It feels like there's this enormous, sophisticated scientific edifice that can draw pictures of proteins and explain how they interact, and in the centre of it all is a giant rotating question mark that everyone by convention ignores and pretends isn't there.
>> "This effect is so real, large and standard that it's mandated by law to take it into account yet we understand basically nothing about it"
What would you prefer doctors do? Not use life-saving and life-improving treatments that are proven more effective than placebo after rigorous trials just because they don't understand it 100%?
Doctors will outright suggest you are mentally ill and need to see a therapist if your life is on the line, you aren't satisfied with their course of treatment and you question what they are doing and/or express concerns that this could kill you. Once they more or less declare you crazy for questioning them, you lose even more control over your body, your health, your life and your right to actively make decisions for yourself.
There is definitely room for improvement in our current process.
It would be like someone writing off Newtonian physics before quantum mechanics was a thing because a lot more of the how wasn't yet understood. The practice of medicine has moved past the "if she floats, she's made of wood, and that means she's a witch" phase even if it still sees anyone other than cishet white dudes as witches.
I think my comment says essentially the same thing theirs did.
I mean we're in an environment where the US President is forcing an entire nation to take an experimental medical treatment on the back of (failed!) trials, simply because politician's faith in "science" and the medical establishment is 100% unshakeable. Largely because scientists themselves hardly seem to admit to the true levels of uncertainty in their own work (replication crisis etc). There's a huge mismatch between people's perception of study rigor and "sometimes people think themselves better lol magic innit", which is basically the state of our understanding of the placebo effect.
Could you please elaborate on that?
I do skateboarding and had multiple ankle sprains. What happens every single time is that the wound heals, physiotherapy proceeds and strengthens the whole joint system, and then I'm left with an ankle that is still in pain when it should not physically be anymore since it has fully recovered.
That is, until I literally "decide" the remaining pain is a construct of my mind, and then the pain vanishes overnight, and the ankle that I felt brittle and was scared to use to its full extend suddenly feels as strong and stable as ever, if not more.
In a nutshell, the idea that there's a straightforward causal link between something being physically broken in your body and you feeling pain is simply wrong. Sometimes people feel pain in various body parts without any detectable physical changes and sometimes classical training injuries, like herniated spinal disks, can be found by medical imaging without the person feeling any pain at all. Also the common advice to rest until the pain subsides is often - but no always - wrong; there are plenty of anecdotes of people with completely fucked up knees or ankles or back starting heavy powerlifting program and suddenly healing from their injuries or at least learning to use their body in such a way that the injuries don't bother them anymore.
I participated in a chronic pain study where I personally learned that there are times, much more often than not, that one should not second-guess their joint that is having a flare-up and continue to walk a similar amount each day. I can't overstate how empowering it is to not be in a thought loop on a case by case basis and trust the learned system.
Increased blood flow, released endorphins, usage of muscle, flexing of connective tissues and operation of joints often addresses the issue (if it is not an acute injury that really does need our body's regenerative abilities). We evolved to walk.
I have a serious medical condition. I sometimes go for a short walk when I feel awful because I know from long experience that doing so frequently makes me feel better and I've gotten good at telling when I feel awful in a way that will likely be helped by taking a walk.
Gonna give that a try as there isn’t anything that shows up on scans etc