Hypnosis

Summary:
Clinical hypnosis uses focused attention and guided imagery to reduce pain perception and stress. It may be used preventively or during attacks.

Biological Plausibility

Hypnosis modulates attention and pain processing in the brain. Imaging studies show altered activity in pain-related regions during hypnotic analgesia, suggesting it may reduce central sensitization.

Evidence

Some small trials and case studies suggest benefit in migraine, particularly when integrated with cognitive-behavioral strategies. Data is sparse but promising.

Effect Size

Unknown. Most studies report qualitative improvement, with some showing reduced frequency and disability.

⚠️ Risk

Minimal. May not be effective for all users. Requires trained provider.

Cost

$$$

Scores

  • Benefit: 2
  • Burden: 3
  • Ratio: 0.67

Clinical Takeaways

  • May be a useful adjunct in stress-sensitive patients.
  • Works best when combined with other behavioral strategies.
  • Requires engagement and access to trained practitioner.

Key References

  • Hammond DC. *Hypnosis in the treatment of headache and migraine.* Am J Clin Hypn. 2007.
  • Dillworth TM, et al. *Hypnosis and guided imagery for chronic pain management: mechanisms and efficacy.* Am Psychol. 2009.
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