The Placebo Effect

There are a lot of things people with fibromyalgia worry about, but one of the most unfortunate is the worry that he or she may be a hypochondriac.  Certainly we can be treated like hypochondriacs not only by family and friends but by healthcare workers, physicians, etc.  When I was first diagnosed with fibromyalgia, I tried to explain it to a friend.  Her reaction was, “We’re all getting old,” which stopped me in my tracks from trying to explain it anymore, and made me start to worry – if I feel 80 years old now, what the heck am I going to feel like when I’m actually 80?

It’s a typical reaction – everybody has aches and pains.  It’s true.  But I’m surrounded by people who have been successfully treated for their pain, and that relief seems out of reach, because, after all, there is nothing wrong with me.

So is it all in my head?  Am I a hypochondriac?  Maybe I’m just lazy?  There have been studies examining the effectiveness of certain drugs on fibro symptoms, and there is a high placebo success in this population.  People are given either the real thing or a placebo, and the placebos perform quite well. In one study, it was estimated that 50% of responses to these drugs were a placebo effect (see Okifuji article). Is that damning evidence?  No.

Shortly after my initial fibro diagnosis, I was put in a study.  Patients were given either actual acupuncture or a placebo acupuncture, however that is done.  I had a definite reaction to the acupuncture treatments which was very similar to acupuncture treatments my father was undergoing.  I was convinced I was part of the actual acupuncture arm of the study.  As the study ended, I was taken down by a pulmonary embolism and hospitalized.  When I attributed a dramatic decrease in symptoms to the acupuncture, I was told – no, I wasn’t in the acupuncture arm, I was in the placebo arm, and any improvement was probably to be attributed to resolving the pulmonary embolism and getting a free flow of oxygen.  I was so disappointed.

The thing is, I had made up my mind to feel better.  I was determined that acupuncture was going to help and that I was going to feel better.  If anything, I think people with fibromyalgia are hypERchondriacs, if that’s a word.  The opposite of hypOchondriacs.  We want to find that something that’s going to make us feel better, and we will convince ourselves of the efficacy of whatever that may be.  The power of the mind can take over that direction too.  We aren’t trying to feel bad – pain is not all in our heads.  But maybe the cure can be?