Hypnotherapy for Chronic Pain: Can Hypnosis Help Change Your Experience of Pain?

When you have lived with pain for months or years, it can start to shape far more than the part of your body that hurts.

You might think twice before making plans because you don’t know how you’ll feel that day. You might wake up and immediately check your body to see how bad the pain is going to be. Perhaps you’ve stopped doing things you once enjoyed because you’re worried about triggering a flare-up.

And then there is the sheer exhaustion of it.

The broken sleep. The constant adjusting. The frustration when your body won’t do what you want it to do. The mental calculation behind seemingly ordinary decisions: Can I manage that walk? Will I be able to carry the shopping myself? How long will I have to sit? How much is this going to hurt tomorrow?

For some people, there is another frustration too: tests and scans haven’t fully explained why the pain is still there, or treatment has dealt with the original problem but the pain has remained.

If that sounds familiar, I want to begin with something important to hear:

Your pain is real.

Exploring the role of the brain, nervous system, emotions or subconscious mind does not mean suggesting that pain is imaginary or all in your head.

In fact, modern pain science tells us something much more interesting than that.

Chronic pain is more than a signal from the place that hurts

We often grow up with a fairly simple understanding of pain:

Something is damaged → the damaged area sends a pain signal → we feel pain.

That works reasonably well for something like touching a hot pan or falling off a bike.

Chronic pain can be much more complex.

The International Association for the Study of Pain describes pain as both a sensory and emotional experience and states that it is influenced, to different degrees, by biological, psychological and social factors. It also makes an important distinction between pain and nociception (the activity of the nerves involved in detecting potential harm). They are related, but they are not the same thing. (IASP)

In other words, your brain is not simply a passive receiver waiting for pain messages to arrive.

It is constantly interpreting information.

It takes account of what is happening in the body, but also context, previous experience, stress, expectation, attention, emotion and perceived threat.

Usually, this system is incredibly useful. After all, pain is designed to protect us.

But sometimes a protective system can become persistently sensitive.

Think of a house alarm.

You absolutely want it to sound if somebody smashes a window. But imagine that, over time, it becomes so sensitive that it starts sounding when a branch brushes against the glass.

The alarm isn’t fake.

It really is sounding.

But the threshold at which it responds has changed.

Something similar can happen within some chronic pain conditions, particularly where altered pain processing or sensitisation has become part of the picture. This does not mean that every chronic pain condition has the same cause, and it does not mean that physical or medical causes should be ignored. It means that, for some people, the nervous system itself becomes an important part of the pain picture. (IASP)

And that matters, because systems that can learn can also change.

So where does hypnosis fit in?

Hypnosis is a state of focused attention.

You are not unconscious. You are not asleep. You do not surrender control.

Instead, we deliberately use focused attention, relaxation, imagery, suggestion and therapeutic techniques to influence some of the processes that normally happen automatically.

And pain is full of automatic processes.

You don’t consciously decide how much attention your brain gives a painful sensation.

You don’t deliberately make your muscles tense when you anticipate something hurting.

You don’t choose for your mind to think, Here we go again, when you notice the beginning of a familiar flare-up.

Those responses can happen before you have had time to think about them.

This is one of the reasons I find hypnotherapy so interesting in chronic pain work.

Rather than simply telling yourself to think positively about pain, hypnosis and hypnotherapy give us a way of working with the automatic patterns surrounding the experience itself.

Depending on the individual, that might involve helping the nervous system experience greater safety, reducing unnecessary muscular tension, directing attention differently, changing the qualities associated with a painful sensation, reducing fear around movement or flare-ups, or developing a greater sense of influence over what the body is experiencing.

The aim is not to convince you that something doesn’t hurt. It is to discover whether your brain and body can learn a different response to what is happening.

Can hypnosis actually reduce chronic pain?

There is strong evidence behind the use of hypnosis for pain, although, as with most chronic pain treatments, it is important not to pretend that everybody responds in exactly the same way.

A 2022 systematic review and meta-analysis examined randomised controlled trials of hypnosis and self-hypnosis for chronic musculoskeletal and neuropathic pain. The researchers found evidence that hypnosis could reduce pain intensity, with larger effects seen in studies using more extensive hypnosis programmes. They concluded that hypnosis could offer an effective complementary approach to chronic pain management. (PubMed)

One particularly interesting randomised controlled trial looked at adults with chronic lower-back pain. More than half of those receiving hypnosis reported a reduction in pain intensity of at least 30% (a level generally regarded as clinically meaningful) and those improvements were maintained for at least six months. (PubMed)

Research across chronic pain conditions has also suggested that hypnosis may influence more than pain intensity alone. Studies have explored changes in pain interference, sleep, emotional distress and people’s ability to engage more fully in everyday life. Results vary according to the condition, the individual and the way hypnosis is delivered. (PubMed)

This isn’t evidence for a miracle cure.

It is evidence for something more useful: pain is not necessarily as fixed and unchangeable as it can sometimes feel.

The pain–stress–pain cycle

There is another reason hypnosis can be useful.

Pain is stressful.

And stress can make pain harder to manage.

Imagine that you feel the beginning of a familiar pain.

Your mind immediately recognises it.

Not again.

You become vigilant.

How bad is this going to get? Is this another flare-up? Will I be able to work tomorrow? Am I going to have to cancel everything again?

Your breathing changes. Your muscles tighten. Your attention narrows towards the painful area.

None of this means that your thoughts caused the original pain.

But they can become part of what happens next.

Pain increases stress. Stress increases tension and vigilance. Your attention becomes increasingly captured by pain. The sensation becomes more threatening. The nervous system receives more information suggesting that something is wrong.

And the loop continues.

Hypnosis gives us an opportunity to interrupt that loop. Not by fighting the pain. Not by pretending it isn’t there. But by helping your system discover a different way of responding to it.

What might pain management hypnosis feel like?

Your pain has its own history.

So do you.

Before hypnosis, I want to understand things such as when the pain began, what was happening around that time, what makes it better or worse, what you have already tried, how you think and feel about the pain, and, importantly, what you would be doing differently if the pain were no longer taking up so much space in your life.

That last question matters.

Because the real goal often isn’t simply 'I want the number on the pain scale to come down.'

It might be:

I want to walk the dog again.

I want to sleep through the night.

I want to play with my children or grandchildren without constantly calculating whether I’m going to pay for it afterwards.

I want to stop being frightened of my own body.

I want to make plans without wondering whether pain will ruin them.

I want my life to feel bigger than my pain.

That gives us something meaningful to work towards.

During hypnosis, I might then use techniques designed to change your relationship with the sensation itself, reduce automatic threat responses, build sensations of comfort or safety, or help your mind rehearse moving and living with greater confidence.

The work is personalised because chronic pain is personal.

What if doctors haven’t found anything that fully explains my pain?

This can be one of the most difficult experiences of all.

You know what you are feeling.

You know how much it affects you.

Yet you may have been told that scans are normal, that an injury has healed, or that there is nothing obvious left to treat.

Sometimes people hear that as:

There is nothing wrong with you.

Or worse:

It must be in your imagination.

That is not what modern pain science tells us.

Pain does not require visible tissue damage for the experience to be real. The International Association for the Study of Pain explicitly recognises that pain and activity in sensory nerves are not identical things, and that a person’s report of pain should be respected. (IASP)

If the body’s alarm system has become persistently sensitive, the absence of something dramatic on a scan does not make your experience less real. It may simply mean that we need to think about pain differently.

Is hypnotherapy right for every type of chronic pain?

No and I think that distinction is important.

Hypnotherapy should not be used to explain away new or unexplained pain, nor should it replace a medical investigation or treatment.

Pain can be an important warning signal.

If your pain is new, has changed significantly, has not been medically assessed, or you are concerned about its cause, speak to your GP first. Where chronic pain has already been medically assessed, hypnosis can be considered as a broader approach to managing it.

What if I have lived with pain for years?

Then your system has had years to practise its current response. But duration doesn’t automatically mean permanence.

One of the things I find most hopeful about working with the brain is its capacity to learn.

The goal of chronic pain hypnotherapy isn’t to battle your body into submission.

It is to become curious about what your nervous system has learned and whether some of those patterns can now be updated.

Sometimes the first change is physical.

Sometimes it is sleeping better.

Sometimes somebody notices that they went several hours without thinking about the painful area.

Sometimes they move more freely.

Sometimes the sensation is still present, but it no longer creates the same fear or panic.

And sometimes pain itself begins to reduce.

The destination will be different for everybody.

But the starting point is the same:

What if your current experience of pain isn’t the only experience your brain is capable of creating?

Taking the next step

If chronic pain has gradually made your world smaller, you don’t have to begin by forcing yourself to do more or trying harder to ignore it.

We can start by understanding it.

I offer one-to-one clinical hypnotherapy online, including work with people experiencing persistent pain and mind–body symptoms.

If you’re curious about whether hypnotherapy could form part of your approach to chronic pain, you can book a free 20-minute Pathway Consultation.

www.jonathanjamespathways/book

It is simply a chance for us to talk about what you’ve been experiencing, what you’ve already tried, what you would like to change and whether I think hypnotherapy is an appropriate next step for you.

Because living with pain can teach you to organise your life around what your body might not let you do.

Sometimes change begins by asking a different question:

What might become possible if pain didn’t have to take up quite so much space?

Research referenced

• International Association for the Study of Pain (2020). Revised Definition of Pain.

• Langlois, P. et al. (2022). Hypnosis to manage musculoskeletal and neuropathic chronic pain: A systematic review and meta-analysis. Neuroscience & Biobehavioral Reviews, 135, 104591.

• Tan, G. et al. (2015). A randomized controlled trial of hypnosis compared with biofeedback for adults with chronic low back pain. European Journal of Pain, 19(2), 271–280.

• Jensen, M. P. & Patterson, D. R. (2014). Hypnotic approaches for chronic pain management: Clinical implications of recent research findings.

• NICE (2021). Chronic pain (primary and secondary) in over 16s: assessment of all chronic pain and management of chronic primary pain (NG193).

• This article is for general information and does not provide medical advice. Hypnotherapy can complement appropriate medical care but should not be used as a substitute for medical assessment, diagnosis or treatment.