Pain caused by damage to the nervous system is among the hardest kinds to treat. It may burn, shoot or tingle. It often responds poorly to ordinary painkillers, and the drugs that do help can cause drowsiness and other side effects.
People with multiple sclerosis (MS) and spinal cord injury live with this kind of pain in large numbers. A research group at the University of Washington in Seattle, led by the psychologist Mark Jensen, has spent years testing whether self-hypnosis can help.
The multiple sclerosis trial
In a 2009 study, 22 people with MS and chronic pain were assigned to training in either self-hypnosis or progressive muscle relaxation.
Relaxation is a fair comparison. It is pleasant, credible, and involves the same amount of contact with a clinician.
Results. The self-hypnosis group reported greater pain reduction, both during sessions and after treatment. Average daily pain fell significantly in the self-hypnosis group and not in the relaxation group. The benefit was still present at three months.
The spinal cord injury trial
In a second study, 37 adults with spinal cord injury and chronic pain received ten sessions of either self-hypnosis training or EMG biofeedback, a technique for learning to relax muscles using a monitor.
Results. Both groups reported less intense pain during the sessions. But only the self-hypnosis group showed a significant fall in average daily pain from before treatment to after, and it was maintained at three months. The self-hypnosis group also reported a greater sense of control over pain.
More recently, the same university has reported on a therapy combining hypnosis with cognitive therapy for pain after spinal cord injury.
What these studies show
Both trials are small. But they have a strength many hypnosis studies lack: a credible active comparison. Hypnosis did better than relaxation and better than biofeedback, which suggests the benefit is more than rest or attention.
They also show something important about expectations. These were people with permanent neurological damage. Hypnosis did not cure the pain. It reduced it, and gave people more sense of control.
What the Seattle group has learned
Across many studies, Jensen and colleagues have reported a consistent picture.
- Responses vary. Some people get substantial, lasting relief; some get relief only while they are practising; some get little.
- Two kinds of benefit. A lasting drop in everyday pain, and a short-term drop during and just after self-hypnosis that can be used whenever needed.
- Extra benefits. Many people report better sleep, less stress and a greater sense of wellbeing even when pain itself changes little.
- People keep using it. At follow-up, most participants were still practising.
- Hypnotizability matters less than expected. It predicts response only modestly.
The side benefits may be one reason people continue: almost everyone gets something.
How the training works
The programme teaches self-hypnosis as a skill.
- An induction, usually relaxation and counting.
- Suggestions for comfort: reduced pain, a pleasant alternative sensation, or distance from the pain.
- Suggestions for the brain to process pain signals differently.
- A post-hypnotic suggestion that the comfort lasts beyond the session and returns with a cue, such as a deep breath.
- Recordings of each session for daily practice.
- Short self-hypnosis without a recording, for use through the day.
Suggestions that suit nerve pain
Standard relaxation imagery does not always fit. These tend to work better:
- Replacing the sensation: burning becomes coolness; shooting becomes a dull pressure; pins and needles becomes a gentle hum
- A dimmer switch on the signal
- Numbness spreading from a comfortable area
- Attention elsewhere: absorbed in a place where the body feels different
- A filter between the body and awareness
It helps to try several and keep what works.
A daily practice
- Twenty minutes with a recording, once a day.
- Three or four short sessions of a minute or two: a deep breath, eyes closed, recall the comfort.
- A cue for flares: a slow breath in, hold, and release.
- Review after a month.
Practical points
- Fatigue. Short sessions suit MS fatigue. Lying down is fine.
- Cognitive changes. Recordings remove the need to remember steps.
- Spasms. Relaxation suggestions may ease the tension around them.
- Positioning. Get comfortable and supported first. With spinal cord injury, keep to your usual pressure-relief routine.
Where it fits
Hypnosis is added to medical care, not swapped for it.
- Keep taking prescribed treatment unless your doctor advises otherwise.
- Report new or changing pain. It is not always the underlying condition.
- Ask your MS or rehabilitation team whether a psychologist trained in hypnosis for pain is available.
- Physiotherapy, activity and good sleep all contribute.
The bottom line
For chronic pain in multiple sclerosis and spinal cord injury, self-hypnosis has outperformed relaxation and biofeedback in small trials. It will not remove the pain, but for many people it lowers it, and it gives back a measure of control.
Next in the series: How to Judge a Hypnosis Claim: A Reader’s Guide to the Evidence
This article is for general information and is not medical advice.