4 ms·

Placebo is such an interesting phenomenon. I had a certain physical pain difficult to describe that I could’ve sworn to have felt, but after addressing my persp

by crehn 5y ago

Placebo is such an interesting phenomenon. I had a certain physical pain difficult to describe that I could’ve sworn to have felt, but after addressing my perspective I’ve no longer had any such symptoms. Not sure if related, but I still don’t understand it.

newby 5y ago
> after addressing my perspective Could you please elaborate on that?
- lloeki 5y ago
  (don't want to put words in GP's mouth, this is my interpretation of it, and my experience) I do skateboarding and had multiple ankle sprains. What happens every single time is that the wound heals, physiotherapy proceeds and strengthens the whole joint system, and then I'm left with an ankle that is still in pain when it should not physically be anymore since it has fully recovered. That is, until I literally "decide" the remaining pain is a construct of my mind, and then the pain vanishes overnight, and the ankle that I felt brittle and was scared to use to its full extend suddenly feels as strong and stable as ever, if not more.
  - vkk8 5y ago
    In the (power)lifting scene, I have really enjoyed the articles by Austin Baraki et al. from Barbell Medicine on pains and aches in the context of physical activities. See for example https://startingstrength.com/article/aches-and-pains https://startingstrength.com/article/aches-and-pains or https://www.barbellmedicine.com/blog/the-barbell-medicine-guide-to-tendinopathy/ https://www.barbellmedicine.com/blog/the-barbell-medicine-gu... In a nutshell, the idea that there's a straightforward causal link between something being physically broken in your body and you feeling pain is simply wrong. Sometimes people feel pain in various body parts without any detectable physical changes and sometimes classical training injuries, like herniated spinal disks, can be found by medical imaging without the person feeling any pain at all. Also the common advice to rest until the pain subsides is often - but no always - wrong; there are plenty of anecdotes of people with completely fucked up knees or ankles or back starting heavy powerlifting program and suddenly healing from their injuries or at least learning to use their body in such a way that the injuries don't bother them anymore.
    - datameta 5y ago
      I dont know about rapidly resuming the activity that caused the injury, but I totally agree that stopping all activity to exclusively rest and recover is terrible. You have to try to walk a bit at the very least. I participated in a chronic pain study where I personally learned that there are times, much more often than not, that one should not second-guess their joint that is having a flare-up and continue to walk a similar amount each day. I can't overstate how empowering it is to not be in a thought loop on a case by case basis and trust the learned system. Increased blood flow, released endorphins, usage of muscle, flexing of connective tissues and operation of joints often addresses the issue (if it is not an acute injury that really does need our body's regenerative abilities). We evolved to walk.
      - DoreenMichele 5y ago
        Physical activity -- muscle movement -- also increases the flow of interstitial fluid back to the circulatory system. This is how the body "takes out the trash" which is essential to the healing process. I have a serious medical condition. I sometimes go for a short walk when I feel awful because I know from long experience that doing so frequently makes me feel better and I've gotten good at telling when I feel awful in a way that will likely be helped by taking a walk.
        datameta 5y ago
        This connects the dots even further! I had a time where I went on a walk and thought it would be an extremely short one. After I thought I had been hitting the wall and I was sure I was making it worse, my joint started feeling much better. I extended the walk and returned feeling like the flare-up I had been experiencing before the walk had rapidly dissipated. That was a defining learning moment for me.
        DoreenMichele 5y ago
        You might find this comment of interest: https://news.ycombinator.com/item?id=25427090 https://news.ycombinator.com/item?id=25427090
  - jamiek88 5y ago
    Wow. I’ve struggled with and babied my left ankle for decades now ever since breaking it three time in three years. Gonna give that a try as there isn’t anything that shows up on scans etc
native_samples 5y ago
I find it a rather disturbing phenomenon, to be honest. Governments, scientists and media insist that we place enormous faith in the outputs of medical trials and studies. Anyone who expresses doubt about these is ostracised and forced to comply regardess. Yet every single one of them has to control for this entirely mysterious, inexplicable force that magically heals people with no actual medicine. This effect is so real, large and standard that it's mandated by law to take it into account yet we understand basically nothing about it (often even what the placebo was chosen to be is opaque), it's barely researched and the total lack of ability to explain it doesn't seem to bother anyone. Least of all regulators, who are meant to ensure the effect size of trials are correctly interpreted. It feels like there's this enormous, sophisticated scientific edifice that can draw pictures of proteins and explain how they interact, and in the centre of it all is a giant rotating question mark that everyone by convention ignores and pretends isn't there.
- Kye 5y ago
  It's not like they don't try to figure it out. But as you said: >> "This effect is so real, large and standard that it's mandated by law to take it into account yet we understand basically nothing about it" What would you prefer doctors do? Not use life-saving and life-improving treatments that are proven more effective than placebo after rigorous trials just because they don't understand it 100%?
  - DoreenMichele 5y ago
    The problem is we currently tend to ignore certain biases in our process which are known to introduce errors. Once it becomes a recommended medical practice that medical professionals use, medical opinion often trumps common sense and patients have trouble defending themselves even when they, personally, are certain this is harming them. Doctors will outright suggest you are mentally ill and need to see a therapist if your life is on the line, you aren't satisfied with their course of treatment and you question what they are doing and/or express concerns that this could kill you. Once they more or less declare you crazy for questioning them, you lose even more control over your body, your health, your life and your right to actively make decisions for yourself. There is definitely room for improvement in our current process.

by crehn 5y ago

newby 5y ago

> after addressing my perspective Could you please elaborate on that?

lloeki 5y ago
(don't want to put words in GP's mouth, this is my interpretation of it, and my experience) I do skateboarding and had multiple ankle sprains. What happens every single time is that the wound heals, physiotherapy proceeds and strengthens the whole joint system, and then I'm left with an ankle that is still in pain when it should not physically be anymore since it has fully recovered. That is, until I literally "decide" the remaining pain is a construct of my mind, and then the pain vanishes overnight, and the ankle that I felt brittle and was scared to use to its full extend suddenly feels as strong and stable as ever, if not more.
- vkk8 5y ago
  In the (power)lifting scene, I have really enjoyed the articles by Austin Baraki et al. from Barbell Medicine on pains and aches in the context of physical activities. See for example https://startingstrength.com/article/aches-and-pains https://startingstrength.com/article/aches-and-pains or https://www.barbellmedicine.com/blog/the-barbell-medicine-guide-to-tendinopathy/ https://www.barbellmedicine.com/blog/the-barbell-medicine-gu... In a nutshell, the idea that there's a straightforward causal link between something being physically broken in your body and you feeling pain is simply wrong. Sometimes people feel pain in various body parts without any detectable physical changes and sometimes classical training injuries, like herniated spinal disks, can be found by medical imaging without the person feeling any pain at all. Also the common advice to rest until the pain subsides is often - but no always - wrong; there are plenty of anecdotes of people with completely fucked up knees or ankles or back starting heavy powerlifting program and suddenly healing from their injuries or at least learning to use their body in such a way that the injuries don't bother them anymore.
  - datameta 5y ago
    I dont know about rapidly resuming the activity that caused the injury, but I totally agree that stopping all activity to exclusively rest and recover is terrible. You have to try to walk a bit at the very least. I participated in a chronic pain study where I personally learned that there are times, much more often than not, that one should not second-guess their joint that is having a flare-up and continue to walk a similar amount each day. I can't overstate how empowering it is to not be in a thought loop on a case by case basis and trust the learned system. Increased blood flow, released endorphins, usage of muscle, flexing of connective tissues and operation of joints often addresses the issue (if it is not an acute injury that really does need our body's regenerative abilities). We evolved to walk.
    - DoreenMichele 5y ago
      Physical activity -- muscle movement -- also increases the flow of interstitial fluid back to the circulatory system. This is how the body "takes out the trash" which is essential to the healing process. I have a serious medical condition. I sometimes go for a short walk when I feel awful because I know from long experience that doing so frequently makes me feel better and I've gotten good at telling when I feel awful in a way that will likely be helped by taking a walk.
      - datameta 5y ago
        This connects the dots even further! I had a time where I went on a walk and thought it would be an extremely short one. After I thought I had been hitting the wall and I was sure I was making it worse, my joint started feeling much better. I extended the walk and returned feeling like the flare-up I had been experiencing before the walk had rapidly dissipated. That was a defining learning moment for me.
        DoreenMichele 5y ago
        You might find this comment of interest: https://news.ycombinator.com/item?id=25427090 https://news.ycombinator.com/item?id=25427090
- jamiek88 5y ago
  Wow. I’ve struggled with and babied my left ankle for decades now ever since breaking it three time in three years. Gonna give that a try as there isn’t anything that shows up on scans etc

native_samples 5y ago

I find it a rather disturbing phenomenon, to be honest. Governments, scientists and media insist that we place enormous faith in the outputs of medical trials and studies. Anyone who expresses doubt about these is ostracised and forced to comply regardess. Yet every single one of them has to control for this entirely mysterious, inexplicable force that magically heals people with no actual medicine. This effect is so real, large and standard that it's mandated by law to take it into account yet we understand basically nothing about it (often even what the placebo was chosen to be is opaque), it's barely researched and the total lack of ability to explain it doesn't seem to bother anyone. Least of all regulators, who are meant to ensure the effect size of trials are correctly interpreted. It feels like there's this enormous, sophisticated scientific edifice that can draw pictures of proteins and explain how they interact, and in the centre of it all is a giant rotating question mark that everyone by convention ignores and pretends isn't there.

Kye 5y ago
It's not like they don't try to figure it out. But as you said: >> "This effect is so real, large and standard that it's mandated by law to take it into account yet we understand basically nothing about it" What would you prefer doctors do? Not use life-saving and life-improving treatments that are proven more effective than placebo after rigorous trials just because they don't understand it 100%?
- DoreenMichele 5y ago
  The problem is we currently tend to ignore certain biases in our process which are known to introduce errors. Once it becomes a recommended medical practice that medical professionals use, medical opinion often trumps common sense and patients have trouble defending themselves even when they, personally, are certain this is harming them. Doctors will outright suggest you are mentally ill and need to see a therapist if your life is on the line, you aren't satisfied with their course of treatment and you question what they are doing and/or express concerns that this could kill you. Once they more or less declare you crazy for questioning them, you lose even more control over your body, your health, your life and your right to actively make decisions for yourself. There is definitely room for improvement in our current process.