Hypnosis as a treatment of chronic widespread pain in general practice: a randomized controlled pilot trial

Jan Robert Grøndahl, Elin Olaug Rosvold, Jan Robert Grøndahl, Elin Olaug Rosvold

Abstract

Background: Hypnosis treatment in general practice is a rather new concept. This pilot study was performed to evaluate the effect of a standardized hypnosis treatment used in general practice for patients with chronic widespread pain (CWP).

Methods: The study was designed as a randomized control group-controlled study. Sixteen patients were randomized into a treatment group or a control group, each constituting eight patients. Seven patients in the treatment group completed the schedule. After the control period, five of the patients in the control group also received treatment, making a total of 12 patients having completed the treatment sessions. The intervention group went through a standardized hypnosis treatment with ten consecutive therapeutic sessions once a week, each lasting for about 30 minutes, focusing on ego-strengthening, relaxation, releasing muscular tension and increasing self-efficacy. A questionnaire was developed in order to calibrate the symptoms before and after the 10 weeks period, and the results were interpolated into a scale from 0 to 100, increasing numbers representing increasing suffering. Data were analyzed by means of T-tests.

Results: The treatment group improved from their symptoms, (change from 62.5 to 55.4), while the control group deteriorated, (change from 37.2 to 45.1), (p = 0,045). The 12 patients who completed the treatment showed a mean improvement from 51.5 to 41.6. (p = 0,046). One year later the corresponding result was 41.3, indicating a persisting improvement.

Conclusion: The study indicates that hypnosis treatment may have a positive effect on pain and quality of life for patients with chronic muscular pain. Considering the limited number of patients, more studies should be conducted to confirm the results.

Trial registration: The study was registered in ClinicalTrials.gov and released 27.08.07 Reg nr NCT00521807 Approval Number: 05032001.

Figures

Figure 1
Figure 1
Float diagram of participants in the study.
Figure 2
Figure 2
Hypnosis in general practice – how is it done?
Figure 3
Figure 3
Symptom score before and after the treatment period in the treatment group and before and after the control period in the control group, (Blue and purple columns). The results for the five patients in the control group who later received treatment is included (white column).

References

    1. Wolfe F, Smythe H, Yunus M, et al. The American College of Rheumatology 1990 Criteria for the classification of Fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum. 1990;33:160–72. doi: 10.1002/art.1780330203.
    1. Abusdal UG, Hagen KB, Bjørndal A. Chronic muscular pain among women in Oslo. Journal of The Norwegian Medical Association. 1997:1606–10.
    1. Forseth KØ. Musculoskeletal pain and fibromyalgia: prevalence, incidence, natural history and predictors. 2000. ISBN 82-7722-126-6.
    1. Natvig B. Musculoskeletal pain. From humdrum nuisance to chronic, disabling disease. 2001. ISBN 82-7703-070-3.
    1. Ohrbach R, Blasovich J, Gale EN, McCall WD, Jr, Dworkin SF. Psychophysiological assessment of stress in chronic pain: comparisons of stressful stimuli and of response systems. J Dent Res. 1998;77:1840–50.
    1. Westgaard RH. Effects of physical and mental stressors on muscle pain. Scand J Work Environ Health. 1999;25:19–24.
    1. Nampiaparampil DeviE, Shmerling RobertH. A review of fibromyalgia. Am J Manag Care. 2004;10:794–800.
    1. Castel A, Perez M, Sala J, Padrol A, Rull M. Effect of hypnotic suggestion on fibromyalgic pain: comparison between hypnosis and relaxation. Eur J Pain. 2007;11:463–8. doi: 10.1016/j.ejpain.2006.06.006.
    1. Wik G, Fischer H, Brage B, Finer B, Fredrikson M. Functional anatomy of hypnotic analgesia: a PET study of patients with fibromyalgia. Eur J Pain. 1999;3:7–12. doi: 10.1016/S1090-3801(99)90183-0.
    1. Elkins G, Jensen MP, Patterson DR. Hypnotherapy for the management of chronic pain. Int J Clin Exp Hypn. 2007;55:275–87. doi: 10.1080/00207140701338621.
    1. Fors EA, Sexton H, Gøtestam KG. The effect of guided imagery and amitriptyline on daily fibromyalgia pain. Journal ofPsychiatric Research. 2002;36:179–187. doi: 10.1016/S0022-3956(02)00003-1. Abstract PubMed.
    1. Buchser E. Hypnose und selbsthypnose von pflegenden angewandt undt instruiert zwecks lindering chronischer schmerzen: eine kontrollierte klinische studie. (Hypnosis and self-hypnosis administered and taught by nurses for relief of chronic pain: a controlled clinical trial) Forsh Komplementarmed. 1999;6:41–3. doi: 10.1159/000057131.
    1. Haanen HC, et al. Controlled trial of hypnotherapy in the treatment of refractory fibromyalgia. J Reumatol. 1991;18:72–5.
    1. Kirkewood BR, Sterne JA. Essential Medical Statistics. Oxford: Blackwell Science Ltd; 2003. pp. 400–1.
    1. Hillestad PO. Wormnes b, – Hypnose. Teori, utvikling, metode. (Hypnosis Theory, development, method) Tano. 1990. ISBN 82-518-2794-9 55-72.
    1. Taylor WJ, Myers J, Simpson RT, et al. Quality of life of people with rheumatoid arthritis as measured by WHO-BREF: score distribution and psychometric properties. Arthritis Rheum. 2004;15:350–7. doi: 10.1002/art.20398.
    1. Ihlebæk C, Eriksen HR, Ursin H. Prevalence of subjective health complaints (SHC) in Norway. Scand J Public Health. 2002;30:19–29.
    1. Strand BH, Dalgard OS, Tambs K, Rognerud M. Measuring the mental health status of the Norwegian population: a comparison of the instruments SCL-25, SCL-10, SCL-5 and MHI-5 (SF-36) Nord J Psychiatry. 2003;57:113–8. doi: 10.1080/08039480310000932.
    1. Kirkewood BR, Sterne JA. Essential Medical Statistics. Oxford: Blackwell Science Ltd; 2003. pp. 444–6.
    1. Lambe R, Osier C, Franks P. A randomized controlled trial of hypnotherapy for smoking cessation. J Fam Pract. 1986;22:61–5.
    1. Roberts L, Wilson S, Singh S, Roalfe A, Greenfield S. Gut-directed hypnotherapy for irritable bowel syndrome: piloting a primary care-based randomized controlled trial. Br J Gen Pract. 2006;6:115–21.

Source: PubMed

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