April 20, 2006

Hypnosis may relieve non-cardiac chest pain

NEW YORK (Reuters Health) - People with chest pain that's
not caused by a heart condition or heartburn may find hypnosis
provides significant pain relief and improves their sense of
general well-being, British investigators report.

The causes of non-cardiac chest pain, as it's termed, are
unknown. It can create so much anxiety that many people with
the condition actually seek more care than patients with bona
fide heart disease.

According to the researchers' article in the medical
journal Gut, many patients still have symptoms even after
treatment with gastric acid-lowering drugs and antidepressants.

Dr. Peter J. Whorwell and colleagues at Wythenshawe
Hospital in Manchester have previously shown that functional
gastrointestinal disorders, such as irritable bowel syndrome,
respond well to hypnotherapy.

Based on that success, they tested the strategy in 28
patients with non-cardiac chest pain who were randomly assigned
to hypnotherapy or just supportive listening. Both
interventions were administered in twelve 30-minute sessions
over 17 weeks.

The hypnosis started with participants being told that
their symptoms could be due to disturbances of motility,
visceral sensation and stress. Then, after progressive muscular
relaxation, 'chest-focused' suggestions were introduced,
"centered around normalization of function" of the esophagus,
the investigators explain. Patients were advised to practice
the techniques daily.

Eighty percent of patients in the hypnosis group had
complete or moderate improvements in chest pain compared with
only 23 percent of those in the non-hypnosis group.
Corresponding improvements in general well-being were reported
by 73 percent and 23 percent.

Hypnosis was also associated with significantly greater
reductions in pain severity as assessed on a linear analog
scale and by decreased medication use, as well as with a trend
toward reduced frequency of pain.

However, the two groups had similar anxiety and depression

Whorwell's group acknowledges that hypnotherapy can be
expensive, but it could be cost-saving in the long run by
reducing testing, medication, and visits to doctors.

SOURCE: Gut, May 2006.