Can a placebo work for back pain, even when you now you’re taking it?
My initial response to this question, is off course not. A placebo is anything that seems to be a “real” medical treatment — but isn’t i.e. it is fake. The judgement of what is fake is based on the availability of scientific evidence. Traditionally in medical trails patients don’t know if they are taking a placebo. For most of my readers, they would probably refuse to take a placebo, as they know its a placebo, so you would think your wasting your time. I would agree with this, but was a bit surprised by some recent research.
Around half of 97 patients with chronic lower back pain were given a pill bottle with the word “Placebo” printed on it – after they been told that a placebo contains no active ingredient – along with a standard NSAID (non-steroidal anti-inflammatory drug) pain killer, while the remainder of the group was just given the NSAID.
After taking the pills twice a day for three weeks, the patients taking they placebo plus the NSAID reported a 30% reduction in pain compared with a 9% decrease in those given only the NSAID.
So the researches discovered that a placebo may be effective treatment for lower back pain even when people know they are taking a placebo!
Reference
Carvalho, Cláudia; Caetano et al, 2016, Open-label placebo treatment in chronic low back pain: a randomized controlled trial, Journal of Pain, December 2016, Vol 157, Issue 2, p 2766 – 2772
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Good news for the desk bound…
We have all heard about the target of walking about 10,000 steps per day which roughly equates to walking 5 miles per day. Well many years ago when I worked long hours in IT some days, and lets be frank even some months, the possibility of me walking 10,000 steps per day was a pipe dream. I would say this was especially true in the winter when the dark skies, cold, wind and rain didn't exactly entice me to go outside even though I love walking. Researchers in Trondenheim University in Norway have discovered that in heart patients after just 12 weeks of walking 3000 steps every day, the hearts pumping function improved which in turn improved their ability to exercise. They concluded that moderate continuous exercise, such as walking 3,000 steps or 1.5 miles in 30 minutes had as much benefit on the heart as more vigorous, intensive exercising. Moderate walking decreased the strain on the heart, improved heart muscle function, improved blood vessel dilatation, helped form new blood vessels and lowered blood pressure. On average a sedentary person completes between 1,000 to 3,000 steps per day. Which is good news for the desk bound as you can now aim for 3,000 continuous steps which is much easier to achieve than 10,000! Reference http://circ.ahajournals.org/content/early/2017/01/19/CIRCULATIONAHA.116.022924

So how does massage reduce pain? – Part 2
Previously I explained the scientific theory for "How does massage reduce muscle pain?" in the short term . But what about the long term? I would like to introduce to you the "descending pain suppression mechanism." The brain is not a passive receiver of sensory messages, but rather a centre that interprets them and makes constant adjustments accordingly. For example, everyone knows that the way you perceive pain will be influenced by whether you focus on it or think of something else instead. And it seems reasonable to suppose that evolutionary selection may have favoured those individuals who could ignore pain signals for long enough to take actions that let them escape and survive danger.
Unpleasant cutaneous sensations stimulate nuclei within the mid brain. These nuclei in turn initiate activity in the descending spinal tracts that release endogenous opiates (inhibitory neurotransmitters) within the spinal segment receiving the painful input. This diminishes the intensity of the pain transmitted to the higher centres. Sports and Deep Tissue massage techniques can reinforce a naturally occurring discomfort, causing much greater release of opiates and achieve a more profound pain suppression.
References Basbaum A, Fields H. (1978) Endogenous pain control mechanisms: review and hypothesis. Ann Neurol 4: 451-2. Watson J (1982) Pain mechanisms: a review. 3. Endogenous pain mechanisms. Australian Journal of Physiotherapy 27: 135-43
Smell the wellness
I had always assumed that its just tradition that you buy flowers for somebody that is ill. Speaking as a woman who loves flowers, its always nice to receive flowers but I had underestimated their power. Research completed by the American Society of Horticulture Science discovered that surgical patients exposed to flowers or plants in their recovery rooms have
- lower blood pressure
- lower heart rates
- less pain
- less anxiety
- less fatigue

