& Pain Control
& Pain Control
Watch Allan's Video exploring hypnosis and pain control.
Hypnotic Treatment of Chronic Pain. J Behav Med. 2006 Jan 11;:1-30. Jensen M, Patterson DR.
This paper reviewed various controlled trials involving the use of hypnosis to control pain. It concluded that hypnosis can provide a significantly greater reduction in pain than physical therapy, education, or the management of medications. It even found that the hypnotic treatment did not even have to be called 'hypnosis' for it to be effective.
Pain Management: Hypnosis and Its Place in
Modern Pain Management - Review Article. Niger
Postgrad Med J. 2007 Sept;14(3):238-41. Amadasun FE.
This paper reviewed the various scientific studies that showed hypnosis was an effective treatment for pain management. It concluded that in spite of some of the "methodological flaws" involved in many of the studies, there was "sufficient clinical evidence of sufficient quality" to conclude that hypnosis is an effective treatment for chronic pain.
A Meta-Analysis of Hypnotically Induced Analgesia: How Effective is Hypnosis? Int J Clin Exp Hypn. 2000 Apr;48(2):138-53. Montgomery GH, DuHamel KN, Redd WH.
This paper reviewed 18 studies conducted on the use of hypnosis to relieve pain over a a two-decade period. It concluded that hypnosis provided an effective way to help people deal with pain because it had a "moderate to large hypnoanalgesic effect." It further concluded that hypnosis should be more widely used in the treatment of pain.
Hypnosedation: A Valuable Alternative to Tradition Anaesthetic Techniques. Acta Chir Belg. 1999;99:141- 146. Faymonville ME, Meurisse M, Fissette J.
reports on the anecdotal use of hypnosis in over 1650 surgeries that
were performed in the Department of Anaesthesia and Intensive Care,
at the University of Liège in Belgium. It confirmed that
hypnosedation combined with local anaesthesia can be used as an
alternative to more traditional means of sedation.
Psychological Approaches During Conscious Sedation. Hypnosis Versus Stress Reducing Strategies: A Prospective Randomized Study. Pain 1997, Dec;73(3)361-7. Faymonvillea ME, MambourgPH, Jorisa J, Vrijensc B, Fissetted J, Alberte A, Lamyf M.
Sixty patients patients who were going to have plastic surgery using local anesthetic and intravenous sedation (they could request midazolam and alfentanil if needed) where randomly placed into a control group where they were taught strategies for reducing stress, or into a group where they would receive hypnosis during the surgery. Their behaviour was monitored by a psychologist before, during, and after surgery where their levels of anxiety and pain, and feelings of being in control, were recorded. Not only did the group using hypnosis require significantly lower levels of midazolam and alfentanil than the control group. They reported experiencing significantly lower levels pain and anxiety; and a greater feeling of being in control during the entire process. Their vital signs were also found to be significantly more stable than those of the control group.
Use of Hypnosis Before and During Angioplasty. Am J Clin Hypn. 1991 Jul;34(1):29-37. Weinstein EJ, Au PK.
Thirty-two subjects were recruited for this study. Sixteen were randomly assigned to be in the control group and 16 were hypnotized before they underwent an angioplasty (a procedure where a balloon is inserted into a vein and then inflated to help open the vein while the patient remains conscious and aware). This study found that the surgeons involved were able to keep the balloon inflated 25% longer with the hypnotized group. Forty-four percent of the control group also asked for more pain medication, compared with only 13% of the hypnotized group.
Science Behind Hypnotic Pain Control
Naloxone Fails to Reverse Hypnotic Alleviation of Chronic Pain. Psychopharmacology (Berl). 1983;81(2):140-3. Spiegel D, Albert LH.
Some researchers had previously believed that the reason hypnosis helps to reduce chronic pain was that it caused the body to produce endorphins (our natural pain killers). To test this theory, 6 patients suffering from chronic pain (caused by peripheral nerve irritation) were taught self-hypnosis to reduce their feelings of pain. They were then randomly given either a saline solution (a placebo) or naloxone (a drug that is known to block the effects of endorphins) and were tested for pain at 5 minute intervals for an hour. If the analgesic effect of hypnosis was somehow caused by the internal production of endorphins, then naloxone would have caused the pain to return. However, the results of this study demonstrated that naloxone had no effect on the power of hypnosis to reduce pain. As a result, it was determined that endorphins are not involved in hypnotic pain control.
fMRI Study of Hypnosis-Induced Analgesia. A paper presented to the 17th Meeting of the European Neurological Society, 2007. May TS.
This paper reports on a study involving 13 healthy subjects who underwent 'functional magnetic resonance imaging' (fMRI) of their brain while their left hand was subjected to a painful laser beam. The researchers found that there was a significant difference in the way their brains responded to pain while they were in a normal state, compared to when they were in a state of hypnosis. In both the normal and the hypnotic state the primary somasensory cortex (the area in the brain that first receives the pain signals) had a noticeable reaction to the pain. When the subjects were in a normal state, this had a cascading effect on other parts of the brain involved in the perception of, and reaction to, pain (such as "the anterior cingulated gyrus"). However, when they were in a state of hypnosis, this cascading effect did not occur. This means that while in a state of hypnoanalgesia the brain registers the pain, however it does not pass these signals onto the other areas of the brain involved in perceiving, feeling and reacting to the pain.
Functional Anatomy of Hypnotic Analgesia: A PET Study of Patients with Fibromyalgia. European Journal of Pain. Vol. 3(1) 1999; 7-12. Wik G, Fischer H, Bragée B, Finer B, Fredrikson M.
In an attempt to understand what happens in the brain when a person is hypnotized and then given suggestions for pain relief, subjects were recruited who were suffering from the painful condition of fibromyalgia. PET (positron emission tomography) scans were then taken of their brains when they were resting and then when they were in a state of hypnotically-induced analgesia. The subjects all reported experiencing less pain when they were in the state of hypnosis, then they did when they were in a state of rest. The researchers also found that there were significant differences in the way the blood flowed through the brain in these two states. They found that during hypnotically-induced analgesia the blood flow "was bilaterally increased in the orbitofrontal and subcallosial cingulate cortices, the right thalamus, and the left inferior parietal cortex, and was decreased bilaterally in the cingulate cortex." This study proved that hypnosis leads to real physical changes in the brain.
(Also see the study immediately above).
Controlled Trial of
Hypnotherapy in the Treatment of Refractory Fibromyalgia. Rheumatol. 1991 Jan;18(1):72-5 . Haanen HC,
Hoenderdos HT, van Romunde LK, Hop WC, Mallee C, Terwiel JP, Hekster
Forty patients who were suffering from refractory fibromyalgia were randomly put into either a control group (where they received physical therapy) and a hypnosis group for 12 weeks. They were all reassessed again after 24 weeks. The group that received hypnosis reported feeling significantly better than the physical therapy group in terms of pain, sleeping patterns, and fatigue upon waking-up. The hypnosis group also reported experiencing significantly lower physical and mental levels of discomfort as determined by the Hopkins Symptom Checklist.
An Experimental Study of Hypnosis in Painful Burns. American Journal of Clinical Hypnosis. Vol 21(1), Jul 1978, 3-12. Wakeman, R. John; Kaplan, Jerold Z.
This paper reports on the results of two studies conducted on burn patients and the effectiveness of hypnosis to help control the feelings of acute pain. Both studies showed that those who received hypnosis required significantly less medication than those who were in the control groups. It was also found that among those who were given hypnosis, those patients who were between 7 and 28-years-old required significantly less medication for pain than did those who were older. This study concluded that hypnosis and hypnotic ego-strengthening techniques can play an important role in helping burn patients cope with pain.Temporomandibular Disorders (TMD)
Medical Hypnosis for Temporomandibular Disorders: Treatment Efficacy and Medical Utilization Outcome Oral Surgery Oral Medicine Oral Pathology Oral Radiology & Endodontics. 2000 Jul;90(1) :54-63. Simon EP, Lewis DM.
Twenty-eight patients who did not respond well to conventional treatments were recruited into a hypnosis treatment program. This study found that hypnosis has the potential to be a valuable tool in the treatment of TMD because these patients reported that they had a significant decrease in the frequency, duration and intensity of their pain, as well as an improvement in their ability function on a daily basis.
Migraine and Hypnotherapy. International Journal of Clinical & Experimental Hypnosis 1975; 23(1): 48-58. Anderson JA, Basker MA, Dalton R.
Forty-seven subjects were recruited and asked to report the number and severity of migraines they had each month for one year. Twenty-three subjects were treated with hypnosis (and taught self-hypnosis) and 24 were treated with the drug prochlorperazine (Stemetil). At the end of the study it was found that those who had been treated with hypnosis experienced significantly fewer blinding migraine attacks than did the medicated group. Furthermore, 10 of those who had been treated with hypnosis no longer experienced any migraines at all, compared to only 3 in the other group.
Review of the Efficacy of Clinical Hypnosis with Headaches and Migraines. International Journal of Clinical and Experimental Hypnosis, Vol. 55(2) April 2007;207-219. Corydon Hammond.
A 12-member assessment team from National Institute of Health Technology (in the US) reviewed numerous studies on hypnosis and concluded that it met the criteria to be considered a well-established, effective treatment for headaches and migraines. Furthermore, they concluded that it had no side-effects and that it did not carry any risk of causing an adverse reaction.
Comparison of Self-Hypnosis and Propranolol in The Treatment of Juvenile Classic Migraine. Pediatrics. 1987 Apr;79(4):593-7. Olness K, MacDonald JT, Uden DL.
This study focused on children, 6 to 12 years of age, who were suffering from juvenile classic migraines. They were randomly placed into two groups. One group received a placebo for the first three months, while the other received propranolol. At the end of the three months they switched, so the group who had been receiving propranolol were then given the placebo, while those who had been given the placebo were switched to propranolol for a further three months. At the end of this initial 6-month period both groups were then taught self-hypnosis. The study found that the mean number of headaches experienced was 13.3 while taking the placebo, 14.9 while taking propranolol, and 5.8 when doing self-hypnosis.
Treatment of Chronic Tension-Type Headache With Hypnotherapy: A Single-Blind Time Controlled Study. Headache. 1991 Nov;31(10):686-9. Melis PM, Rooimans W, Spierings EL, Hoogduin CA.
This paper reports on a study where a special hypnotic technique was used to help patients cope with chronic-tension type headaches. When compared to a control group, the results showed that this hypnotic technique significantly reduced the intensity of the headaches. It also led to a significant reduction in the frequency of the headaches and a reduction in the general level of anxiety.
Hypnosis in the Management of Persistent Idiopathic Orofacial Pain - Clinical and Psychosocial Findings. Pain. 2007 Aug 3, Abrahamsen R, Baad-Hansen L, Svensson P.
This study involved 41 people were suffering from Persistent Idiopathic Orofacial Pain (PIOP). PIOP is a condition that involves persistent pain in the mouth and face which has no discernable underlying cause. The participants were randomly assigned to two groups: one that received five 1-hour hypnosis sessions and a control group that received five 1-hour relaxation sessions. The effectiveness of the treatments was measured in a number of ways. The most important was the Visual Analog Scale (VAS) where the subjects assessed their own level of pain three times a day on a scale of 0 (no pain) to 10 (agonizing pain). Subjects were also assessed using the McGill Pain Questionnaire, a symptom check-list, SF-36 (a quality of life questionnaire with 8 categories scored on a scale of 0-100), the quality of sleep, and the use of medication for pain relief.
The VAS pain scores for group that used hypnosis decreased by 33.1%, while those of the control group only decreased by 3.2%. Furthermore it was found that those in the hypnosis group who were highly hypnotizable had a 55.0% decrease in the VAS scores, compared to a 17.9% decrease in those who were less susceptible to hypnosis. The researchers also found two other statistically significant differences between the two groups because those who used hypnosis had a significant change in their perception of the pain (as determined by the McGill Pain Questionnaire) and they used significantly less pain-relief medication. However, they found no significant differences between the two groups in terms of the symptom check list and the SF-36 scores. They concluded that hypnosis offers "clinically relevant pain relief," for PIOP, especially for those who are highly hypnotizable. They also noted that a truly effective program should also involve training in stress-management and quality of life skills.