It hurts to think about how much Americans spend on creams that are supposed to relieve pain. In fact, those creams often do relieve pain, but apparently they do that no better than placebos. This disturbing news comes from Johns Hopkins University, whose researchers conducted a double blind, randomized, placebo-controlled study from August 2015 to February 2018. A Johns Hopkins news release reports that the research involved 399 participants ages 18-90, of whom 43 percent were active duty military personnel; the remaining participants were retired or dependents, such as spouses. Participants, who before the study reported an average pain score of 4 or greater on the 0-10 pain scale, were divided into three groups: patients with neuropathic pain caused by disease or damage to the nerves, such as shingles or diabetes; those with nociceptive pain caused by injury to tissue, such as burns or sprains; and so-called mixed pain caused by damage to the nerves and tissues, such as certain types of back pain.  Participants, who were not told if the cream they were given was the real thing or a placebo, applied cream three times a day, and twice a day noted their pain scores. The researchers found no statistically significant difference the of average self-reported pain scores for patients in the treatment and placebo groups for any of the three types of pain. Ouch!