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Seeing, it appears, is believing when it comes to back surgery

More news about the placebo effect: British surgeons report that patients who underwent a surgical procedure (lumbar microdiscectomy) for back pain caused by a spinal disc tear (“slipped disc”) had better outcomes when they received fragments of their removed disc after the operation.

That’s right. Simply taking home a souvenir of the operation in a pot of saline solution improved the patients’ recovery. They reported less leg and back pain, less leg weakness and less “pins and needles” sensations (paresthesia). They also took fewer pain medications after the surgery.

The study, published in the September issue of the Journal of Neurology, Neurosurgery, and Psychiatry, involved 74 surgery patients at London’s St. George’s Hospital who were randomly divided into two groups: One got the surgical souvenir; the other (control) did not. (A fun detail from the study: One patient had to be moved from the treatment group to the control group because she squeamishly refused to look at her disc fragments.)

The surgeons said they decided to do the study for two main reasons: They knew that a patient’s anxiety and depression going into surgery for a spinal disc tear has a big impact on the recovery process. They had also noticed, anecdotally, that many of their patients who responded best to the surgery — and who seemed to experience the least anxiety and depression afterwards — were those who had been given their disc fragments.

Why would such a simple action — presenting patients with the physical remnants of the source of their prior pain — have such an impressive result? Here are the surgeons’ explanations for their findings (which I found quite amusing for what they also say about human nature):

There are several possibilities [for the study’s results]: firstly, the pot [with the disc fragments] may provide a powerful visual confirmation to the patient that the operation was technically successful. Secondly, we found that patients often keep the pot for several months, which may augment the disc fragments’ beneficial effect. One patient reported that referring to the excised disc prevented recurrence of symptoms. Thirdly, since many patients show the pot to friends and family, we speculate that the positive comments made by these people amplify the benefit produced by merely seeing the disc material.

That third point really warmed my soul — the idea that people unflinchingly offer empathetic comments when the fragments of somebody else’s body (um, TMI?) are held up for them to view.

Human kindness — perhaps the strongest medicine, placebo or not, we have.

Comments (1)

  1. Submitted by dan buechler on 09/03/2009 - 08:43 pm.

    A good article on how patients anxiety and real attempts to relieve it can be successful. A good use of science.

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