Can Hypnosis Help Relieve Chronic Pain?

By Pat Anson, PNN Editor

Two new studies suggest that hypnotherapy can relieve pain for some patients with irritable bowel syndrome (IBS), complex regional pain syndrome (CRPS) and other chronic pain conditions.

The first study, published in The Lancet medical journal, involved nearly 500 IBS patients who were recruited from 11 hospitals in the Netherlands. IBS is a common condition characterized by repeated attacks of stomach pain, cramps, diarrhea and constipation.

Study participants were randomly assigned to one of three groups: individual hypnotherapy, group hypnotherapy, or support sessions that included dietary advice and education about IBS.  The hypnotherapy sessions were designed to reduce pain and discomfort from IBS.

After three months, 41% of the people in individual hypnotherapy and 33% of those in group hypnotherapy reported adequate relief, compared to less than 17% of those in education and support sessions.   

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The results from group hypnotherapy were even better after 9 months. Nearly half the patients in that group reported relief from IBS symptoms.

“The trial finding that hypnotherapy works better than educational support adds evidence to previous studies showing that hypnotherapy may have a helpful effect,” the UK’s National Health Service said in a review of the Dutch study. “The finding that group hypnotherapy works about as well as individual hypnotherapy is interesting, as this means many people could be treated by the same therapist at the same time, which could reduce waiting times and the cost of treatment.

“It also demonstrates that unfortunately, even with the best care, IBS can still be a difficult condition to treat. Half or more people receiving hypnotherapy still gained no symptom relief.”

Hypnosis and CRPS

Another hypnosis study, recently reported by Japanese researchers at the World Congress of Pain, involved 121 patients with refractory chronic pain – also known as intractable pain – who agreed to hypnotherapy either biweekly or in monthly 60 minute sessions. The patients all had chronic conditions that were difficult to treat, such as CRPS, phantom limb pain, neuropathic pain and cancer pain.

Researchers found that 71% of the patients reported pain relief during the hypnosis sessions. And for many of them, the analgesic effect continued after the session ended.

“These patients have all undergone multidisciplinary pain treatment, including medication, physiotherapy and CBT (cognitive behavioral therapy),” Miyuki Mizutani, PhD, a clinical psychologist at Aichi Medical University, told Pain Medicine News. “And ultimately, they did not respond completely to those treatments. So we believe the untreatable part of the pain can be treated by hypnosis.”

Hypnotherapy even works for patients with CRPS, although they often require more hypnosis sessions before having an analgesic effect.

“I’ve now been performing hypnosis for 18 years, and have found it very effective in those patients, though it can be difficult to administer in chronic pain,” Mizutani said. “It takes time, and complete remission is not very common. However, our experience is that repeated analgesic experiences can lead to long-term improvements in chronic pain.”

The 4 H’s That Can Help Lower Pain Levels

By Barby Ingle, Columnist

One of my goals in this continuing series on alternative pain care is to help people find an effective treatment that they hadn’t considered before. Even we help just one person, it makes it all worthwhile.

I understand that not all treatment options work for everyone. I am also very aware that some patients would rather only do what is “traditional” for their chronic condition. But what if you could get even more relief by adding another therapy or combining multiple treatment options? I believe a treatment I received took me from a wheelchair to walking, but I know that I would have done even better by adding a multi-modal approach to my pain care.

This segment of my series will cover the 4 H’s: hypnotherapy, hyperbaric therapy, holistic living and herbal therapy.

Hypnotherapy

Hypnotherapy is used in chronic pain treatment to create a subconscious change in patients. It will not “cure” a patient of their pain or physical challenges, but it can help form new responses, thoughts, attitudes, and behavior patterns to help cope with constant pain.

Hypnotherapy is a complementary therapy that utilizes suggestive techniques that patients can use to alter their state of consciousness. Using skilled relaxation techniques, the hypnotherapist makes appropriate suggestions to relax our conscious thoughts in order to focus on the subconscious ones.

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There are multiple approaches to hypnotherapy, so learning about the different types may be helpful. A few of them include cognitive behavioral therapy, Ericksonian therapy, neuro-linguistic programming, cortical integrative therapy, and past life regression.

There is wide endorsement for hypnotherapies that can be used in habit breaking, stress-related challenges, and treating long-term conditions. We have a hypnotherapist on the iPain board of directors and the National Institute for Health and Care Excellence has also endorsed hypnotherapy for multiple uses.

But there is still a need for more testing and research to provide more concrete evidence that hypnotherapy can help and be used in tandem with traditional treatments.

Not everyone responds to hypnotherapy, as our susceptibility and commitment to the process varies from patient to patient, as do the treatments. It could be a single hypnosis session for issues like smoking cessation or it could be weekly visits for chronic pain.

Costs can vary between $50-150 per session. Some insurance companies will cover hypnotherapy, so it’s a good to check with them before making an appointment. If you want to feel more comfortable about hypnosis before trying it, I suggest that you talk to the therapist first and do some research online. If you need help finding a hypnotherapist in your area, you can start by clicking here.

Hyperbaric Therapy

Hyperbaric oxygen therapy is painless to participate in. It was originally created for deep-sea divers to help them overcome decompression sickness, but has also been used for decades to treat infections, severe burns and carbon monoxide poisoning. More recently it has been found to help people with fibromyalgia and other chronic illnesses.

Many chronic pain patients have trouble with vascular constriction and getting proper oxygen throughout the body, especially to areas that most affected by pain.

Hyperbaric therapy helps improve oxygen levels, which reduces nerve pain, fights infections, and promotes cell growth and wound healing.

Patients undergoing hyperbaric oxygen therapy sit in a pressurized room or tube. The higher air pressure allows lungs to gather more oxygen than they would normally, resulting in 10 to 15 times the normal amount of oxygen being brought to each cell.

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This stimulates cell healing and provides vital nutrients to cells that are not functioning correctly. When our cells are not getting the proper amount of oxygen and nutrients, we lose energy, tissue becomes malnourished, and it delays or prevents healing.

Most patients using hyperbaric therapy will require a few rounds of treatment over several weeks to get results. The cost can be quite high, but if you can get your provider to test your vascular constriction with a Doppler Study or another measuring device, your insurance may pay for this treatment.

Holistic Living

Holistic living is more of a lifestyle approach than a treatment, because it is aimed at improving the mind, body and spirit. Once we bring harmony into our lives physically, mentally, spiritually and emotionally, we create a balance that can make the tough times of living with chronic pain more bearable.

The good news is you can start consciously living in a holistic manner at any time. Taking one step at a time is the way to get on the path of self-improvement. Living holistic is about being conscious of all aspects of who you are and the choices you make.  

Holistic living also makes use of massage, acupuncture, acupressure, herbal medicine and other healing options. These are typically out of pocket expenses, so access to them can be limited. But with YouTube, Zubia and other online platforms, it’s easy to find videos – like the one below --to help learn how to live holistically on your own.

Herbal Therapy

Herbal therapy was first introduced to me back in college when I had a cheerleading injury and a friend took me to Chinatown to see a doctor who had been treating her.

I thought it was such a strange experience. He looked at my eyes, my fingers and my tongue. What could he see? What was he looking for? I could hardly understand him, but when he was done, we headed into a room with all kinds of herbs and plants stored in bins.

He walked around the room, chose some items for me, and wrote out on a piece of paper what to do. I took the stuff back to my dorm room and made it into a tea that I drank a little of each day. It was to help with inflammation from my injury.

Some people, including my friend, just ate the herbs and plants. But I didn’t like the taste, so making the tea was easier for me to get it down.

Just because an herb or plant is in its natural state doesn’t make it right for all of us. You should check with an herbalist who has some training in this area. Herbs can interact with some over-the-counter and prescription medications. And be sure to tell your healthcare providers about any herbal medications you are taking.

This month’s spotlight on H’s that can help with pain care are meant to be idea starters. As always, I look forward to hearing from those of you who have tired any of these modalities and whether it improved your general health and to chronic pain specifically.

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Barby Ingle lives with reflex sympathetic dystrophy (RSD), migralepsy and endometriosis. Barby is a chronic pain educator, patient advocate, and president of the International Pain FoundationShe is also a motivational speaker and best-selling author on pain topics.

More information about Barby can be found at her website. 

The information in this column should not be considered as professional medical advice, diagnosis or treatment. It is for informational purposes only and represents the author’s opinions alone. It does not inherently express or reflect the views, opinions and/or positions of Pain News Network.

Hypnosis and Mindfulness Reduce Acute Pain

By Pat Anson, Editor

Hypnosis and mindfulness training can significantly reduce acute pain in hospital patients, according to a small study published in the Journal of General Internal Medicine.

Researchers at the University of Utah enrolled 244 hospital patients in the study who reported “intolerable pain” or “inadequate pain control” as a result of illness, disease or surgical procedures. Participants were randomly assigned to a single 15-minute session in one of three mind-body therapies: mindfulness, hypnotic suggestion or pain coping education.

All three types of intervention reduced the patients’ pain and anxiety, while increasing their feelings of relaxation.

Those who received hypnosis experienced an immediate 29 percent reduction in pain, while those who received mindfulness training had a 23 percent reduction and those who learned pain coping techniques experienced a 9 percent reduction.

Patients who received hypnosis or mindfulness training also had a significant decrease in their desire for opioid medication.

“About a third of the study participants receiving one of the two mind-body therapies achieved close to a 30 percent reduction in pain intensity,” said Eric Garland, lead author of the study and associate dean for research at the University of Utah’s College of Social Work. “This clinically significant level of pain relief is roughly equivalent to the pain relief produced by 5 milligrams of oxycodone.”

Garland’s previous research has found that multi-week mindfulness training programs can be an effective way to reduce chronic pain and decrease prescription opioid misuse. The new study added a new dimension to that work by showing that brief mind-body therapies can give immediate relief to people suffering from acute pain.

“It was really exciting and quite amazing to see such dramatic results from a single mind-body session,” said Garland. “The implications of this study are potentially huge. These brief mind-body therapies could be cost-effectively and feasibly integrated into standard medical care as useful adjuncts to pain management.”

Garland and his research team are planning a larger, national study of mind-body therapies that involve thousands of patients in hospitals around the country. Garland was recently named as director of the university’s new Center on Mindfulness and Integrative Health Intervention Development. The center will assume oversight of more than $17 million in federal research grants.

Many chronic pain patients are skeptical of mindfulness, cognitive behavioral therapy (CT) and other mind-body therapies, but there is evidence they work for some.

A recent study found that CBT lessened pain and improved function better than standard treatments for low back pain. Another study at Wake Forest University found that mindfulness meditation appears to activate parts of the brain associated with pain control.

You can experience a free 20-minute online meditation program designed to reduce pain and anxiety by visiting Meditainment.com.