The mystery of the placebo effect against pain

The placebo effect is a positive response of a patient to a given treatment, even if this treatment does not contain any pharmacologically active compound. Far from being a simple medical curiosity, studies carried out at Harvard in particular indicate that the placebo effect could take part in the treatment of the pain caused by certain diseases.

We all have a personal attitude to pain: some individuals experience great pain following a given stimulus (a prick or a cut, for example) while others are only very slightly affected under the same conditions. These differences are due to the active participation of the brain in the process involved in pain. For example, negative autosuggestion triggers the activation of certain areas of the brain that mimic pain and this signal can aggravate the actual physical pain caused by a given trauma. This effect, which is called the nocebo effect, is also responsible for the physical pain felt by certain hypochondriacs: by dint of convincing themselves that they are affected by a disease, these people feel real pain.

Conversely, it is sometimes possible to reduce the feeling of pain by positive self-suggestion. This effect, known as the placebo effect, is caused by the activation of other areas of the brain (in the prefrontal cortex) which interfere with pain signals and reduce their impact.

The importance of the placebo effect is particularly well illustrated during clinical studies where the effectiveness of a drug is compared to a control containing no active ingredient: up to a third of people who ingest a tablet devoid of pharmacological activity show a therapeutic response similar to that elicited by the drug!

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In other words, the simple fact of believing that a tablet contains a medicine capable of curing a disease is often enough to cause a positive therapeutic effect.

The placebo effect occurs even when patients know there is nothing

It was long thought that the placebo effect was observed only when the patient did not know that the drug administered to him did not contain any active ingredient. Results obtained by researchers at Harvard University, however, suggest that the placebo effect can occur even when patients are fully aware of the absence of medication. The researchers recruited 80 people affected by irritable bowel syndrome (a condition characterized by frequent abdominal pain as well as other symptoms like headaches and irritability, among others) and separated these people into two groups . In the first group, patients were closely monitored by a medical team, but received no medication. In the other group, the patients received the same medical support, but in addition received a placebo, containing no active ingredient. However, this placebo was presented to patients by the researchers as an inert substance, but capable of reducing the symptoms associated with irritable bowel by promoting self-healing through thought.

As surprising as it may seem, 59% of the patients who received the placebo said they were in better shape following a treatment lasting 3 three weeks, compared to 35% of the patients who did not receive any tablets.

In practice, the placebo response is virtually equivalent to that observed in several clinical trials with drugs commonly used to relieve irritable bowel syndrome!

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Reduce the feeling of pain with positive self-suggestion

It goes without saying that this placebo effect cannot alleviate the pain associated with all illnesses and it does not cure itself. The placebo effect is generally less effective in dealing with severe pain associated with cancer or other diseases that results from profound damage to the body’s deep homeostasis balance. These observations nevertheless indicate that by attenuating the signals involved in the sensation of pain, positive auto-suggestion could attenuate part of the pain felt in the face of certain chronic diseases and thus play a beneficial role in the healing process.


Kaptchuk TJ et al. Placebos without deception: A Randomized Controlled Trial in Irritable Bowel Syndrome. PLoS One 5: e15591.


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