The effectiveness of hypnotherapy with physiotherapy: Pain intensity, functional disability, and psychological distress among patients with non-specific low back pain
DOI:
https://doi.org/10.22122/cdj.v4i2.220Keywords:
Hypnotherapy, Physiotherapy (Techniques), Low Back Pain, Psychological StressesAbstract
BACKGROUND: It has been demonstrated in previous investigations that non-specific low back pain is caused by multiple factors. Evidently, integrative therapies should be used in order to improve this disorder. Documents exhibit that integrative therapies are capable of improving different aspects of low back pain and preventing the recurrence of clinical symptoms. The aim of the present study was to determine the effectiveness of hypnotherapy with physiotherapy on low back pain.
METHODS: The statistical sample included 28 women who were randomly divided into two groups. One group received hypnotherapy with physiotherapy and the other received pure physiotherapy. The Depression Anxiety and Stress Scales (DASS-21), the Numerical Rating Scale (NRS), the Roland Morris Disability Questionnaire (RDQ) were used to measure the trend of changes (pretest, mid-test, and posttest) of psychological distress, pain intensity, and functional disability. The Hypnotic Induction Profile (HIP) was used to measure suggestibility. In order to analyze data, repeated measures analysis of variance (ANOVA) was used in SPSS software.
RESULTS: The results revealed that hypnotherapy with physiotherapy affects pain intensity in the same way as pure physiotherapy (P < 0.050). Furthermore, it was found that hypnotherapy with physiotherapy is more effective than pure physiotherapy on functional disability (P < 0.050). It was also discovered that only hypnotherapy with physiotherapy can improve psychological distress (P < 0.050).
CONCLUSION: It can be concluded that hypnotherapy with physiotherapy can improve pain intensity, functional disability, and psychological distress, and the total effectiveness of hypnotherapy with physiotherapy is more than the total effectiveness of pure physiotherapy.
References
Jensen MP, Ehde DM, Gertz KJ, Stoelb BL, Dillworth TM, Hirsh AT, et al. Effects of self-hypnosis training and cognitive restructuring on daily pain intensity and catastrophizing in individuals with multiple sclerosis and chronic pain. Int J Clin Exp Hypn 2011; 59(1): 45-63.
Cifuentes M, Webster B, Genevay S, Pransky G. The course of opioid prescribing for a new episode of disabling low back pain: Opioid features and dose escalation. Pain 2010; 151(1): 22-9.
Lin CW, Haas M, Maher CG, Machado LA, van Tulder MW. Cost-effectiveness of guideline-endorsed treatments for low back pain: A systematic review. Eur Spine J 2011; 20(7): 1024-38.
Choi HK, Gwon HJ, Kim SR, Park CS, Cho BJ. Effects of active rehabilitation therapy on muscular back strength and subjective pain degree in chronic lower back pain patients. J Phys Ther Sci 2016; 28(10): 2700-2.
Martin BC, Fan MY, Edlund MJ, Devries A, Braden JB, Sullivan MD. Long-term chronic opioid therapy discontinuation rates from the TROUP study. J Gen Intern Med 2011; 26(12): 1450-7.
Hegmann KT, Weiss MS, Bowden K, Branco F, DuBrueler K, Els C, et al. ACOEM practice guidelines: Opioids for treatment of acute, subacute, chronic, and postoperative pain. J Occup Environ Med 2014; 56(12): e143-e159.
Deyo RA, Dworkin SF, Amtmann D, Andersson G, Borenstein D, Carragee E, et al. Report of the NIH Task Force on research standards for chronic low back pain. Pain Med 2014; 15(8): 1249-67.
Degenhardt L, Bruno R, Lintzeris N, Hall W, Nielsen S, Larance B, et al. Agreement between definitions of pharmaceutical opioid use disorders and dependence in people taking opioids for chronic non-cancer pain (POINT): A cohort study. Lancet Psychiatry 2015; 2(4): 314-22.
Johnson AJ, Marcus J, Hickman K, Barton D, Elkins G. Anxiety reduction among breast-cancer survivors receiving hypnotic relaxation therapy for hot flashes. Int J Clin Exp Hypn 2016; 64(4): 377-90.
Henschke N, Kuijpers T, Rubinstein SM, van Middelkoop M, Ostelo R, Verhagen A, et al. Trends over time in the size and quality of randomised controlled trials of interventions for chronic low-back pain. Eur Spine J 2012; 21(3): 375-81.
Farrar JT, Young JP Jr, LaMoreaux L, Werth JL, Poole RM. Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale. Pain 2001; 94(2): 149-58.
Tonsing KN. Psychometric properties and validation of Nepali version of the Depression Anxiety Stress Scales (DASS-21). Asian J Psychiatr 2014; 8: 63-6.
Bijur PE, Latimer CT, Gallagher EJ. Validation of a verbally administered numerical rating scale of acute pain for use in the emergency department. Acad Emerg Med 2003; 10(4): 390-2.
Osman ZJ, Mukhtar F, Hashim HA, Abdul LL, Mohd Sidik S, Awang H, et al. Testing comparison models of DASS-12 and its reliability among adolescents in Malaysia. Compr Psychiatry 2014; 55(7): 1720-5.
Wilkowska A, Landowski LJ. P.2.a.009 Stress reaction during myocardial infarction and depression: Predictive value of Depression Anxiety Stress Scale (DASS) 21. Eur Neuropsychopharmacol 2011; 21(Supplement 3): S359.
Pirbaglou M, Katz J, de Souza RJ, Stearns JC, Motamed M, Ritvo P. Probiotic supplementation can positively affect anxiety and depressive symptoms: A systematic review of randomized controlled trials. Nutr Res 2016; 36(9): 889-98.
Lin JD, Su SF, Lin LP, Hsu SW, Wu JL, Chu CM. The RolandMorris disability scale for the assessment of non-specific low back pain outcomes among disability sector workers. Res Autism Spectr Disord 2014; 8(12): 1635-40.
Schiphorst Preuper HR, Reneman MF, Boonstra AM, Dijkstra PU, Versteegen GJ, Geertzen JH. The relationship between psychosocial distress and disability assessed by the Symptom Checklist-90-Revised and Roland Morris Disability Questionnaire in patients with chronic low back pain. Spine J 2007; 7(5): 525-30.
Stevens ML, Lin CC, Maher CG. The roland morris disability questionnaire. J Physiother 2016; 62(2): 116.
Spiegel H, Aronson M, Fleiss JL, Haber J. Psychometric analysis of the Hypnotic Induction Profile. Int J Clin Exp Hypn 1976; 24(3): 300-15.
Terhune DB, Cardena E. Differential patterns of spontaneous experiential response to a hypnotic induction: a latent profile analysis. Conscious Cogn 2010; 19(4): 1140-50.
Konidena A, Sharma D, Puri G, Dixit A, Jatti D, Gupta R. Effect of TENS on stimulation of saliva in postmenopausal women with or without oral dryness-An interventional study. J Oral Biol Craniofac Res 2016; 6(Suppl 1): S44-S50.
Jones AY, Hutchinson RC. A comparison of the analgesic effect of transcutaneous electrical nerve stimulation and entonox. Physiotherapy 1991; 77(8): 526-30.
Katz JN. Lumbar disc disorders and low-back pain: Socioeconomic factors and consequences. J Bone Joint Surg Am 2006; 88(Suppl 2): 21-4.
Abrahamsen R, Dietz M, Lodahl S, Roepstorff A, Zachariae R, Ostergaard L, et al. Effect of hypnotic pain modulation on brain activity in patients with temporomandibular disorder pain. Pain 2010; 151(3): 825-33.
Finger ME, Selb M, De Bie R, Escorpizo R. Using the international classification of functioning, disability and health in physiotherapy in multidisciplinary vocational rehabilitation: A case study of low back pain. Physiother Res Int 2015; 20(4): 231-41.
Richardson J, Smith JE, McCall G, Pilkington K. Hypnosis for procedure-related pain and distress in pediatric cancer patients: A systematic review of effectiveness and methodology related to hypnosis interventions. J Pain Symptom Manage 2006; 31(1): 70-84.
van Middelkoop M, Rubinstein SM, Kuijpers T, Verhagen AP, Ostelo R, Koes BW, et al. A systematic review on the effectiveness of physical and rehabilitation interventions for chronic non-specific low back pain. Eur Spine J 2011; 20(1): 19-39.
Kizhakkeveettil A, Rose K, Kadar GE. Integrative therapies for low back pain that include complementary and alternative medicine care: A systematic review. Glob Adv Health Med 2014; 3(5): 49-64.
Smallwood RF, Laird AR, Ramage AE, Parkinson AL, Lewis J, Clauw DJ, et al. Structural brain anomalies and chronic pain: A quantitative meta-analysis of gray matter volume. J Pain 2013; 14(7): 663-75.
Taxter AJ, Chauvin NA, Weiss PF. Diagnosis and treatment of low back pain in the pediatric population. Phys Sportsmed 2014; 42(1): 94-104.
Elkins G, Jensen MP, Patterson DR. Hypnotherapy for the management of chronic pain. Int J Clin Exp Hypn 2007; 55(3): 275-87.
Jensen MP, Patterson DR. Hypnotic approaches for chronic pain management: Clinical implications of recent research findings. Am Psychol 2014; 69(2): 167-77.
Pan CX, Morrison RS, Ness J, Fugh-Berman A, Leipzig RM. Complementary and alternative medicine in the management of pain, dyspnea, and nausea and vomiting near the end of life. A systematic review. J Pain Symptom Manage 2000; 20(5): 374-87.
Berger MM, Davadant M, Marin C, Wasserfallen JB, Pinget C, Maravic P, et al. Impact of a pain protocol including hypnosis in major burns. Burns 2010; 36(5): 639-46.
Crawford HJ, Gur RC, Skolnick B, Gur RE, Benson DM. Effects of hypnosis on regional cerebral blood flow during ischemic pain with and without suggested hypnotic analgesia. Int J Psychophysiol 1993; 15(3): 181-95.
