ABSTRACT

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, r = −.33, p =.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.

摘要

与其他慢性健康问题相比，慢性疼痛不仅对生活质量产生最大的负面影响，而且导致全世界最大的残疾。鉴于慢性神经性疼痛与其他疼痛过程的关联，不到一半的患者对单一止痛药有反应的事实以及缺乏有关联合疗法的证据（即，将几种预定的止痛药合用的治疗方案），其管理尤其具有挑战性）安全性和有效性。面对这些挑战，人们对诸如瑜伽，针灸和催眠之类的辅助和替代医学（CAM）疗法的应用越来越感兴趣。我们介绍了一例67岁男性患有严重的糖尿病性神经病的一线，二线和三线治疗所致。他的致残性疼痛促使他过早退休，导致严重的抑郁症和自杀倾向，需要住院治疗。最终，他通过综合健康方案获得了缓解，并且他将催眠术视为治疗疼痛的最有效方法。通过个人和小组会议，录音和每日自我催眠，他改善了慢性疼痛症状和生活质量，同时减少了阿片类药物的使用。对他的疼痛等级随时间进行的仿真模型分析表明，在进行催眠后，疼痛等级可以可靠地降低，通过个人和小组会议，录音和每日自我催眠，他改善了慢性疼痛症状和生活质量，同时减少了阿片类药物的使用。对他的疼痛等级随时间进行的仿真模型分析表明，在进行催眠后，疼痛等级可以可靠地降低，通过个人和小组会议，录音和每日自我催眠，他改善了慢性疼痛症状和生活质量，同时减少了阿片类药物的使用。对他的疼痛等级随时间进行的仿真模型分析表明，在进行催眠后，疼痛等级可以可靠地降低，r = −.33，p = .001。越来越多的研究表明，催眠作为对慢性疼痛的综合治疗方法的一部分是有益的，并且可以增强其他疗法的功效。我们在医学上具有挑战性的案例研究支持催眠可以作为治疗慢性神经性疼痛的可行且持久的方法。