Using Hypnosis for Treating Chronic Back Pain
Research on the use of hypnosis for chronic pain is new. Some of the early studies actually found hypnosis to be ineffective, but we have since learned that these studies used the wrong types of post-hypnotic suggestions. We now know that in chronic pain situations the post-hypnotic suggestions need to focus on the five factors (from the list above) that are maintaining or aggravating the chronic pain syndrome.
So, instead of suggesting to chronic pain patients that their pain will go away, which doesn’t work, the therapist might suggest that they’re going to feel more energy and more motivated to participate in physical therapy or an exercise program. These suggestions are more successful in helping somebody who is coping with chronic pain.
Chronic pain and SCI
Many different kinds of chronic pain are associated with SCI.
Musculoskeletal pain. Pain that is associated with how you are carrying yourself, how you are sitting or using your wheelchair, e.g., shoulder pain.
Neuropathic pain. Caused by abnormal signals from the damage to nerves that occurred in your injury.
Paresthesia. Burning, prickling pain.
Dysthesia. Pain on touch.
Allodynia. Pain caused by stimuli that normally do not produce pain.
The vast majority of persons with spinal cord injury do report chronic, unpleasant sensations or pain. In addition, about a third describe the chronic pain as severe, which is a very, very hard thing to live with.
Chronic pain in persons with spinal cord injury tends to exist at multiple body sites and generally does not improve with time. It can interfere significantly with normal activities such as work and social life, and perhaps for that reason is associated with depression.
Few medications are consistently helpful. Narcotics might provide some relief, but have potentially dangerous side effects. Many people cannot function day to day on doses of narcotics required to manage the pain. We need more non-pharmacological interventions like hypnosis, relaxation, imagery, meditation and autogenic training for these pain syndromes. Medications are not going to be the answer.
A study here at the University of Washington found that hypnosis was effective in reducing chronic pain levels in SCI. The 34 participants, who reported an average pain level of six (on a 10-point scale) at the beginning of the study, received 10 sessions of hypnosis with a therapist, as well as self-hypnosis training so they could continue the treatment at home.
At the end of the 10 sessions, average pain levels dropped to five—not a huge drop but nonetheless important for people with chronic pain. Furthermore, this reduced level of pain was maintained three and six months later.
Sleep also improved because of the hypnosis. Pain often interferes with sleep, and before the intervention, participants reported their sleep disturbance at about six; after the session, this interference dropped to a four, improving sleep significantly. Again, this improvement continued when participants were assessed three and six months after completing the 10 sessions.
Overall, this study found that hypnotic analgesia seems to be effective for roughly 23% of persons with SCI, is modestly effective for another 30%, and generally ineffective for 38%. It is not helping third of the people, and we need to figure out why. This study also found that those who scored high on the hypnotizability scale had a better response. However, even those who had mild to moderate hypnotizability scores showed improvement. These findings are very promising.