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Using Hypnosis or Biofeedback to Treat Chronic Low Back Pain

Presented by Tenley Fukui, MA; pilot study by Tenley Fukui, MA; Gabriel Tan, PhD; Diana Rintala, PhD; Mark Jensen, PhD; Donna Smith MA; and Andrew Robinson, MA.

Chronic low back pain (CLBP) is a serious problem that results in significant costs to individuals and society. A pilot study using manualized hypnosis and psychoeducation resulted in decreased CLBP; therefore, a trial was designed using manualized hypnosis or surface electromyography (sEMG) biofeedback to treat CLBP. Both complementary alternative medicine approaches have the potential to help individuals with CLBP, but relatively few controlled trials have been published testing their efficacy, and we are aware of no studies that have directly compared them. 100 veterans with CLBP were randomly assigned to receive 8 sessions of face-to-face hypnosis training (Group 1), 8 sessions of face-to-face hypnosis training plus hypnosis home practice CDs (Group 2), 2 sessions of face-to-face hypnosis training plus hypnosis home practice CDs (Group 3), or 8 sessions of sEMG biofeedback (Group 4). Participants in all three hypnosis groups reported significant pre- to post-treatment reductions in pain intensity and pain interference. The largest effects were found for the participants who received the most face-to-face sessions and who were given home practice CDs. Benefits were maintained at 6 months follow-up. The findings indicate that veterans can be taught self-hypnosis for CLBP management using a manualized protocol and that positive effects can occur with only two face-to-face sessions, as long as they are accompanied by CDs for home practice.

After attending this workshop the provider will be able to compare the benefits of hypnosis with psychoeducation, hypnosis alone or biofeedback to improve compliance for chronic pain treatment, assess whether their practice might benefit from manualized hypnosis protocols, provide evidence for adding psychoeducation with hypnosis, to provide hypnosis for multiple dosed sessions or with less sessions, balance replicability and objectivity with clinical work to enable patients to better manage chronic pain and discuss the importance of home practice of hypnosis. They will also be able to make reductions in pain for many patients and increase their patients' ability to use self-hypnosis to experience temporary reductions in pain. They may be able to treat patients with fewer sessions, which is more cost effective. They will be able to apply suggestions that will encourage patients to practice self-hypnosis regularly and learn to better control their pain allowing them to participate better in activities of daily living and social activities. They will be able to describe at least two complicated case histories and create individualized suggestions to enable their patients to benefit from pain management. They will be able to analyze subjects' feedback to treatment and apply changes in the manualized protocol appropriate to their practice.