Placebo Effect

A widely used surgical procedure in which cement is used to fortify cracks in the spine is no better than a sham operation, two groups of researchers independently reported Wednesday in the New England Journal of Medicine. The findings shocked clinicians because the procedure, first introduced in the early 1990s, is now widely accepted and assumed to be very effective at relieving pain and improving mobility.

Re: "Step Right Up, Folks!" [Dec. 11]: Most of us have been smitten by the potential allure of these products. I was interested in stimulation of growth hormone by supplementation. As a physician I had the knowledge to pursue it with various lab tests (on myself) and after a year determined all these claims were strictly bogus. There are some products that probably do have some value, but in my opinion probably over 90% is pure chicanery. So many people are still throwing away their hard-earned money on these worthless products.

Re "Chiropractic's Success on Back Pain Disputed in Study," Oct. 8: The low back studies which are cited so often, including the one mentioned, do not ever seem to address the question of mercy. Is it merciful to let a patient leave the office with a pamphlet on back exercises, leaving it up to the patient to work through the misery alone? Further, I wonder how well any study measures the economic losses due to poor workplace performance versus absence resulting from pain. The provider's role--be that a physician, chiropractor or physical therapist--includes that of an educator, a coach and entails reassurance, all of which may be difficult to distinguish from the placebo effect, but are essential components of care.

Re "On Pain's Trail" [Aug. 22]: I am a 19-year-old sufferer of fibromyalgia. Not always able to do much else, I have spent a lot of my time researching fibromyalgia, and many of the posited theories and potential treatments for it. Unfortunately, I find an inordinate amount of attention being focused on rather unpromising theories, and treatments whose effects seemed to amount to the placebo effect. So many sufferers are in such poor physical states and so desperate that they are vulnerable to being misled by people who have misguided ideas about the condition.

Researchers have cut the rate of multiple sclerosis attacks in half for a group of patients by injecting interferon into their spines, researcher Lawrence Jacobs reported last week. The report, which confirms an effect shown in previous studies, shows beta interferon works to prevent attacks, Jacobs said Beta interferon is an anti-viral substance produced by the human body. Jacobs, chief of research at the Dent Neurologic Institute in Buffalo, N.Y.

About half of American doctors in a new survey say they regularly give patients placebo treatments -- usually drugs or vitamins that won't really help their conditions. And many of the doctors are not honest with their patients about what they are doing, the survey found. That contradicts advice from the American Medical Assn., which recommends that doctors use treatments with the full knowledge of their patients. "It's a disturbing finding," said Franklin G.

Like the Wizard of Oz healing wounded travelers with hope and trinkets, the notion that doctors can cure about a third of their patients with a simple sugar pill seems too good not to be true. Perhaps that's why it took researchers half a century to seriously challenge the "placebo effect" after Boston anesthesiologist Henry Beecher dreamed it up in 1955. Beecher claimed that he essentially could trick 35% of his patients into fighting sickness by having them gulp down sugar pills.

The drug Campral, approved two years ago to treat alcoholism, works no better than a placebo in reducing the craving for alcohol, according to a study released Tuesday. The report in the Journal of the American Medical Assn. compared several treatments for alcoholism and found the older generic drug naltrexone offered the clearest benefits. The study of 1,383 patients at 11 medical centers in the U.S. should spur increased use of naltrexone, which is not widely prescribed, researchers said.

Allergies were far from Christie Littauer's mind when she fed creamed spinach to her son Jack for the first time. The 6-month-old had already eaten peas and green beans. Why not try something more exciting? "A few bites into it, he started wheezing," says Littauer, of Henderson, Nev. "He got bright red. Something was obviously wrong."

If you see professional athletes or weekend warriors with a crazy crosshatch of tape on their shoulders, knees or elbows, they probably aren't making a fashion statement. Chances are they're trying to tape over some pain. So-called kinesiology tapes — two prominent examples are Kinesio Tex Tape and KT Tape — gained worldwide attention during the 2008 Olympics, largely thanks to the heavily taped shoulder of American beach volleyball player Kerri Walsh. Unlike traditional tapes that wrap around joints to provide support and compression, kinesiology tape sticks directly to the sore spots like big Band-Aids.