Hypnotherapy and pain management

In this article, we will discuss how hypnotherapy may be able to help reduce the impact of chronic pain. You may have heard about hypnosis being used to help with operations, a toothache, or dental treatment. This more short-term type of pain is often referred to as 'acute pain'. However, we will discuss using hypnosis to help discomfort or pain which has lasted for a number of weeks or months. This longer-lasting pain is usually referred to as 'chronic pain'. We will outline conditions with which chronic pain management hypnotherapy can help. We will also discuss the main interventions a hypnotherapist may use.

What is chronic pain?

As mentioned, we can view pain as either acute or chronic. Acute pain is normally experienced for a short period of time. It may be the result of an illness or accident. Acute pain is normally treatable with prescribed pain killers. Importantly for us, acute pain, though unpleasant, is 'needed'. Let's explain this by using an example. I used to love running. In fact, I have run several 10k runs and a half marathon. However, a few years back I began to get severe pain in my knee. The discomfort was enough that I went to see my doctor to find out what was the trouble. Sadly the doctor told me that I had damaged some cartilage and advised me not to run anymore. As you can see, this acute pain was in fact 'needed'. My body had to send me a signal to stop running and stop putting pressure on that spot. The pain was needed to prevent me causing more damage. Often, acute pain is a quick way to of sending information to warn of danger or to avoid further damage. 

Chronic pain is often more complicated. As we will discuss, in fact sometimes chronic pain isn't strictly 'needed' at all. It may be an unwanted side effect and hold someone back from living their life fully. Chronic pain may be a result of a medical condition, or on occasion, there may not be any obvious cause at all. This doesn't mean the pain isn't real, since to the sufferer it is very real. However, it just makes treatment that much more complex.

I became interested in how pain works when working alongside cancer patients in a hospice. I have worked in three hospices and saw often how pain can have an enormous effect on mood, anxiety, and relationships. For some people with cancer, their pain certainly is not 'needed'. The pain can be caused from inflammation, a tumor pushing on a nerve, or something similar. These pains can be debilitating and compromise the quality of life. They do not have a helpful message but are rather an unwelcome side effect of cancer.

Whilst working with cancer patients, it became very clear that chronic pain was a complicated issue. The good news is that research studies have shown hypnotherapy to be effective in many cases. However, it is clear that there are no 'magic wands', and a variety of approaches are needed to help lessen pain, improve independence, and help sufferers cope with the emotional impact, too. This motivated me to create a hypnotherapy pain management programme which would take into consideration the extra dimensions chronic pain can have.

Which long term conditions has hypnotherapy been shown to help?

There are several conditions for which hypnotherapy can help reduce the impact pain may have on everyday life. Below are a few examples.

Fibromyalgia

Symptoms of fibromyalgia can include widespread aches with muscles feeling stiff. Physical therapy, painkillers, and relaxation therapies are normally advised. Hypnotherapy and mindfulness may be able to help too.

Cluster headaches and migraines

Cluster headaches involve a sudden and sharp pain. This can last anything from 15 minutes to a few hours and can be very painful.

Endometriosis

This gynaecological condition occurs when cells similar to those found in the womb are also found elsewhere. Though some women experience no pain at all, many do experience severe period pain, pelvic pain, and pain during or after sex.

Sciatica and back pain

Sciatica occurs when the sciatic nerve is irritated by the back. This can often occur after a slipped disc. The result is an ache down the leg for sufferers. Back pain is very common, with a number of different causes. Some back pains may be caused by a previous injury or the overuse of muscles.

Cancer

As mentioned, unfortunately, many people who develop cancer will experience pain at some point. Again, this pain is not necessarily 'needed', and can be very debilitating. Often, opioids or other drugs work well but result in drowsiness. The degree of pain will be dependent on individual circumstances.

Multiple sclerosis (MS)

MS affects the brain, nerves, and spinal cord. Many MS sufferers will experience pain. This discomfort can either be due to pressure on muscles/joints or 'neuropathic', where damaged nerve fibres cause a burning/stabbing sensation. 

Arthritis

Arthritis causes inflammation and stiffening of the joints. With arthritis, pain can vary between people. Some have mild pain, whilst others experience more severe pain, which makes day-to-day activities difficult.

Research studies into the effectiveness of hypnotherapy for pain management

The good news is that several respected studies have demonstrated that hypnotherapy can help some chronic pain sufferers. Even when the physical pain itself was not affected, people felt more able to cope, and their quality of life improved. Of course, another plus is that hypnotherapy involves no drugs and so has no significant side effects. People increasingly are looking for alternatives to medication, so it is wonderful that there is now evidence for the use of hypnotherapy in this area.

A study at the University of Washington, published in 'American Psychologist' in 2014, demonstrated that hypnotherapy can have a positive effect on chronic pain sufferers. The study found that, for some, their pain was reduced, and for most participants they found their overall well-being and outlook improved. They gained better sleep and more confidence as well. Importantly, as mentioned, the hypnotherapy intervention had no side effects.

In 2005, Drs. Rumi Peynovska, Jackie Fisher, David Oliver, and Prof V.M. Mathew, published findings in the European Journal of Clinical Hypnosis. They reported on research indicating the positive effect of hypnotherapy for decreasing pain and anxiety of NHS cancer patients in Kent.

Clinical research published in the International Journal of Clinical and Experimental Hypnosis has shown hypnosis to be effective in reducing pain for people with a number of conditions including cancer, lower back pain, arthritis, fibromyalgia, and chronic pain.

An article published in the British Journal of General Practice, in 2006, showed that pain related to irritable bowel syndrome (IBS) could be reduced by 'gut-directed hypnotherapy'. The study showed considerable improvement among adult participants. Research, published in the British Medical Journal in 2012, also showed significant improvement for children with IBS using hypnotherapy.

What can you expect during hypnotherapy for chronic pain management?

As you can imagine, hypnotherapy will need to address your specific needs and circumstances. Hypnotherapy interventions will often involve visualisations to help you decrease the intensity of the pain you feel. For example, IBS 'gut-directed hypnotherapy' involves using visualisations to calm the gut and digestive systems.

As well as visualisations, an important part of the process will be to look at your thoughts and beliefs about illness and pain. This work is very important to help you put in place better psychological coping mechanisms. Unlike most acute pains, chronic pain and long term illness itself can result in the neglect of friendships, exercise, eating healthily, and feeling optimistic. Holistic pain management should include working with you to improve these as well. Often, pain interferes with sleep and anxiety levels and these may be looked as well.

Studies have shown the benefit of using relaxation or visualisation recordings between sessions. If appropriate, you will be given you a recording to listen to between sessions to ensure you are working on your goals independently. This may include some self hypnosis training too.
 
Pain is often complicated, and your hypnotherapist may ask about any medical diagnosis, medication, and previous interventions you may have had. In some cases, it can be beneficial for you to share, if possible, a summary of your medical history.

Hypnotherapy can be very powerful and effective. However, it is vitality important to remember that a hypnotherapist is never a substitute for appropriate medical care. If you have discomfort or pain, ensure you have seen your GP or consultant. If you are considering hypnotherapy for chronic pain management, you may wish to discuss this with them first also.

Hypnotherapy is a wonderful evidence-based, non-medication and, most importantly, a side-effect free intervention to help you deal well with how pain has impacted on your family, emotions, resilience, motivation, or thoughts about your future.