think a needle anywhere has the same affect as hitting the specific points.

 

[xtfatabd]

It depends on your point of view!

Some acupuncturists believe that it is more to do with the interaction of Qi between patient and doctor, and not the point itself. Others say that it's ok to miss the point so long as you are on the channel (meridian) and others say that getting the exact point is vital.

So if you deliberately miss the point, will you still have some effect? I don't know.

Also, the distinctive sensation from acupuncture called deqi will not be present if you are not on a point, which means that the patients experience is different - this could also effect the plecebo response. It's not an easy subject!