[DanBC]

But that's the point, these people are in genuine pain, their knee is shot, surgeons were performing real surgery.

Surgeons knew it worked because they were cleaning all this gunk out of knees, and patients were recovering and having better quality of life.

For years surgeons refused to try RCTs to test this because to them it was so obvious that it worked.

It was only when trials were run that surgeons started to accept that maybe it's a bit more complicated. They say that the same type of knee would respond to sham surgery as well as real surgery.

This, by the way, is a real problem for pain treatment. We split people up into groups of "this is real pain" and "this is in your head". We need to stop that because it's harmful.

Pain is a complex phenomena. Most people have a complicated interplay between the physical and psychological components. Many people in pain will experience some relief from pain, and a large increase in quality of life and function, with psychological treatment.

Those people aren't faking it; their pain is real; they deserve better treatment.