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Hypnosis & Hypnotherapy for Pain,

                               

Hypnosis is not routinely used in general treatment programs in the United States, but is garnering more attention is recent years, as scientists search for effective, holistic treatment options for chronic pain. Many small studies have shown that hypnosis can provide at least temporary pain relief, and may also lead to a reduction in pain over time. Such approaches to pain management can enhance quality of life and reduce disability related to chronic pain.

                                                 

The current study involved 16 men and women, aged 23 to 54 years, who were randomized to a treatment group or a non-treatment control group. The treatment group participated in 30-minute hypnosis treatment sessions once weekly for 10 weeks. Both groups continued to receive standard treatments, including analgesic and antidepressant drugs, physiotherapy, and chiropractic therapy. After the initial 10-week treatment period, the patients in the control group were offered hypnosis therapy. Patients completed a 25-item questionnaire evaluating pain, fatigue, concentration problems, activities of daily living, pain interference in work and social life, anxiety and pessimism, and overall quality of life. These subjective scores were rated on a scale from 1 to 100, with higher numbers representing more suffering.

                                   

In total, 7 patients from the initial treatment group, plus 5 from the original control group, completed hypnosis therapy. These 12 patients experienced a significant reduction in pain and suffering scores, with a mean improvement of 9.9 points, from 51.5 to 41.6. The 7 patients from the initial treatment group experienced a significant score reduction from 62.5 to 55.4. The 5 patients who completed hypnosis treatment after participating in the control group experienced a near 13-point improvement in functioning, with scores decreasing from 35.97 to 23.54. The 8 patients in the initial control group showed an increase in suffering, with a near 8-point score increase from 37.2 to 45.1.

                                    

All 12 patients that completed hypnosis therapy completed follow-up after 1 year, and reported a score of 41.3, indicating maintenance of quality of life improvement. All of the patients reported using self-hypnosis methods at least once weekly during the year and would have taken advantage of additional hypnosis therapy if it had been available.

                                                 

Seth-Deborah Roth CRNA,CCHt,CI

MRI Study Shows How Hypnosis Eases Pain:

Presented at the 17th Meeting of the European Neurological Society, (ENS).

By Thomas S. May.                                  
Presentation title: MRI Study of Hypnosis-induced Analgesia. Abstract O156.                           
RHODES, GREECE -- June 19, 2007 –
                 
Hypnosis can result in a significant reduction in pain awareness, and the neuro-physiological correlates of this analgesic effect have now been identified by a functional magnetic resonance imaging (MRI) study that was presented here.                                   
                        
The study used 13 healthy subjects and tested them twice: once under hypnosis and once in a normal state. During each session, 200 laser stimuli with intensity ranging from 300 to 600 mJ were administered on the left hand. Subjects rated their sensations from P0 toP4 (P0: nothing perceived, P1: non-painful sensation ,P2: mild pain, P3: moderate pain, P4: intense pain).The researchers used f MRI scans taken during the two sessions to assess activation levels in various brain regions in response to the stimulation.                           
                          
The investigators found that there was a significant difference in the perception of higher intensity pain stimuli in the normal versus the hypnotic state (mean score 1.9±0.3 vs. 1.2±0.4, respectively), but not for the non-painful range of intensity (mean score 0.5±0.2vs. 0.4±0.3, respectively).                                   
                         
These results show that hypnosis is most effective at altering the perception of acute pain, the researchers concluded. "Perception of intense pain was significantly altered while participants were under hypnosis," said Steven Laureys, MD, PhD, director, Coma Science Group, University of Liege, Liege, Belgium. "However, for levels of pain at the low end of the scale, hypnosis barely altered perception of the stimuli," Dr. Laureys stated.                               

In the normal state, high-intensity (painful) compared to low-intensity (non-painful) stimuli induced greater activation in the (bilateral) thalamus, primary somato-sensory cortex (S1), insula, and the anteriorcingulate cortex. But in the hypnotic state, high-intensity compared to low-intensity stimuli resulted in significantly greater activation in areaS1 only, Dr. Laureys reported. There was no significant difference in activation levels in the bilateral thalamus, left insula and bilateral anteriorcingulate cortex during high-intensity vs. low- intensity stimulation in subjects under hypnosis, he noted.                                                
                                      
"We were able to clearly demonstrate, at the level of neural mechanisms, that hypnosis has actual effects in reducing pain perception," said Dr. Laureys. "It appears that pain continues to be registered in the primary somato-sensory cortex," he explained, "but other areas of the brain involved in pain perception, such as the anterior cingulated gyrus, which allows sensory stimuli to trigger appropriate physical reactions and affect emotions, respond to painful stimuli significantly less in the hypnotic state, as compared to the normal state."

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