Pain is something that practically everyone has experienced at some point in their lives. For the most part, it is a key aspect to our survival and helps us to avoid danger where possible. The sharp soreness of a grazed knee teaches us to move with care, and a brush with a stinging nettle can imprint a lasting impression to leave the plant alone. These unpleasant sensory experiences can resemble or result in damage to our bodies, leaving lifelong lessons on how best to keep ourselves safe and healthy.
However, there is also a darker side to pain. Sometimes pain can be a symptom of a condition, but that condition is going nowhere fast. We can experience pain alongside a long-term illness or injury, where it no longer is appreciated as a useful function and can make daily life difficult to enjoy.
A survey conducted by the NHS in 2019 revealed that 34% of adults in the UK suffer from some kind of chronic pain, with some literature suggesting that the number may be as high as 51% (Fayaz, 2016). For those over the age of 75, the number rises still to 62%.
These statistics highlight the widespread need to find a way to manage pain and restore quality of life to those living with it. There are many methods used, each with its own merit, but where does hypnotherapy stand as a part of the toolkit? We looked at some peer-reviewed literature to find out.
Recent clinical trials are a great way to see the latest findings. Rigorous efforts will have been made to keep the testing as fair and unbiased as possible, with a focus on good quality evidence.
In 2021, Prasetya, Kusumawati & Wardiyatmi released their findings from a randomised controlled clinical trial examining the effectiveness of hypnotherapy in reducing pain in people suffering with cervical cancer, over a period of 8 months. Ninety people were involved in the trial, with the group randomly split into two groups of 45. One group received standard medical treatment, with the other group also receiving hypnotherapy on top of standard medical care. For the hypnotherapy group, they were given sessions once a day over seven consecutive days at the start of the trial. All of the participants were asked to rate their levels of pain regularly from a scale of 0-10, and over the 8 months, their ratings were compared. The results showed that the mean pain scores from the hypnotherapy group (0.8/10) were significantly lower than the standard care group who had a mean score of 3.2/10.
Literature reviews and meta-analyses do a lot of the hard work for you and cover a large number of studies all at once. There is no written rule on what qualifies for the studies that are analysed, so each meta-analysis will have different levels of quality and depth.
A meta-analysis from 2013, although a few years old, had a high bar for quality when examining the evidence for hypnotherapy and its effectiveness against chronic pain. Adachi et al. sorted through hundreds of studies to find 15 clinical trials that fit their criteria for the highest-quality studies examining hypnotherapy and the benefits it could have for chronic pain. Their examination of the data revealed that hypnosis was moderately effective for managing chronic pain compared to those receiving standard care alone, after the initial intervention. With the exception of headaches, hypnosis also resulted in a significant moderate effect for reducing chronic pain when compared to an assortment of other psychological interventions. Further analysis revealed that in studies which had follow-ups after a long period of time, hypnosis had a superior efficacy compared to other psychological interventions. This means that not only was hypnotherapy more effective but that it also had long-lasting results. Adachi et al. went on to compare the data from their meta-analysis on hypnosis with a meta-analysis on CBT, and saw that Hypnotherapy seemed to have a greater effect size which may suggest that hypnosis could compete with CBT for effectiveness with pain management. They went on to suggest further study in this area for a more definitive comparison between hypnosis and CBT for chronic pain.
When considering evidence and seeking answers, there is a balance to be had for the value of quality versus quantity. Large trials and meta-analyses can cover vast numbers of people, but the details of the efficacy of an intervention such as hypnotherapy can be oversimplified when someone’s experience is reduced to numbers on a scale. This is where it can also be beneficial to look at case studies to better understand the improvements that can be made to a person's life.
Early in 2022, Thomson published a case study detailing the story of a 17-year-old female who had been suffering with complex regional pain syndrome four years before receiving hypnotherapy. During a difficult divorce between her parents, the teenager received a mild injury to her right foot whilst playing hockey. Over time, the symptoms spread to her left foot, then to her knees and hands. The young woman had previously been a dancer and an athlete before her symptoms forced her to stop pursuing her hobbies. After her initial diagnosis, the subject was given various therapies, ranging from pharmacological to physical therapies. After the four previous years of treatment with limited success, hypnotherapy was recommended. The subject of the case study received four hypnotherapy sessions. The hypnosis allowed the subject to change her behaviour and outlook, creating goals and increasing feelings of hope. Her condition improved dramatically with a near complete resolution of her symptoms.
Looking at the evidence above, hypnotherapy could certainly argue a case for a more integral role in the management of pain. This is, of course, not to say that hypnotherapy should ever be used to replace medical treatment for pain, but more to the point that the body and the mind should both be taken into consideration during the healing process. Whilst pain is a physical sensation, the emotional toll that it can take can arguably be just as devastating and our treatment of it could benefit from reflecting that.