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Hypnosis has been used to reduce pain in a number of painful clinical conditions as well as experimental pain (Jensen et al. 2000). Hypnosis is appealing as a potential treatment because it is non-pharmacological although its use is controversial given the variability in hypnotic responsiveness.

Table 11 Hypnotic Suggestion Post-SCI Pain

Author Year

Country

PEDro Score

Research Design

Total Sample Size

MethodsOutcome
Jensen et al. 2009

USA

RCT

PEDro=5

N=37

Population: Mean Age=49.6yrs; Sex: males=28, females=9. Type of pain=neuropathic.

Intervention: Participants were randomized to receive either hypnosis or biofeedback. Individuals receiving hypnosis underwent 10 sessions of training daily or weekly. While the biofeedback group received 10 sessions of Electromyography biofeedback.

Outcome Measures: Numeric Rating Scale (NRS)

1.     Individuals with neuropathic pain a significant decrease in daily pain intensity was seen in the hypnosis group post-session (p<0.01) but not the biofeedback group.

2.     Neither treatment was effective in reducing pain for individuals without neuropathic pain.

Jensen et al. 2000

USA

Pre-post

N=22

Population: Age=24-76 yr; Gender: males=64%, females=36%; Time since injury=1.75-42.33 yr; Duration of pain=13.88 yr. Type of pain=neuropathic and musculoskeletal.

Treatment: Hypnotic suggestions for pain relief were given to each subject.

Outcome Measures: Pain intensity and unpleasantness and hypnotic responsiveness (modified version of the Stanford Hypnotic Clinical scale).

 

 

 

1.     86% reported decrease in pain intensity and unpleasantness from pre-induction to just after induction.

2.     A significant time effect emerged for both pain intensity (p<0.001) and pain unpleasantness (p<0.001).

3.     Significant effect for analgesic suggestion on pain intensity over and above the effects of the induction alone, with a significant decrease occurring in reported pain intensity before and after the analgesic suggestion (p<0.05).

4.     Pre-induction, post-induction, and post-analgesia suggestion pain intensity ratings were all significantly lower than average pain during the previous 6 months (p<0.01, p<0.0001, p<0.0001 respectively).

5.     Statistical significance was noted for two of the associations: Effect of pain plus analgesia suggestion on pain intensity (p<0.01) and effect of induction alone relative to least pain (p<0.05).

Discussion

Jensen et al. (2009) randomly allocated participants into hypnosis or the biofeedback treatment group. Participants in the hypnosis group reported a significant decrease in neuropathic pain intensity compared to those in the biofeedback group (p<0.01). However, no such effect was seen between the two groups in individuals without neuropathic pain. Jensen et al. (2000), in a before and after study, examined the impact of hypnosis on pain post-SCI. Eighty-six percent of the SCI patients reported a decrease in pain intensity and unpleasantness after hypnosis, although there was no control group.

Conclusion

There is level 2 and level 4 evidence (from one randomized controlled trial and one pre-post study; Jensen et al. 2009, 2000) that hypnosis reduces neuropathic and musculoskeletal pain intensity post SCI.

Hypnosis may reduce neuropathic and musculoskeletal pain intensity post SCI.