There’s certainly evidence that placebo helps ease aches and pains from digging deep. Though the term comes from Latin – the literal meaning is ‘I shall please’ – a series of trials throughout the 1900s set about formalising the idea that if your belief is strong enough, you’ll enjoy the positive outcome you’re after.
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There are numerous examples of placebo but one of the most fascinating came out of World War II when medic Henry Beecher noticed that wounded soldiers often responded to saline solutions in lieu of morphine, which was in short supply.
The medics told them it was pain relief, the soldiers believed them and, at least temporarily, the pain eased. Beecher subsequently undertook many trials into placebo to treat different diseases and said that 35% of patients responded positively.
The placebo effect is seen in every facet of life, from the sporting amphitheatre to the medical arena where the greater the belief, the stronger the impact. This belief grows through myriad factors.
Take the medical sector where studies have shown that: expensive-looking pills work better than cheap-looking pills; two pills work better than one; capsules work better than tablets; injections better than capsules; and brand names outperform generic offerings.
When it comes to placebo, there’s very much a case that it taps into your belief system – that if you truly believe something will work, it will (which could be a struggle for extreme sceptics).
But the advent of neuroimaging has revealed that placebo also triggers neurobiological responses in the brain that can reduce the perception of pain, boost well-being and crank up tolerance for hard exercise.
Take a 2007 study by Fabrizio Benedetti where athletes repeatedly performed handgrip tests under blood-flow restriction. Groups received different combinations of real morphine, placebo or morphine-blocking drugs. The remarkable finding?
That athletes who’d previously received morphine still gained pain-reduction benefits even when the final dose was placebo. But when that placebo was combined with naloxone (which blocks morphine’s pathways), the effect vanished. Placebo had produced a measurable, biological pain-reducing response – and naloxone shut it down.
Why seemed to be that when you expect pain relief, the brain releases endorphins – the body’s natural opioids – that bind to the same receptors targeted by drugs like morphine. In turn, blocking these receptors with naloxone also blocked the placebo mechanism.
There’s a final placebo fact in store: you can knowingly take a placebo and it still delivers a positive effect. Sport scientist Bryan Saunders explained to a group of cyclists that he was giving them a placebo, the red capsules containing nothing but flour.
But they still improved their 1km time-trial performance by 0.7%. Small, but decisive at the peak of the sporting pyramid. Crucially, effort markers like heart rate didn’t change.
The authority of the expert, conscious expectation, reduced scepticism and activation of learned neurobiological pathways were all needed to ‘trick’ the brain.
