Highlights
- •Hypnosis can be combined with education in patients with chronic low back pain.
- •The addition of hypnosis improves pain intensity, disability, and catastrophizing.
- •The beneficial effects are enhanced, at least in the short- and medium-term.
- •The intervention can be offered in group settings.
Abstract
The potential benefits of combining pain education (PE) with clinical hypnosis (CH)
has not yet been investigated in individuals with chronic pain. A total of 100 patients
with chronic nonspecific low back pain were randomized to receive either: 1) PE alone,
or 2) PE with CH. Outcomes were collected by a blinded assessor at 2 weeks and 3 months
after randomization. The primary outcomes were average pain intensity, worst pain
intensity (both assessed with 11-point numeric rating scales), and disability (24-item
Roland Morris Disability Questionnaire) at 2 weeks. At 2 weeks, participants who received
PE with CH reported lower worst pain intensity (mean difference = 1.35 points, 95%
confidence interval [CI] = .32–2.37) and disability (mean difference = 2.34 points,
95% CI = .06–4.61), but not average pain intensity (mean difference = .67 point, 95%
CI = −.27 to 1.62), relative to participants who received PE alone. PE with CH participants
also reported more global perceived benefits at 2 weeks (mean difference = −1.98 points,
95% CI = −3.21 to −.75). At 3 months, participants who received PE with CH reported
lower worst pain intensity (mean difference = 1.32 points, 95% CI = .29–2.34) and
catastrophizing (mean difference = 5.30 points, 95% CI = 1.20–9.41). No adverse effects
in either treatment condition were reported. To our knowledge, this is the first trial
showing that additional use of hypnosis with PE results in improved outcomes over
PE alone in patients with chronic nonspecific low back pain.
Perspective
This study provides evidence supporting the efficacy of another treatment option for
teaching patients to self-manage chronic low back pain that has a relatively low cost
and that can be offered in groups.
Key words
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Article info
Publication history
Published online: April 11, 2018
Accepted:
March 15,
2018
Received in revised form:
February 6,
2018
Received:
November 28,
2017
Footnotes
R.R.N.R. is an instructor of Continuous Education Courses of Clinical Hypnosis and Pain Education for chronic pain conditions, and his masters scholarship was supported by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Brazil. M.P.J. is the author of 3 books on hypnosis, and receives royalties for the sale of these books. The remaining authors have no conflicts of interest to declare.
Supplementary data accompanying this article are available online at www.jpain.org and www.sciencedirect.com.
Identification
Copyright
© 2018 by the American Pain Society
