How effective are placebos for headaches?


As of September 2017, new Sweat Science columns are being published at Check out my bestselling new book on the science of endurance, ENDURE: Mind, Body, and the Curiously Elastic Limits of Human Performance, published in February 2018 with a foreword by Malcolm Gladwell.

- Alex Hutchinson (@sweatscience)


We all know that placebos work (even if we know we’re taking a placebo, as this study showed). But how well do they work? Researchers in the Netherlands did a meta-analysis of 119 headache studies to evaluate the recovery rate among the placebo/control groups. The verdict: 38.5% of patients given placebo pills recovered, while 15.0% of patients in control groups that didn’t receive pills recovered.

This isn’t surprising, of course (though it’s nice to see some numbers to get a sense of scale). But what does it mean? How do we use this information? A recent McGill study found that one in five Canadian doctors acknowledged prescribing placebos to their patients. The German Medical Association, meanwhile, just released a report from its scientific advisory board encouraging greater use of placebos:

“The placebo effect plays a critical role in every day practice,” says Robert Jütte, lead author of the report. Indeed, a survey of German doctors found that half of them had used a placebo before. In the southern German state of Bavaria, the figure was close to 90%. Jütte says that this majority is right: “Every good doctor should have a couple of white or blue sugar pills handy.”

To me, the ideal scenario is that we devote more research resources to understanding how and why placebos work — though of course there’s little incentive (and strong disincentives, in some ways) for pharmaceutical companies to pursue this topic. Is deception really necessary for this effect to work? Or is it possible that, once we understand it better, we’ll be able to harness the power of the brain in a more controlled (and honest) way.?