Read on: danhwilliams.com

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So, in the Cochrane review people who took paracetamol reported improved pain by some 26 points on a 100-point scale. Function up by 15 points.

That looks like paracetamol works, right?

But the authors concluded that ‘paracetamol resulted in little benefit’.

How is THAT so?

Well, let's pause and take a moment...

And people who took the ‘sugar pill’ placebo also reported improved pain by 23 points. Function up by 12 points.

Huh? That makes no sense...


Do sugar pills actually work?

Well, no, that’s not quite it.

It’s worth bearing in mind that osteoarthritic joint pain varies up and down.

People have good days and bad day. Good weeks and bad weeks.

Also, worth spotting that people tend to start taking a painkiller, effective or not, when  pain is bad. They're in a dip.

Or they sign up to a trial when their pain is bad.

And in the up and down world of joint pain, from that point on, the only way is up.

Pain generally gets better. At least a bit better. No matter what they do, or what we do.

And a substantial effect is not unusual.

Indeed, a group from Nottingham in the UK looked at the placebo effect in osteoarthritis across 198 trials.

A clever idea.

And they found that the effect- the effect of doing something, anything at all- significantly improved pain, function and stiffness.