We have all heard of the placebo effect occuring with pills and other medicines, and according to a 2002 study published in the New England Journal of Medicine it may even apply to surgery too. Performed at the Baylor School of Medicine in conjunction with the VA Hospital of Houston, this study involved patients with osteoarthritis of the knee who had moderately-severe pain and had been recommended surgery to reverse their symptoms.
The patients were divided into three groups. The first received the standard arthroscopic debridement surgery, a procedure that shaves rough cartilage, removes loose debris, and trims and smooths any damaged sections of the meniscus. The second group received a flushing procedure known as lavage, which involves flushing several liters of fluid through the knee joint to remove any inflammation causing agents. The third group received a placebo procedure, where the surgeon made incisions on the skin and manipulated the knee as if he was actually performing the operation. Patients in all groups were cared for the same way after surgery, spending the night in the hospital and following the same rehabilitation program.
All of the participants were tracked for two years post-surgery. During that time, there was no difference in outcome among any of the three groups. None. Several of the recipients of the placebo surgery even made dramatic recoveries, returning from the sidelines to basketball games with grandchildren and hikes on steep and unstable terrain.
What can we learn from this study? I'll suggest three things. First of all, surgery is often overprescribed and unnecessary. In some cases, it's required and beneficial; we must remember, however, that with the associated risks and trauma to the body it is always a last resort. The second point I'd like to emphasize is the power of proper training and therapy. After reading this study, I believe that part of the reason the placebo group fared so well is that they went through a progressive strengthening and recovery program after the surgery. As they went through therapy, the members of this group learned to use their muscles correctly to stabilize their knees. This work is aimed at the root cause of the problem, which is always a more effective approach in the long run.
Finally, this study emphasizes the power of the human mind. When our mind believes in something strongly enough, it makes the object of belief happen. The members of the placebo group believed that their surgery would make them better, and it did. This teaches us how useful it can be to visualize our healed state when doing therapy, to see our successful outcome when training, and even to feel the satisfied energy of accomplishment on the way to give a presentation.
If you or someone close to you is considering surgery, I hope this article will motivate you to exhaust all other options beforehand. In our clinic we see the lingering effects of old surgeries as well as the trauma of new ones, and that makes the surgeries that we're able to prevent even more rewarding.