surgery that is recommended to patients with osteoarthritis when medication fails
CHAPTER TWO: Superhealing Mind-Body Research Breakthrough 65 to relieve their pain. Although the surgery brings results, it is unclear to surgeons what the true physiological source of pain relief is. There is no proof that arthroscopy actual y cures or halts the process of osteoarthritis. So this team of surgeons designed a study to assess the true effectiveness of arthroscopic surgery. The Baylor College study was a double-blind design, which means that neither the subjects nor the researchers themselves knew which patients received arthroscopic surgery and which did not. There were 180 patients with degenerative knee arthritis in the study; the experimental group was given one of two kinds of authentic orthopedic surgery—one using a laprascope, the other using lavage (washing out) or debridement (removal of tissue)—and the control group was given a fake surgery. In the control group, three scalpel incisions were made around the knee like those used in actual surgery so as to keep the patients and the medical evaluators from discovering that they hadn’t been operated on. The results of all the surgeries—both of the real ones and the fake one—were the same. The findings determined that surgery mostly relieves pain because the patients believe it does.28 Knee surgery for arthritis is not the only operation to be under- mined when compared with sham surgery. Another study found something similar with patients undergoing a common procedure called vertebroplasty, which involves an injection into the lumbar spine. The procedure alleviated pain to the same degree as a placebo “surgery” in which the physicians tapped on the spine and piped in the smell of cement to the treatment room to make groggy volunteer subjects believe they were receiving the real treatment. Researchers found that the thirty-six volunteers who received the sham surgery did just as well as the thirty-five who got the real operation.29 One of the most fascinating double-blind studies I’ve seen com- pared the placebo effect to neurosurgery for Parkinson’s disease, a 66 PART ONE: Your Superhealing Mind serious disorder marked by the brain’s diminished ability to produce dopamine, the chemical that is released when we feel pleasure. The study found that those who received a real transplant of dopamine neurons experienced improvement in their movement, whereas those who had sham surgery did not. Even so—and this is the part that intrigues me—the participants’ perception of having had sur- gery did influence their responses. In their report, the researchers stated, “Those who thought they received the transplant at twelve months reported better quality of life than those who thought they received the sham surgery, regardless of which surgery they actual y received.”30 In other words, their beliefs improved their lives. Researchers at the University of California at Los Angeles have also investigated whether brain activity is altered by placebos. Their study involved giving patients with major depression a placebo instead of an antidepressant drug while leading them to believe they were receiving the actual drug. Using an imaging technique known as quantitative electroencephalography, the researchers discovered that the brain function of those who received the placebo was quite similar to the brain function caused by the antidepressant drugs. After nine weeks, the patients were classified as being medication responders, placebo responders, or, in some cases, nonresponders to either medication or placebos. Among the participants who were responders, it was found that the same brain region was changed whether they were medication responders or placebo responders.31 The researchers didn’t anticipate that the participants receiving the placebos would actual y have detectable changes in the speed and processing of their brain