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Cited by 50Pain Management and Placebo EffectMusculoskeletal pain and rehabilitationPain Management and Treatment

Hypnosis enhances the effects of pain education in patients with chronic nonspecific low back pain: a randomized controlled trial

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Rizzo, Rodrigo R.N., Medeiros, Flavia C., Pires, Leandro G., Pimenta, Rafael M., McAuley, James H., Jensen, Mark P., Costa, Leonardo O.P.·2018·The Journal of Pain
DOI 10.1016/j.jpain.2018.03.013
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Abstract

The potential benefits of combining pain education (PE) with clinical hypnosis (CH) has not yet been investigated in individuals with chronic pain. A total of 100 patients with chronic nonspecific low back pain were randomized to receive either: 1) PE alone, or 2) PE with CH. Outcomes were collected by a blinded assessor at 2 weeks and 3 months after randomization. The primary outcomes were average pain intensity, worst pain intensity (both assessed with 11-point numeric rating scales), and disability (24-item Roland Morris Disability Questionnaire) at 2 weeks. At 2 weeks, participants who received PE with CH reported lower worst pain intensity (mean difference = 1.35 points, 95% confidence interval [CI] = .32-2.37) and disability (mean difference = 2.34 points, 95% CI = .06-4.61), but not average pain intensity (mean difference = .67 point, 95% CI = -.27 to 1.62), relative to participants who received PE alone. PE with CH participants also reported more global perceived benefits at 2 weeks (mean difference = -1.98 points, 95% CI = -3.21 to -.75). At 3 months, participants who received PE with CH reported lower worst pain intensity (mean difference = 1.32 points, 95% CI = .29-2.34) and catastrophizing (mean difference = 5.30 points, 95% CI = 1.20-9.41). No adverse effects in either treatment condition were reported. To our knowledge, this is the first trial showing that additional use of hypnosis with PE results in improved outcomes over PE alone in patients with chronic nonspecific low back pain.Perspective This study provides evidence supporting the efficacy of another treatment option for teaching patients to self-manage chronic low back pain that has a relatively low cost and that can be offered in groups.

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  • One study reported benefits of adjunctive hypnosis to education for worst pain postintervention and at 3 months, and disability and patients' impression of change postintervention in chronic pain.

    “However, one study reported benefits for the worst pain postintervention and at 3 months, and disability and patients' impression of change postintervention.122”

    From Adjunctive use of hypnosis for clinical pain: a systematic review and meta-analysis (2024) · cites this paper as [122]

  • Hypnosis adjunctive to diet for people with IBS did not provide additional pain reduction than diet alone postintervention (MD: −1.0, −16.6 to 14.6, n = 49).

    “One additional study117 found that hypnosis adjunctive to diet for people with IBS did not provide additional pain reduction than diet alone postintervention (MD: −1.0, −16.6 to 14.6, n = 49).”

    From Adjunctive use of hypnosis for clinical pain: a systematic review and meta-analysis (2024) · cites this paper as [117]

  • This form of pain education was developed in Australia and has been adapted in numerous Western countries, demonstrating mixed results for effectiveness for managing LBP.

    “This form of pain education (widely known as ‘Explain Pain’ or ‘Pain Neuroscience Education’)15–24 was developed in Australia and has been adapted in numerous Western countries, demonstrating mixed results for effectiveness for managing LBP.15 17 21 23–25”

    From Results of a feasibility randomised clinical trial on pain education for low back pain in Nepal: the Pain Education in Nepal-Low Back Pain (PEN-LBP) feasibility trial (2019) · cites this paper as [21]

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Authors
Rizzo, R. R. N., Medeiros, F. C., Pires, L. G., Pimenta, R. M., McAuley, J. H., Jensen, M. P., & Costa, L. O. P.
Affiliations
  • Universidade Cidade de São Paulo (BR)
  • UNSW Sydney (AU)
  • University of Washington (US)
Corresponding author
Rizzo, Rodrigo R.N.
ORCID
Venue
The Journal of Pain
Publisher
Elsevier BV
Published
2018-10
Volume
19
Issue
10
Pages
1103.e1-1103.e9
ISSN
1526-5900 (ISSN-L)
DOI
10.1016/j.jpain.2018.03.013
OpenAlex
W2797513159
Cited by
50
References
49
Citations by year
2026: 6 · 2025: 10 · 2024: 5 · 2023: 4 · 2022: 8 · 2021: 8 · 2020: 5 · 2019: 3 · 2018: 1
FWCI
2.53
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Pain (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Pain Management and Placebo Effect
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
Keywords
hypnotherapy, pain education, chronic non-specific low back pain, pain catastrophizing, pain intensity, disability, self-management, group intervention
MeSH terms
Adult, Female, Humans, Hypnosis, Male, Middle Aged, Patient Education as Topic, Treatment Outcome, Low Back Pain, Chronic Pain, Pain Management

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