Hypnosis: Effective for Treatment of Pain?

Sometimes alternative medicine can seem a little whack to those of us most familiar with the typical examen, diagnose and prescribe routine used by most providers.  But just because a practice is unconventional, doesn't mean it is ineffective.  Hypnosis is certainly an out-of-the box method of managing pain, but maybe it works.  

Many studies have revealed that hypnosis is effective in modifying chronic pain and relieving stress and anxiety before surgery.  Patients using hypnosis have also been shown to require fewer medications and as well as have shorter hospital stays making the practice cost effective.  Many people, however view hypnosis as a little too out outside the norm.  Clinical psychologist Julie Schnur states that "Hypnosis is sort of the good kid with the bad reputation; it's a fantastic procedure and can be very effective and very helpful to patients but it does come with this baggage."  Let's debunk the myths associated with hypnosis as a medical treatment and evaluate it's efficacy in pain relief. 

What Exactly Is Hypnosis?

Contrary to popular belief, medical hypnosis is not a casino act in which a creepy middle aged man dangles a watch in front of the participant's face.  Medical hypnosis is more along the lines of meditation.  In medical hypnosis, a licensed therapist instructing the patient to relax deeply, usually with long, slow breaths and focus their attention intently.  Sometimes the therapist will ask the patient to imagine a serene location such as a beach.  Once relaxed, the therapist gives the patient soothing messages such as "You do not have the urge to smoke", or "Your pain is being lifted away".  According to the American Psychological Association, the goal of hypnosis is to minimize distraction, heighten responsiveness to suggestions and alter thoughts, feelings and behaviors.  Contrary to popular belief, during hypnosis the patient is not asleep or unconscious; they do not lose control of their actions notes Harold Pass, professor of clinical psychiatry.

How Does Hypnosis Work?

We aren't certain of the exact mechanisms behind hypnosis but researchers have been chipping away at the question giving us some limited insight.  A study done by Cornell University used MRI to examen the brains of hypnotized individuals.  Researchers found that when hypnotized, the brain shows decreased activity in areas involved in visual processing as well as areas of the brain handling conflict.  Dr. Michael Posner believes the decreased activity in these areas of the brain leaves people more accepting of the instructions given to them under hypnosis.  A study released earlier this month in the Archives of General Psychiatry indicates that individuals having a high level of control over their neurological pathways controlling memory, attention, motor planning and conflict resolution are more likely to be effectively hypnotized. More research is needed to evaluate these neurological networks to further identify exctly how hypnosis affects the brain's function.

Is Hypnosis Effective for Chronic Pain Relief?

Research indicates that hypnosis is largely effective in relief of chronic pain.  A group of psychologists reviewed 18 studies on hypnosis and pain relief finding that 75% of study participants with different types of pain achieved substantial pain relief from hypnotic techniques.  Hypnosis has also been shown to relieve acute pain associated with child birth, burns, dental work and various surgical procedures. 

Despite these studies, some providers remain skeptical.  Michael Clark, director of the Pain Treatment Program at John Hopkins University states that there really isn't overwhelming evidence that hypnosis is effective for treatment of chronic pain, but there is some evidence nonetheless.  He also notes that hypnosis "doesn't really have any serious risk associated with it; it may not have a huge evidence base, but the risk-benefit equation is favorable".

Should You Recommend Hypnosis for Treatment of Pain in You Patients?

Based on the stereotypes hypnosis carries, some of your patients may think you are 'out of your mind' if you recommend they get hypnotized.  For others, the recommendation may not seem so foreign.  Hypnotic therapy may be a good option for your patients suffering from chronic pain who are either open to alternative therapies or who have failed all other available medical treatment options.  With essentially no risk, it may be worth a try.