Hypnotic treatment of chronic pain

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J Behav Med. 2006 Feb;29(1):95-124

Hypnotic treatment of chronic pain.

Jensen M, DR.

Department of Rehabilitation Medicine, University of Washington

School of Medicine, Seattle, Washington, USA.

This article reviews controlled trials of hypnotic treatment for

chronic pain in terms of: (1) analyses comparing the effects of

hypnotic treatment to six types of control conditions; (2) component

analyses; and (3) predictor analyses. The findings indicate that

hypnotic analgesia produces significantly greater decreases in pain

relative to no-treatment and to some non-hypnotic interventions such

as medication management, physical therapy, and education/advice.

However, the effects of self-hypnosis training on chronic pain tend

to be similar, on average, to progressive muscle relaxation and

autogenic training, both of which often include hypnotic-like

suggestions. None of the published studies have compared hypnosis to

an equally credible placebo or minimally effective pain treatment,

therefore conclusions cannot yet be made about whether hypnotic

analgesia treatment is specifically effective over and above its

effects on patient expectancy. Component analyses indicate that

labeling versus not labeling hypnosis treatment as hypnosis, or

including versus not including hand-warming suggestions, have

relatively little short-term impact on outcome, although the hypnosis

label may have a long-term benefit. Predictor analyses suggest that

global hypnotic responsivity and ability to experience vivid images

are associated with treatment outcome in hypnosis, progressive

relaxation, and autogenic training treatments. The paper concludes

with a discussion of the implications of the findings for future

hypnosis research and for the clinical applications of hypnotic

analgesia.