Can Hypnotherapy Help with Chronic Pain?
- Vanessa Weiland
- Jun 4, 2024
- 4 min read
Updated: Apr 15
Yes. Chronic pain is is one of the best-researched uses for hypnotherapy. Most studies have found that about 70% of people can can achieve short term pain relief with hypnotherapy, while another 20 to 30% achieve long term, or even permanent, pain relief (1).
Hypnosis has been used since ancient times for pain control. Ancient Egyptians used "dream temples" for healing, and Ancient Greeks used "sleep temples" (hypnos) for various ailments. Let's review the contemporary use of hypnotherapy for chronic pain.
How Does Hypnosis for Chronic Pain Actually Work?
Hypnotherapy impacts the pain circuitry on a neurophysiologic level. Research suggests that an area within the brain called the insula is important in triggering the pain network and creating the subjective experience of pain. Therefore, it is important to know that imaging studies have found changes in activity in the insula during hypnosis, along with other parts of the pain network such as the peripheral nerves, spinal cord, thalamus, sensory cortex, anterior cingulate cortex, and prefrontal cortex (1).
A trained hypnotherapist will be able to approach pain control in two different ways - through direct suggestion, such as directing the client to change the sensation of pain into a pleasant tingly sensation; and through indirect suggestion, such as overall suggestions of health and well-being. Interestingly, these two approaches can have different impacts on the brain.
Direct suggestions activate the frontotemporal network, suggesting that they work via cognitive processes.
Indirect suggestions activate more widespread areas, suggesting that they influence outcomes through an emotionally-weighted network.
Both types of suggestions significantly reduced pain during hypnosis, but only direct suggestions improve pain during normal alertness (1).
This 2019 comprehensive meta-analysis included 85 controlled experimental trials involving 3632 participants (2).
Hypnosis demonstrated analgesic effects for all pain outcomes.
Efficacy was influenced by hypnotic suggestibility and the use of direct analgesic suggestion.
People with high and medium suggestibility experienced clinically meaningful reductions in pain: 42% to 29% reductions respectively.
Minimal benefits were found for people with low suggestibility.
Conclusion: Hypnosis may be an effective and safe alternative to pharmaceutical intervention, but high-quality clinical data is needed for generalizability in chronic pain populations.
How Do I Know If I'm Suggestible Enough For Hypnosis To Work On Me?
Rest assured, the majority of people are either moderately or highly suggestible to hypnosis (also known as hypnotizable). Across various scales, approximately 10-15% of people are highly suggestible, 15-20% are low suggestible, and the rest are somewhere in the middle (3). I myself am moderately suggestible for hypnosis and have found much benefit from the practice, particularly for sleep and pain.
Nine articles with 301 participants were reviewed. The studies looked at various forms of neuropathic pain including complex regional pain syndrome, brachial neuralgia, and spinal cord injury.
All studies found pain and quality of life benefits, and those trials with a comparator (placebo) showed hypnosis as superior to the comparator or standard of care. However, the quality of evidence was again rated as low.
The authors conclude that hypnosis is a viable treatment option for chronic neuropathic pain to both relieve pain and improve function (4).
Hypnosis for Cancer-Related Pain
The American Society of Clinical Oncology (ASCO) includes hypnosis as a recommended psychological approach for managing chronic pain in cancer survivors. They highlight its effectiveness in reducing pain intensity and improving overall quality of life (5).
The American College of Chest Physicians (ACCP) also supports the use of hypnosis for managing pain in cancer patients. Their guidelines note that hypnosis has been consistently found to be effective for a wide range of symptoms in cancer care, including pain intensity, procedural pain, and postsurgical pain (6).
The National Comprehensive Cancer Network (NCCN) recommends hypnosis as part of cognitive-behavioral interventions for cancer pain management. They emphasize its utility in enhancing a sense of control over pain and improving pain-related outcomes (7).
These guidelines collectively underscore the role of hypnosis as a valuable non-pharmacological intervention for managing cancer-related pain.
Future Directions
As discussed earlier in this post, highly hypnotizable people typically achieve better, and longer lasting, pain control through hypnosis. But what if there was a way to modify your suggestibility?
In a March 2024 paper, Serge Marchand reviewed exciting new research showing that brain regions involved in hypnotizability can be modified with Transcranial Magnetic Stimulation (TMS). After the dorsal anterior cingulate cortex was activated through TMS, participants became significantly more hypnotizable than participants receiving sham TMS (8).
This may become a novel avenue for low suggestible clients to achieve long lasting pain relief through hypnosis.
Always consult with qualified practitioners and consider integrating hypnosis into a holistic pain management plan.
References:
Dillworth T, Mendoza ME, Jensen MP. Neurophysiology of pain and hypnosis for chronic pain. Transl Behav Med. 2012 Mar;2(1):65-72. doi: 10.1007/s13142-011-0084-5. PMID: 24073099; PMCID: PMC3717822.
Thompson, T., Terhune, D. B., Oram, C., Sharangparni, J., Rouf, R., Solmi, M., Veronese, N., & Stubbs, B. (2019). The effectiveness of hypnosis for pain relief: A systematic review and meta-analysis of 85 controlled experimental trials. Neuroscience & Biobehavioral Reviews, 99.
Hypnosis. Owen S. Surman MD, Lee Baer PhD. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 2008.Elsevier ISBN: 9780323295079.
McKittrick ML, Connors EL, McKernan LC. Hypnosis for Chronic Neuropathic Pain: A Scoping Review. Pain Med. 2022 May 4;23(5):1015-1026. doi: 10.1093/pm/pnab320. PMID: 34718772.
Management of Chronic Pain in Survivors of Adult Cancers: American Society of Clinical Oncology Clinical Practice Guideline. Paice JA, Portenoy R, Lacchetti C, et al. Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology. 2016;34(27):3325-45. doi:10.1200/JCO.2016.68.5206.
Complementary Therapies and Integrative Medicine in Lung Cancer: Diagnosis and Management of Lung Cancer, 3rd Ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Deng GE, Rausch SM, Jones LW, et al. Chest. 2013;143(5 Suppl):e420S-e436S. doi:10.1378/chest.12-2364.
Adult Cancer Pain, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology. Swarm RA, Paice JA, Anghelescu DL, et al. Journal of the National Comprehensive Cancer Network : JNCCN. 2019;17(8):977-1007. doi:10.6004/jnccn.2019.0038.
Marchand S. Unlocking hypnotizability: Transcranial brain stimulation for enhanced impact in chronic pain. Cell Rep Med. 2024 Mar 19;5(3):101475. doi: 10.1016/j.xcrm.2024.101475. PMID: 38508134; PMCID: PMC10983103.
Bình luận