Hypnosis for refractory severe neuropathic pain: A case study.

Chronic pain not only has the greatest negative effect on quality of life compared with other chronic health problems but also contributes to the greatest disability worldwide. Management of chronic neuropathic pain is particularly challenging given its association with other pain processes, the fact that less than half of patients respond to a single pain medication, and the lack of evidence regarding combination therapy (i.e. a treatment regimen that combines several scheduled pain medications) safety and efficacy. Given these challenges, there is a growing interest in the application of complementary and alternative medicine (CAM) therapies such as yoga, acupuncture, and hypnosis. We present the case of a 67-year-old male with severe diabetic neuropathy refractory to first, second, and third-line treatments. His disabling pain precipitated premature retirement, contributing to severe depression with suicidality requiring hospitalization. Ultimately, he experienced relief through an integrative health regimen, and he identified hypnosis as the most effective therapy for his pain. Through individual and group sessions, recordings, and daily self-hypnosis, he improved both his chronic pain symptomatology and quality of life, simultaneously decreasing opioid use. Simulation modeling analysis of his pain ratings over time showed that they reliably decreased after engaging in hypnosis, = -.33, =.001. A growing body of research suggests that hypnosis is beneficial as part of an integrative treatment approach to chronic pain and enhances the efficacy of other therapies. Our medically challenging case study supports that hypnosis may serve as a viable and durable treatment for chronic neuropathic pain.