The literature and scientific research is extensive in the field of pain control. The rest of this article is a sampling of some of the more recent abstracts from 2000 to 2012.
Some good reviews:
Stoelb BL, Morton IR, Jensen MP, Patterson DR. (2009). The efficacy of hypnotic analgesia in adults: A review of the literature. Contemporary Hypnosis. Mar 1; 26(1):24-39.
This article both summarizes the previous reviews of randomized, controlled trials of hypnotic analgesia for the treatment of chronic and acute pain in adults, and reviews similar trials which have recently been published in the scientific literature. The results indicate that for both chronic and acute pain conditions: (1) hypnotic analgesia consistently results in greater decreases in a variety of pain outcomes compared to no treatment/standard care; (2) hypnosis frequently out-performs non-hypnotic interventions (e.g. education, supportive therapy) in terms of reductions in pain-related outcomes; and (3) hypnosis performs similarly to treatments that contain hypnotic elements (such as progressive muscle relaxation), but is not surpassed in efficacy by these alternative treatments. Factors that may influence the efficacy of hypnotic analgesia interventions are discussed, including, but not limited to, the patient’s level of suggestibility, treatment outcome expectancy, and provider expertise. Based upon this body of literature, suggestions are offered for practitioners who are using, or would like to use, hypnosis for the amelioration of pain problems in their patients or clients.
Montgomery, GH., David, D., Winkel, G., Siverstein, JH., Bovbjerg, DH. (2002). The effectiveness of adjunctive hypnosis with surgical patients: A meta-analysis. Anesthesia and Analgesia. 94(6):1639-1645.
This meta-analysis examined the results of 20 published controlled studies examining the use of hypnosis as an adjunct with surgical patients. In these studies hypnosis was typically administered to patients in the form of a relaxing induction phase followed by suggestions for the control of side effect profiles (e.g. pain, nausea, distress). Only studies in which patients were randomised to either a hypnosis or control group (no-treatment, routine care, or attention control group) were included. The results revealed that patients in the hypnosis treatment groups had better outcomes than 89% of the patients in the control groups. It was found that adjunctive hypnosis helped the majority of patients reduce adverse consequences of surgical interventions.
Montgomery, GH., DuHamel, KN., Redd WH. (2000). A meta-analysis of hypnotically
induced analgesia: how effective is hypnosis? International Journal of Clinical and Experimental Hypnosis. 48(2): 138-53.
This meta-analysis examined the effectiveness of hypnosis in pain management. It compares studies that evaluated hypnotic pain reduction in healthy volunteers vs. those using patient samples, looks at the relationship between hypnoanalgesic effects and participants’ hypnotic suggestibility, and determines the effectiveness of hypnotic suggestion for pain relief relative to other nonhypnotic psychological interventions. Examination of 18 studies revealed a moderate to large hypnoanalgesic effect, supporting the efficacy of hypnotic techniques for pain management. The results also indicated that hypnotic suggestion was equally effective in reducing both clinical and experimental pain.
Patterson, DR, Jensen, MP. (2003). Hypnosis and clinical pain. Psychol. Bull. Jul;129(4):495-521.
Hypnosis has been demonstrated to reduce analogue pain, and studies on the mechanisms of laboratory pain reduction have provided useful applications to clinical populations. Studies showing central nervous system activity during hypnotic procedures offer preliminary information concerning possible physiological mechanisms of hypnotic analgesia. Randomized controlled studies with clinical populations indicate that hypnosis has a reliable and significant impact on acute procedural pain and chronic pain conditions. Methodological issues of this body of research are discussed, as are methods to better integrate hypnosis into comprehensive pain treatment.
Some Specific Areas:
Burns
This is an older but promising study:
Patterson DR, Everett JJ, Burns GL, Marvin JA. (1992). Hypnosis for the treatment of burn pain. J Consult Clin Psychol. Oct; 60(5):713-7.
The clinical utility of hypnosis for controlling pain during burn wound debridement was investigated. Thirty hospitalized burn patients and their nurses submitted visual analog scales (VAS) for pain during 2 consecutive daily wound debridements. On the 1st day, patients and nurses submitted baseline VAS ratings. Before the next day’s would debridement, Ss received hypnosis, attention and information, or no treatment. Only hypnotized Ss reported significant pain reductions relative to pretreatment baseline. This result was corroborated by nurse VAS ratings. Findings indicate that hypnosis is a viable adjunct treatment for burn pain. Theoretical and practical implications and future research directions are discussed.
Mette MB, Davadant M, Marin C, Wasserfallen JB, Pinget C, Maravic P, Koch N, Raffoul W. Chiolero RL. (2010). Impact of a pain protocol including hypnosis in major burns. Science Direct. Aug; 36(5):639-646.
The study focused on the impact of a pain protocol using hypnosis on pain intensity, anxiety, clinical course, and costs. A pain protocol including hypnosis reduced pain intensity, improved opioid efficiency, reduced anxiety, improved wound outcome while reducing costs. The protocol guided use of opioids improved patient care without side effects, while hypnosis had significant psychological benefits.
Pain Management in Breast Cancer
Jensen MP, Gralow JR, Braden A, Gertz, KJ, Fann JR, Syrjala KL. (2012). Hypnosis for symptom management in women with breast cancer: A pilot study. International Journal of Clinical and Experimental Hypnosis. 60(2).
Eight women who were in treatment for breast cancer (n = 4) or breast cancer survivors (n = 4), presenting with 1 or more of 4 symptoms (chronic pain, fatigue, hot flashes, and sleep difficulties), were given 4 to 5 sessions of self-hypnosis training for symptom management. Analyses revealed (a) significant pre- to posttreatment decreases in pain intensity, fatigue, and sleep problems and (b) that pain intensity continued to decrease from posttreatment to 6-month follow-up. Although there was a slight increase in fatigue severity and sleep problems from posttreatment to 6-month follow-up, the follow-up scores did not return to pretreatment levels. The findings provide initial support for using hypnosis to manage symptoms in women who are breast cancer survivors.
Butler L D, Koopman C, Neri E, Giese-Davis J, Palesh O, Thome-Yocam K A, Dimiceli S, Chen X-H, Fobair P, Kraemer HC, Spiegel D. (2009). Effects of supportive-expressive group therapy on pain in women with metastatic breast cancer. Health Psychology. Sept; Vol 28(5):579-587.
This randomized clinical trial examined the effects of group therapy with hypnosis (supportive-expressive group therapy) plus education compared to an education-only control condition on pain over 12 months among 124 women with metastatic breast cancer. Main Outcome Measures: Pain and suffering, frequency of pain, and degree of constant pain were assessed at baseline and 4-month intervals. Those in the treatment group also reported on their experiences using the hypnosis exercises. Results: Intention-to-treat analyses indicated that the intervention resulted in significantly less increase in the intensity of pain and suffering over time, compared to the education-only group, but had no significant effects on the frequency of pain episodes or amount of constant pain, and there was no interaction of the intervention with hypnotizability. Within the intervention group, highly hypnotizable participants, compared to those less hypnotizable, reported greater benefits from hypnosis, employed self-hypnosis more often outside of group, and used it to manage other symptoms in addition to pain. Conclusion: These results augment the growing literature supporting the use of hypnosis as an adjunctive treatment for medical patients experiencing pain.
Montgomery GH, Bovbjerg DH, Schnur JB, David D, Goldfarb A, Weltz CR, Schechter C, Graff-Zivin J, Tatrow K, Price DD, Silverstein JH. (2007). A randomized clinical trial of a brief hypnosis intervention to control side effects in breast surgery patients. J Natl Cancer Inst; Sept 5;99(17):1304-12.
In this study of 200 randomized patients undergoing breast biopsy or lumpectomy, using a 15 minute presurgical hypnosis session, hypnosis subjects significantly reduced pain medications, reported less pain intensity, nausea, fatigue, discomfort and emotional upset. Patients in the hypnosis group cost the institution $772.71 less per patient than those in the control group.
Chronic Muscular Pain
Grondahl JR, Rosvold EO, Hypnosis as a treatment of chronic widespread pain in general practice: A randomized controlled pilot trial.(2008) BMC Musculskelet Discord. 9:124-129.
This pilot study was performed to study the effect of a standardized hypnosis treatment used in general practice for patients with widespread muscular pain. The intervention group went through a standardized hypnosis treatment with ten consecutive therapeutic sessions once a week, each lasting for about 30 minutes, focusing on ego-strengthening, relaxation, releasing muscular tension and increasing self-efficacy. The treatment group improved from their symptoms while the control group deteriorated. One year later the treatment group had a persisting improvement. The sample size was small suggesting more studies are needed.
Fibromyalgia:
Castel A, Cascón R, Padrol A, Sala J, Rull M.,(2012). Multicomponent cognitive-behavioral group therapy with hypnosis for the treatment of fibromyalgia: long-term outcome. J Pain. Mar;13(3):255-65.
This study compared the efficacy of 2 psychological treatments for fibromyalgia with each other and with standard care. Ninety-three patients with fibromyalgia (FM) were randomly assigned to 1 of the 3 experimental conditions: 1) multicomponent cognitive-behavioral therapy (CBT); 2) multicomponent CBT with hypnosis; and 3) pharmacological treatment (standard care control group). The outcome measures of pain intensity, catastrophizing, psychological distress, functionality, and sleep disturbances were assessed before treatment, immediately after treatment, and at 3- and 6-month follow-up visits. CBT and CBT with hypnosis participants received the standard pharmacological management plus 14 weekly, 120-minute-long sessions of psychological treatment. All but 1 session followed a group format; the remaining session was individual. The analyses indicated that: 1) patients with FM who received multicomponent CBT alone or multicomponent CBT with hypnosis showed greater improvements than patients who received only standard care; and 2) adding hypnosis enhanced the effectiveness of multicomponent CBT. This study presents new evidence about the efficacy of multicomponent CBT for FM and about the additional effects of hypnosis as a complement to CBT.
Martínez-Valero C, Castel A, Capafons A, Sala J, Espejo B, Cardeña E. (2008). Hypnotic
treatment synergizes the psychological treatment of fibromyalgia: a pilot study. Am J Clin Hypn. Apr; 50(4):311-21.
In this pilot the efficacy of treatment for fibromyalgia in multimodal cognitive behavioral treatments is studied, with and without hypnosis and with that of a purely pharmacological approach. Six hospital patients were randomly assigned to the three experimental conditions. The results suggest that psychological treatment produces greater symptom benefits than the conventional medical treatment only, especially when hypnosis is added. It is conclude that hypnosis may be a useful tool to help people with fibromyalgia manage their symptomatology.
Headaches (Tension and Migraine)
Hammond CD, (2007). Review of the efficacy of clinical hypnosis with headaches and migrains. 2007). Int. J Clin. Exper. Hypn. 55(2):207-219.
In this extensive review of the literature on tension and migraine headaches, hypnosis qualifies as both efficacious and specific. Hypnosis has been found out to be statistically superior or equivalent in comparison with commonly used medication treatments, in a double-blind placebo controlled study, in comparison to established biofeedback treatments and in research performed by many investigations. This review recognizes that hypnosis has been found to be free from side effects, adverse reactions and ongoing expenses.
Pain Control in Children
Tomé-Pires C, Miró J. (2012). Hypnosis for the management of chronic and cancer procedure-related pain in children. Int J Clin Exp Hypn. Oct; 60(4):432-57.
The aim of this study was to review published controlled trials of hypnotic treatments for chronic and cancer procedure-related pain in children. Trials were included if participants were 18 years of age or below, were randomized and had populations with chronic pain or cancer procedure-related pain. After the studies were assessed, 12 were selected for review. Although the evidence is limited, the findings indicate that hypnosis is an effective pain-control technique when used with children suffering from cancer procedure-related pain or chronic pain. Further research into the use of hypnosis to manage chronic pain in children should be a priority so that empirically based conclusions can be drawn about the effects of hypnosis on children.
Landier W, Tse AM. (2010). Use of complementary and alternative medical interventions for the management of procedure-related pain, anxiety, and distress in pediatric oncology: an integrative review. J Pediatr Nurs. Dec; 25(6):566-79.
This integrative review aims to identify evidence in four electronic databases (MEDLINE, CINAHL,
PsyINFO, and COCHRANE) regarding the effectiveness of complementary and alternative medical interventions, either alone or as an adjunct to pharmacological therapy, in alleviating procedure-related pain, anxiety, and distress in children and adolescents with cancer. A total of 32 articles met inclusion criteria. Results suggest that mind-body interventions, including hypnosis, distraction, and imagery, may be effective, alone or as adjuncts to pharmacological interventions, in managing procedure-related pain, anxiety, and distress in pediatric oncology.
Rogovik AL, Goldman RD.(2007). Hypnosis for treatment of pain in children.
Can Fam Physician. May; 53(5):823-5.
A review of research conducted at the Hospital for Sick Children, Toronto, Ontario, Canada found hypnosis to be effective for analgesia in children. Children can be easier to hypnotize than adults. Studies have shown clinical hypnosis and self-hypnosis to be effective as adjunct treatments for children in pain. Examples include painful medical procedures, such as bone marrow aspiration and lumbar puncture in pediatric cancer patients, postoperative pain and anxiety in children undergoing surgery, and chronic headache.
Childbirth and Hypnosis for Pain Control
There are many studies in this area. Here are two recent reviews:
Landolt AS, Milling LS. (2011) The efficacy of hypnosis as an intervention for labor and delivery pain: a comprehensive methodological review. Clin Psychol Rev. Aug; 31(6):1022-31.
This paper presents a comprehensive methodological review of research on the efficacy of hypnosis for reducing labor and delivery pain. To be included, studies were required to use a between-subjects or mixed model design in which hypnosis was compared with a control condition or alternative intervention in reducing labor pain. An exhaustive search of the PsycINFO and PubMed databases produced 13 studies satisfying these criteria. Hetero-hypnosis and self-hypnosis were consistently shown to be more effective than standard medical care, supportive counseling, and childbirth education classes in reducing pain. Other benefits included better infant Apgar scores and shorter Stage 1 labor. Common methodological limitations of the literature include a failure to use random assignment, to specify the demographic characteristics of samples, and to use a treatment manual.
Cyna AM, McAuliffe GL, Andrew MI. (2004). Hypnosis for pain relief in labour and childbirth: a systematic review. Br J Anaesth. Oct; 93(4):505-11.
Five randomized control trials and 14 non-randomized comparisons studying 8395 women were identified where hypnosis was used for labour analgesia. Results showed women using hypnosis rated their labour pain less severe than controls (P<0.01). Hypnosis reduced opioid (meperidine) requirements (P<0.001), and increased the incidence of not requiring pharmacological analgesia in labour (P<0.001).
If you have a need for pain control please contact me for a free consultation at www.nancybwheeler.com or 503-684-4112. As a certified medical hypnotherapist and hypnoanaesthesia therapist I am qualified and experienced to assist you. Find out how you can live a life of quality and comfort.
