Abstract
BackgroundMany studies show an effectiveness of hypnotic analgesia. It has been discussed whether the analgesic effect is mainly caused by the relaxation that is concomitant to hypnosis. This study was designed to evaluate the effects of hypnotic relaxation suggestion on different somatosensory detection and pain thresholds.MethodsQuantitative sensory testing (QST) measurements were performed before and during hypnosis in twenty-three healthy subjects on the dorsum of the right hand. Paired t-test was used to compare threshold changes. The influence of hypnotic susceptibility was evaluated by calculating correlation coefficients for threshold changes and hypnotic susceptibility (Harvard group scale).ResultsDuring hypnosis significantly changed somatosensory thresholds (reduced function) were observed for the following sensory detection thresholds: Cold Detection Threshold (CDT), Warm Detection Threshold (WDT), Thermal Sensory Limen (TSL) and Mechanical Detection Threshold (MDT). The only unchanged sensory detection threshold was Vibration Detection Threshold (VDT). No significant changes were observed for the determined pain detection thresholds (Cold Pain Thresholds, Heat Pain Thresholds, Mechanical Pain Sensitivity, Dynamic Mechanical Allodynia, Wind-up Ratio and Pressure Pain Threshold). No correlation of hypnotic susceptibility and threshold changes were detected.ConclusionHypnotic relaxation without a specific analgesic suggestion results in thermal and mechanical detection, but not pain threshold changes. We thus conclude that a relaxation suggestion has no genuine effect on sensory pain thresholds.Trial RegistrationClinicalTrials.gov, Identifier: NCT02261155 (9th October 2014).
Highlights
Many studies show an effectiveness of hypnotic analgesia
Cold detection thresholds (CDT) were significantly lowered, warm detection thresholds (WDT) were significantly elevated during hypnosis compared to the measurements before hypnosis
In summary our findings show that the induction of a hypnotic state without special analgesic suggestions has no effects on pain perception thresholds but solely leads to an increase in sensory detection thresholds
Summary
Many studies show an effectiveness of hypnotic analgesia. It has been discussed whether the analgesic effect is mainly caused by the relaxation that is concomitant to hypnosis. This study was designed to evaluate the effects of hypnotic relaxation suggestion on different somatosensory detection and pain thresholds. The question has been raised over whether (a) hypnotic analgesia is a unique pain reduction strategy, (b) a combination of different behavioral and cognitive elements, or (c) if the element of relaxation is responsible for an important part of the analgesic effect [7,8]. This question cannot be answered since the relation between hypnotic analgesia and the different hypnotic techniques/suggestions seems complex [9]. A number of investigations could show that pain reduction was more effective in high than in low hypnotizable subjects [8,15,16] and it seems that at least in a non-hypnotic state only highly hypnotizable subjects can profit from specific suggestions [17]
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