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ABSTRACT
Chronic pain is thought to develop from intense repetitive nociceptive (acute) pain. This condition has various forms and can persist for longer than 3 months, such that finding efficacious treatment is challenging in the clinical setting. The essence of this review is to present a selection of studies highlighting anatomical changes in brain activity in acute and chronic pain. An overview of the interaction between pain and psychological conditions will also be examined followed by the physiological effect of hypnosis. The review concludes with recommendations for further work in developing robust pain management in clinical hypnotherapy practice.
Keywords: chronic pain, pain pathway, hypnotherapy, hypnotic suggestions, pain modulation, pathophysiology
INTRODUCTION
According to a survey assessing the impact of chronic pain on the daily lives of patients, 1 in 5 people in Europe are affected by this condition (Breivik et al., 2006). This presents a compelling case to find efficacious treatments that help in the management of chronic pain.
Over the last three decades, numerous studies using an evidence-based approach have validated hypnosis as being efficacious in the treatment of certain chronic pain conditions (Jensen et al., 2009; Goodin et al., 2012; Del Casale et al., 2015).
Chronic pain
Chronic pain is often described as pain that persists longer than 3 months (Ginzburg, Merskey and Lau, 1988). There are many types of chronic pain conditions including phantom pain, neuropathic pain, lower back pain, fibromyalgia, complex regional pain syndrome and postsurgical pain. Unlike acute pain, which subsides after injury heals, chronic pain continues in the absence of any recognizable peripheral damage (Tsay et al., 2015).
It is thought that the inception of chronic pain develops from intense repetitive nociceptive (acute) pain (Voscopoulos and Lema, 2010).
Nociceptive pain
Acute pain is usually referred to as nociceptive pain that occurs during and after tissue injury to the skin, joints or viscera. Under normal conditions, the body's reaction to this peripheral damage usually follows the pain pathway of transduction, conduction, transmission, perception and modulation. As soon as the injury has healed, acute nociceptive pain usually subsides (Voscopoulos and Lema, 2010).
Pathophysiology of normal (acute) pain - The pain pathway
Nociceptors are free sensory nerve endings located in the skin, joint and walls of organs. They are activated upon tissue...