By David Cosio, PhD, ABPP and Erica H. Lin, PharmD, BCACP
Last updated on: March 26, 2020
In almost all cases, a comprehensive approach to chronic, non-cancer pain should occur within the context of a multidisciplinary setting. In our article on pain education, we outlined the 12 education modules that go over 23 different modalities of pain management care. We start the series off with a look at hypnosis and biofeedback.
As new modalities are considered, the practitioner should focus on an individual’s physical and emotional reactions to their pain perception because they remain the avenues through which treatment approaches can provide relief. Some providers may want to begin practicing “integrative” medicine by adding more modalities to their existing repertoire, whereas others might be more comfortable informing their patients about other treatment modalities available for chronic pain.
The current evidence suggests that hypnosis2 and biofeedback3 are increasing in popularity as modalities of interest in the treatment of chronic, non-cancer pain. Although hypnosis and biofeedback rarely will provide a “cure” for chronic, non-cancer pain, they help patients self-regulate and influence their pain perception.4
Hypnosis Through the Ages
The earliest case reports describing hypnotic strategies for chronic pain management originally were published in the 1950’s,5,6 a time that also witnessed the release of biofeedback technology that helped individuals attain similar physiologic states.7
During the next few decades, knowledge about the stress response and its effects on an individual’s physiology greatly increased. As a result, a large number of studies were conducted investigating the efficacy of hypnosis and biofeedback in the treatment of several pain conditions, including chronic pelvic pain,8 fibromyalgia,9-12 headaches,13,14 irritable bowel syndrome/gastrointestinal conditions,15-17 lower back pain,18 multiple sclerosis,19 and temporomandibular pain.20
What Is Hypnosis?
Hypnosis is a procedure involving cognitive processes (such as imagination) in which a patient is guided by a health professional to respond to suggestions for changes in perceptions, sensations, thoughts, feelings, and behaviors.21 According to the Society of Psychological Hypnosis (Division 30), hypnosis involves learning how to use your mind and thoughts to manage emotional distress (such as anxiety); unpleasant physical symptoms (such as pain); and certain habits or behaviors (such as smoking). Sometimes, people also are trained in self-hypnosis, through which they learn to guide themselves during a hypnotic procedure.
