Hypnosis in the Control of Chronic Low Back Pain

Abstract

Twenty-nine patients were referred because of low back pain. Five were excluded on psychological grounds because they were highly masochistic, extremely depressed, or manifested a low frustration tolerance. Of the 24 in the treatment group, 18 of the patients had surgery two or more times, and six one time. In each case low back pain returned within three to six months after surgery. Twenty of the patients were addicted to or excessively dependent on medications including acetaminophen, secobarbital, codeine phosphate, oxycodone hydrochloride, and morphine sulphate. Common factors among the patients included (1) consistent pain which was primarily organic in origin, (2) analgesic dependence, (3) insomnia, (4) reactive depression, (5) excessive interpersonal dependence, and (6) a fear of becoming a lifelong “backache cripple.” Twenty patients responded positively; four patients failed to respond to the repeated hypnotic induction techniques and were considered failures. Sixteen reported an average of 80% relief during the first four sessions, and all 20 patients reported an average of 70% relief (based on verbal estimates by patients) by the sixth session. Fifteen voluntarily discontinued medication by the third week of therapy, and the rest were withdrawn by their physicians during the ensuing four weeks. Most patients were seen daily the first week, three times the second week, twice the third week, and thereafter as necessary. The mean number of out-patient sessions was 31 over an average of nine months. All patients were taught self-hypnosis. None of the individuals retained their addiction, and only occasionally did they require analgesics. Patients were seen by their referring physicians as needed during the course of hypnotherapy, and frequent consultations between the therapists created a combination of treatments best suited for each patient. It is concluded that hypnosis may be utilized maximally as an important adjunct to other therapeutic methods in the treatment of low back pain.