title: An exploration of the utility of hypnosis in pain management among rural pain patients.
abstract: OBJECTIVE
  Hypnosis is an adjunctive, noninvasive treatment with few side effects that can be useful in the management of chronic pain. However, it has fallen into disfavor in recent years and is often perceived by physicians as simple charlatanism. We evaluated the efficacy of this treatment as used clinically in a large, mostly rural, pain management center.
  
  
  METHODS
  We conducted a chart review of 300 pain patients from the Pain Treatment Center of the Bluegrass who had undergone hypnosis for their pain concerns. A chart audit tool was developed consisting of basic demographics, pre- and posthypnosis pain ratings, a rating of relaxation achieved posthypnosis, and scores on the Beck Depression Inventory, Perceived Disability Scale, and the Pain Anxiety Symptom Scale.
  
  
  RESULTS
  The sample consisted of 79 men (26.3%) and 221 women (73.7%) with a mean age of 46.3 years (SD = 9.9, range = 19-78). Pain levels recorded pre- and posthypnosis revealed significant improvement as a result of the intervention (mean difference = 2.5, t (1,298) = 25.9, p < .001). Patients reported an average of 49.8% improvement in relaxation level posthypnosis (SD = 24.2%) and had a mean score of 19.0 on the Beck Depression Inventory (SD = 9.9), indicating moderate levels of depression. Also, patients saw themselves as severely disabled regarding their ability to engage in physical (8.3/10) or job-related (7.7/10) activities. Attempts to identify predictors of hypnosis success were not fruitful with one exception. "Poor" responders to hypnosis reported greater levels of perceived dysfunction in their sexual functioning compared to the "good" responders, F(1,187) = 7.2, p < .01.
  
  
  CONCLUSIONS
  Hypnosis appears to be a viable adjunct for pain management patients, including those from rural and relatively disadvantaged backgrounds. Prospective trials are needed to examine the utility of this modality in end-of-life and palliative care patients.
authors.affiliation: The Pain Treatment Center of the Bluegrass, Lexington, Kentucky, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Thornberry
authors.forename: Jennifer
authors.initials: J
authors.lastname: Schaeffer
authors.forename: Peter D
authors.initials: PD
authors.lastname: Wright
authors.forename: Mindi C
authors.initials: MC
authors.lastname: Haley
authors.forename: Kenneth L
authors.initials: KL
authors.lastname: Kirsh
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005260:Female; D006801:Humans; D006990:Hypnosis; D007629:Kentucky; D008297:Male; D008875:Middle Aged; D059408:Pain Management; D010342:Patient Acceptance of Health Care; D011203:Poverty; D012189:Retrospective Studies; D012424:Rural Population; D016896:Treatment Outcome