Venue: AS7, Seminar Room B
Content: see below
Title: Using Hypnosis to Treat Chronic Low Back Pain
Tan G, Rintala D, Fukui T, Smith D, Jensen MP
Purpose: To conduct a randomized controlled trial to test the efficacy of hypnosis treatment for low back pain.
Relevance: Chronic low back pain is prevalent, often disabling and very costly to the Veterans Health Administration and to society.
Participants: 85 veterans seen at the Houston VA Medical Center completed all phases of the trial.
Methods: Participants were randomly assigned to receive one of three “doses” of manualized self-hypnosis training or sEMG (surface electromyography) biofeedback (which served as a control condition. Randomization was accomplished using a random number table. Group 1 (n = 23) received two 2-hour sessions of face-to face hypnosis training and 6 weekly 1-hour sessions of face-to-face hypnosis training. Group 2 (n = 19) also received two 2-hour sessions of face-to-face hypnosis training and 6 weekly 1-hour sessions of face-to-face hypnosis, plus hypnosis CDs for home practice for the last 7 weeks. Group 3 (n = 21) received only 2 weekly 2-hour sessions of face-to-face hypnosis, plus CDs for home practice for the last 7 weeks. Group 4 (n = 22) received 8 weekly 1-hour sessions of EMG biofeedback in the therapist’s office. All participants completed pre- and post-treatment measures of pain intensity (0-10 Numerical Rating Scale), pain interference (Brief Pain Inventory), and sleep quality (Pittsburgh Sleep Quality Index). Paired samples t-tests were used to analyze baseline and post-test differences.
Results: Group 1 participants showed significant reductions in pain intensity [effect size, ES = .77, p < .01] and pain interference [ES = 0.76, p < .01], but not sleep problems [ES = 0.38, p = NS]. Group 2 participants reported significant reductions in all three outcome domains: pain intensity [ES size = 1.18, p < .0001], pain interference [ES = 0.90, p < .01], and sleep problems [ES = 0.81, p < .01], as did group 3 participants [ESs = .96, .80, and .52, ps < .0001, .01, and .05, respectively]. Group 4 (EMG biofeedback control group) showed some improvements in the outcome measures, but the improvements were less dramatic [ESs for pain intensity, pain interference, and sleep problems were .67, .45, and .22, ps = .004, .005, and NS, respectively]. The largest effects were found for the participants who received the most sessions (eight) and who were given CDs for home practice. However, participants in all treatment conditions appeared to benefit, and the differences in outcome between the treatment groups were not statistically significant.
Conclusions and Implications: The limitations of this study include (1) a lack of an objective measure of functional improvement and (2) relatively small sample sizes per group, which limited our ability to detect significant between group differences. Despite these limitations, however, the findings suggest that veterans can be taught self-hypnosis using a manualized protocol to successfully manage their chronic low back pain, and that it is possible to provide this treatment using minimal face-to-face contact between therapists and clients. This may improve accessibility and availability of hypnosis to those suffering from chronic low back pain.
Acknowledgement: This project was funded by the VHA Rehabilitations R&D
About the Speaker: Over 35 years of professional psychology experience as a clinician, researcher, and teacher/trainer/consultant. ABPP specialty board certification in clinical health psychology; Diplomates in advanced psychopharmacology and Quantitative EEG; certification in group psychotherapy, clinical hypnosis, and behavioral medicine; and certified senior fellow in biofeedback (peripheral and EEG). Licensed Sex Offender Treatment Provider (LSOTP). Previous academic appointment: Baylor College of Medicine as associate professor in the departments of Anesthesiology, Psychiatry and Behavioral Sciences, and Physical Medicine & Rehabilitation.