The placebo effect of surgery: New evidence shows many operations, such as getting a stent for angina, to have low benefit and high risk

You’ve probably heard of the placebo effect: Someone reports feeling better after taking a pill that is said to help some condition or other, only to later discover the pill did not contain any active ingredients at all. The person’s physical health didn’t change; feeling better was all in their mind. It’s always an interesting experiment in human nature, and it’s easy to shrug off because taking a placebo pill doesn’t usually put you in harm’s way. But what happens when it’s an operation rather than a pill causing the placebo effect?

For countless people who have undergone procedures like having stents put in, this could well be the case as an Imperial College London study found that the operation does nothing to improve a person with angina’s quality of life.

Around ten million Americans suffer from angina, a condition that causes chest pain after being physically active due to restricted blood flow to their heart. Many of these people undergo a procedure to place a stent – a small metal tube – inside to help widen their arteries.

After studying 200 patients who underwent a heart stent procedure or a placebo procedure, the researchers found very little difference between the ability to exercise in each group. Although the stents did improve blood supply, they did not relieve symptoms. This is particularly concerning when you consider that the procedure can cause damage to the arteries or lead to excessive bleeding, among other risks.

Plenty of other operations are also associated with the placebo effect. For example, a 2014 study published in the New England Journal of Medicine explored knee surgery for repairing a torn meniscus. Half of the participants in the study underwent actual knee surgery to repair the meniscus, while the second group went through all the motions of surgery, with anesthesia and a surgical team passing instruments around them, but were never actually operated on. Participants in both of the groups recovered from the meniscus injury equally well. This means that not only was the placebo effect at play, but it also indicates that this and many other surgeries could be completely unnecessary.

Meanwhile, a review published in the British Medical Journal looked at 53 clinical trials that compared the results of legitimate surgery with placebos. In 39 of the 53 trials, the placebo control group noted improvements, and in 27 of these, the results for the placebo group and surgical group were identical! It’s also worth noting that serious side effects were noted by control group participants in 18 of the trials despite never getting any surgery, which shows that your mind truly is capable of influencing your physical health.

Many operations associated with placebo effect

Some of the operations that also fall into this category include arthritis operations, vertebroplasty, endometriosis surgeries, migraine implants, and gastric balloons for obesity. In certain operations – say, an organ transplant – it’s a lot more cut and dry, but in those where the effectiveness is a bit more subjective, such as operations to correct problems like stiffness and pain, the placebo effect can be very much at play. While improving the comfort level of patients is a good outcome, the risks of these unnecessary operations can be quite serious – not to mention the costs. Of course, the cost is also the main reason many doctors continue to perform these procedures without informing patients of the placebo effect.

University of New South Wales Surgery Professor Ian Harris said: “Once you accept that some or all of the effect of the surgery you are doing is down to placebo, but you carry on doing it anyway, you have removed the only barrier between mainstream medicine and alternative medicine.

“You can no longer say, as a doctor, that homeopathy is rubbish because you’re doing the same thing.”

Sources include:

comments powered by Disqus