Placebo effect, it is not just present in the use of medications but in medical procedures too says the NY Times Most of us when we hear about the placebo effect, we think of a sugar pill that was given to us that helped us feel better, even though it offered no clinical effect. Apparently, this is true to some medical procedures too. In our practice, we have commonly seen this in procedures for the knee and ankle, where a surgery was done to prepare a torn meniscus or perhaps, a problem in the ankle and later on, the problem appeared to seem better to the patient, yet, the mechanical problem that caused it was never addressed and clinically, they appeared to be the same as before. I have also seen this with the use of epidural steroid injections, prolo therapy and in other types of interventions where the patient had a short term perceived benefit, even though clinically, things were just as bad or worse after the procedure. These are expensive ways to administer a placebo and risky as well. The NY Times reports on this phenomenon with regards to medical procedures For a drug to be approved by the Food and Drug Administration, it must prove itself better than a placebo, or fake drug. This is because of the "placebo effect," in which patients often improve just because they think they are being treated with something. If we can't compare a new drug with a placebo, we can't be sure that the benefit seen from it is anything more than wishful thinking. But when it comes to medical devices and surgery, the requirements aren't the same. Placebos aren't required. That is probably a mistake. At the turn of this century, arthroscopic surgery for osteoarthritis of the knee was common. Basically, surgeons would clean out the knee using arthroscopic devices. Another common procedure was lavage, in which a needle would inject saline into the knee to irrigate it. The thought was that these procedures would remove fragments of cartilage and calcium phosphate crystals that were causing inflammation. A number of studies had shown that people who had these procedures improved more than people who did not. read more