Hypnosis offers new hope for people with spinal cord injury pain

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Hypnosis was effective in helping people with recent spinal cord injuries learn coping strategies to fight chronic pain, a new study shows. Almost 90% of participants reported benefit from the treatment.

Now a University of Washington School of Medicine psychologist and colleagues are planning a larger study in hopes of making a difference for people who often have pain resistant to biomedical treatment.

Once the province of variety-show hucksters wielding pocket watches, hypnosis appears to have real value in modern medicine.

Clinical hypnosis is absolutely different from entertainment hypnosis. Clinical hypnosis is really focused on accessing and leveraging the parts of your brain that do things for you automatically. Your brain does hundreds of things for you on a daily basis, like breathing and blinking."

Amy Starosta, Assistant Professor, Department of Rehabilitation Medicine, University of Washington School of Medicine

Starosta tries to hard-wire cognitive therapy practices into the brain so that, when patients begin to experience pain, they automatically redirect how they experience the sensation.

Hypnosis has long been used to treat pain and other conditions, Starosta said. Her study is the first, she said, to examine the effects of hypnosis in an inpatient rehabilitation setting — before chronic pain emerged from a recent spinal cord injury.

In her recent study, 71% percent of the 53 participants completed at least three hypnosis sessions. Of those, 88% reported benefit from, and satisfaction with, the treatment. The findings are detailed in their paper, published in Archives of Physical Medicine and Rehabilitation.

Acute pain following a spinal cord injury is common and can negatively affect rehabilitation.

"We specifically targeted this population because we know that pain is so prevalent and such an impactful thing that they have to live with," Starosta said. "If we could help give people strategies to cope with pain or maybe even prevent pain, then we might be able to improve their quality of life from the beginning of their rehabilitation."

Starosta recently received a grant from the Craig H. Neilsen Foundation for a larger randomized trial after completing the pilot study that indicated that the treatment has merit. Study recruitment will begin this fall and continue at Harborview Medical Center for the next three years. Starosta and her team will examine the effect of the intervention for patients during hospitalization and after their discharge.

The authors also published a case study in the Journal of Clinical Medicine about the treatment of a patient on a ventilator, who struggled to communicate or relax.

"The other piece that's really exciting for us is that this was a really brief intervention," she said. "So many studies or interventions that we see are eight to 12 sessions that are done on an outpatient basis. They require the patient to keep coming in and setting up ways of accessing that care. We think this is something that can be taught quickly, accessed easily and is broadly helpful."

Source:
Journal reference:

Starosta, A. J., et al. (2023). Feasibility of brief, hypnotic enhanced cognitive therapy for SCI- related pain during inpatient rehabilitation. Archives of Physical Medicine and Rehabilitation. doi.org/10.1016/j.apmr.2023.06.005.

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