Melissa L McKittrick1, Erin L Connors2,3, Lindsey C McKernan2,3,4. 1. Department of Anesthesiology, Vanderbilt University Medical Center (VUMC), Nashville, Tennessee, USA. 2. Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center (VUMC), Nashville, Tennessee, USA. 3. Osher Center for Integrative Medicine at Vanderbilt, Nashville, Tennessee, USA. 4. Department of Physical Medicine & Rehabilitation, Vanderbilt University Medical Center (VUMC), Nashville, Tennessee, USA.
Abstract
OBJECTIVE: Neuropathic pain is complex and often refractory. Clinical hypnosis has emerged as a viable treatment for pain. This scoping review is the first comprehensive review of hypnosis for chronic neuropathic pain. It critically assesses available evidence noting practice implications, literature gaps, and future research opportunities. SUBJECTS: Individuals with chronic neuropathic pain treated with hypnosis. METHODS: Following PRISMA guidelines, we searched PubMed, CINAHL, Embase, and PsycInfo for studies for which the intervention and primary outcome(s) were associated with hypnosis and neuropathic pain, respectively. Included studies were empirical, in English, and published from January 1996 to August 2021. RESULTS: Nine articles with 301 total participants were reviewed. Neuropathic pain included, for example, complex regional pain syndrome (CRPS), brachial neuralgia, and spinal cord injury. Hypnosis dose varied with administration and format. Six studies used comparators. Every trial demonstrated pain and quality-of-life benefits, with several controlled trials indicating hypnosis as superior to active comparator or standard of care. CRPS-specific studies showed notable improvements but had significant study limitations. Methodological weaknesses involved trial design, endpoints, and recruitment strategies. CONCLUSIONS: The evidence is weak because of poor study design, yet encouraging both for analgesia and functional restoration in hard-to-treat chronic neuropathic pain conditions. We highlight and discuss key knowledge gaps and identify particular diagnoses with promising outcomes after hypnosis treatment. This review illustrates the need for further empirical controlled research regarding hypnosis for chronic neuropathic pain and provides suggestions for future studies.
OBJECTIVE: Neuropathic pain is complex and often refractory. Clinical hypnosis has emerged as a viable treatment for pain. This scoping review is the first comprehensive review of hypnosis for chronic neuropathic pain. It critically assesses available evidence noting practice implications, literature gaps, and future research opportunities. SUBJECTS: Individuals with chronic neuropathic pain treated with hypnosis. METHODS: Following PRISMA guidelines, we searched PubMed, CINAHL, Embase, and PsycInfo for studies for which the intervention and primary outcome(s) were associated with hypnosis and neuropathic pain, respectively. Included studies were empirical, in English, and published from January 1996 to August 2021. RESULTS: Nine articles with 301 total participants were reviewed. Neuropathic pain included, for example, complex regional pain syndrome (CRPS), brachial neuralgia, and spinal cord injury. Hypnosis dose varied with administration and format. Six studies used comparators. Every trial demonstrated pain and quality-of-life benefits, with several controlled trials indicating hypnosis as superior to active comparator or standard of care. CRPS-specific studies showed notable improvements but had significant study limitations. Methodological weaknesses involved trial design, endpoints, and recruitment strategies. CONCLUSIONS: The evidence is weak because of poor study design, yet encouraging both for analgesia and functional restoration in hard-to-treat chronic neuropathic pain conditions. We highlight and discuss key knowledge gaps and identify particular diagnoses with promising outcomes after hypnosis treatment. This review illustrates the need for further empirical controlled research regarding hypnosis for chronic neuropathic pain and provides suggestions for future studies.
Authors: Lindsey C McKernan; Michael T M Finn; Leslie J Crofford; A Gracie Kelly; David R Patterson; Mark P Jensen Journal: Int J Clin Exp Hypn Date: 2022-07-14