Hypnotic Cognitive Therapy for Chronic Pain in Spinal Cord Injury: A Randomized Controlled Trial

Area of Science:

• Neurology
• Psychology
• Rehabilitation Medicine

Background:

• Chronic pain is a prevalent and disabling condition for individuals with spinal cord injury (SCI).
• Existing treatments for SCI-related pain often have limited efficacy.
• Hypnotic cognitive therapy (HYP-CT) is a potential therapeutic approach for managing chronic pain.

Purpose of the Study:

• To determine the efficacy of HYP-CT in reducing average pain intensity in adults with SCI.
• To assess the impact of HYP-CT on depression symptoms in this population.
• To compare HYP-CT with usual care (UC) in a randomized controlled trial.

Main Methods:

• A single-blind, randomized, parallel-group trial involving 127 adults with SCI and moderate-to-severe chronic pain.
• Participants were randomized 1:1 to receive 6 weekly sessions of HYP-CT (delivered via telephone or Zoom) or UC.
• The primary outcome was average pain intensity, assessed using a 0-10 numerical rating scale at 6 and 12 weeks post-randomization.

Main Results:

• Average pain intensity decreased significantly more in the HYP-CT group compared to the UC group at both 6 weeks (-0.55) and 12 weeks (-0.79).
• Depression scores also showed significant improvement in the HYP-CT group at 6 and 12 weeks.
• Exploratory analyses indicated similar efficacy for HYP-CT delivered via telephone versus Zoom, and greater pain reduction in those with purely neuropathic pain.

Conclusions:

• Hypnotic cognitive therapy (HYP-CT) is an effective adjunctive treatment for reducing pain intensity in individuals with spinal cord injury (SCI).
• HYP-CT also demonstrates benefits in improving depression symptoms associated with SCI.
• Further replication studies are recommended to validate these findings.