miércoles, 12 de febrero de 2020

Hypnosis vs Painkillers

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By Dr. Sanchari Sinha Dutta, Ph.D.Reviewed by Dr. Jennifer Logan, MD, MPH

Chronic pain can be associated with many severe health conditions, as well as can reduce the overall quality of life. It is often difficult to treat chronic pain because the reason for pain often remains unidentified. On a positive note, recent studies have identified that hypnosis and hypnotherapy can act as an effective alternative intervention to medication to treat both active and chronic pain.

Image Credit: Kaspars Grinvalds / Shutterstock

What is pain?

Pain can be of two types: acute pain and chronic pain. Acute pain is a short-term pain sensation that can be caused by physical injuries or temporary illness. In contrast, chronic pain can persist for a longer time and is mainly associated with serious health complications, such as arthritis and fibromyalgia.

The management of chronic pain is a very complex process because the causative factors for pain induction notably vary from person to person. Therefore, proper diagnosis is important in order to identify an effective treatment plan.

Mostly, doctors recommend pain medications as a treatment option. These medicines include non-steroidal anti-inflammatory drugs, acetaminophen, COX-2 inhibitors, antidepressants, opioids, and anti-seizure medicines. However, all these medicines come with mild-to-moderate side-effects. The major drawback of taking pain killers is that one can become addicted or tolerant, even to over-the-counter medications.

A growing pool of recent evidence suggests that hypnosis and hypnotherapy can be applied as an effective alternative to conventional pain therapies.

Hypnosis and pain

Hypnosis, also known as hypnotherapy or hypnotic suggestion, is a therapeutic process that is used to increase concentration, reduce distraction from surroundings, and improve responsiveness to suggestions for changing a person’s own believe/thoughts, feelings, behavior, or state of mind. Although hypnosis is not intended to be used as a sole treatment strategy, it is generally employed as a part of a treatment plan to significantly improve the intensity and efficacy of treatment.

Although hypnosis is found to be effective in the majority of people, some may be resistant to its effects. Several studies regarding hypnotic management of pain have clearly demonstrated that hypnosis is particularly effective in modulating psychological consequences of the pain experience.

Hypno-analgesia, which is a technique to reduce pain by hypnotic suggestion, is known to significantly reduce pain rating, the need for a hospital stay, and the requirement for analgesics. Patients who undergo hypnosis have been shown to have higher treatment-related satisfaction, improved overall quality of life, and increased physiological stability. These effects are maximum in patients who are highly motivated and receptive to hypnotic suggestions.

Recently, a study involving 3,500 patients has found that about 15% of patients exposed to heat-, cold-, pressure-, laser-, or exercise-induced pain were significantly receptive to hypnotic suggestions and experienced almost a 40% pain reduction. Moreover, patients who are moderately receptive to suggestions have been found to experience a 29% pain reduction. According to these findings, on an average, most of the patients will experience about 30% reduction in pain, which makes hypnosis a clinically significant pain reliever.

Many persons who take narcotic pain killers chronically become addicted to them. This has become a national crisis in many countries. In 2017, the number of people died in the US due to opioid overdose is estimated to be 47,000. Hypnosis can be applied employed to reduce the use of painkillers and their associated risks.

How hypnosis works to reduce pain?

Hypnosis works by altering the pattern of thoughts related to pain and allowing the mind to relax and focus on something pleasant. By temporarily bypassing the conscious brain signaling, hypnosis helps open up the mind to suggestions. The hypnotic suggestions are primarily aimed at reducing stress, anxiety, and fear related to pain and relaxing the nervous system to become less sensitive to pain signals.

Studies have found that hypnosis is able to alter the activity and connectivity of some brain parts. It has been found that there is a reduction in activity in the dorsal anterior cingulate cortex, which is involved in decision making, cognition, motivation, and motor control. Also, there is increased connectivity between the dorsolateral prefrontal cortex and insula, which makes a mind-body connection to help control the physiological processes of the body. Another important change in brain function by hypnosis is reduced connectivity between the dorsolateral prefrontal cortex and medial prefrontal and posterior cingulate cortex. This makes it possible to disconnect between a person’s activity and the awareness of activity, which is important to improve receptiveness to suggestions.

The number of the hypnotic session a patient needs depends on his/her responsiveness to the therapy. Usually, a patient requires about 4 – 10 sessions to get a satisfactory outcome. After a successful hypnotic session, a hypnotherapist may provide post-hypnotic suggestions so that the patient can continue with self-hypnosis and manage pain for a longer time.