The vast majority of persons with spinal cord injury report chronic, unpleasant sensations or pain. And about a third describe the chronic pain as severe, which is a very hard thing to live with.
Chronic pain in persons with spinal cord injury tends to exist at multiple body sites and generally does not improve with time. It can interfere significantly with normal activities such as work and social life, and perhaps for that reason is associated with depression.
Acute pain takes place before healing has occurred, whereas chronic pain sets in after the healing is already done: the injury has healed, but the pain remains, and it becomes chronic pain. Traditional biomedical treatments, like opiate medications, are generally effective for acute but not chronic pain management. Chronic pain is extremely complex and difficult to treat with narcotics alone.
A number of factors complicate chronic pain conditions and their treatment:
- Psychological distress. There is a significant association between chronic pain and depression and anxiety. We have found that people don't get used to chronic pain. Instead, it actually gets worse; people get worn down after years of unrelenting chronic pain.
- Grieving the loss of activity. When chronic pain results in an inability to continue with usual life activities, grief over this loss can increase or maintain the pain.
- Original cause of pain is often gone.
- Deactivation. When you are having pain with any kind of movement, what do you do? You avoid movement, and as a result your muscles become deactivated and start to atrophy (shrink and become weaker). Thereafter, any movement you try to do is far more painful because the muscles haven't been used. This becomes a vicious cycle.
- Guarding. This is the tendency to tense up or tighten the muscles around the injured area as a way of protecting it, which then causes you to move or walk differently. For instance, if you sprain your ankle, the muscles around it tense up, causing additional pain. Furthermore, you will probably put more weight on the other foot, eventually causing pain in other parts of your body. In fact, a common problem following sprained ankle is hip pain on the side opposite the ankle sprain.
Using Hypnosis for Treating Chronic Pain
For hypnosis to be effective in chronic pain situations, the post-hypnotic suggestions need to focus on the five factors (from the list above) that are maintaining or aggravating the chronic pain syndrome. So, instead of suggesting to chronic pain patients that their pain will go away, which doesn’t work, the therapist might suggest that they're going to feel more energy and more motivated to participate in physical therapy or an exercise program. These suggestions are more successful in helping somebody who is coping with chronic pain.
Hypnotherapy can be highly effective in addressing the other factors: depression, anxiety, and grief. In other words, going beyond giving suggestions to the receptive subconscious mind, with hypnotherapy we can deal with the emotional (and spiritual) “collateral damage”.
Pain often interferes with sleep, so decreasing pain helps increase restful sleep. Studies show that sleep also improves as a result of the hypnosis.
Another research team at the University of Washington School of Medicine Rehabilitation Medicine, documented a case of working with a U.S. Army soldier stationed in Iraq who developed myriad pain problems after sustaining a high-level spinal cord injury from a gunshot wound. These problems were negatively impacting his ability to participate fully in his physical rehabilitation and care. Ten sessions of self-hypnosis training were administered to the patient over a 5-week period to help him address these problems. Both the patient and his occupational therapist reported a substantial reduction in pain over the course of treatment, which allowed the patient to actively engage in his therapies. Six months post treatment, the patient reported continued use of the hypnosis strategies taught, which effectively reduced his experience of pain.
Based in part on a report by Shelley Wiechman Askay, PhD, Clinical Psychologist at Harborview Medical Center and assistant professor, Rehabilitation Medicine, University of Washington retrieved from [http://sci.washington.edu/info/forums/reports/hypnosis_for_sci_pain.asp].
 Stoelb BL, Jensen MP, Tackett MJ. American Journal Clinical Hypnosis, Jan 2009, 51(3):273-280.