New study explores who benefits the most from different psychological chronic pain treatments

There are many non-pharmacological treatments that can help with pain, such as hypnosis and cognitive therapy. However, not all patients respond to these in the same way and we do not yet know how to best match patients to the treatment that is best for them. If the factors that make a patient more or less likely to respond to a given treatment were known, providers could better match patients to treatments. A new study seeks to explore these factors.

Patients with low back pain or chronic pain associated with multiple sclerosis, spinal cord injury, acquired amputation, or muscular dystrophy were assigned to four sessions of cognitive therapy, hypnosis focused on pain reduction, hypnosis focused on changing pain-related cognitions and beliefs, and a pain education control condition. Seven possible moderators (catastrophizing, hypnotizability, and electroencephalogram (EEG)-assessed oscillation power across five bandwidths) were assessed pre-treatment. The study findings, while preliminary, suggest that hypnotizability and EEG brain activity predict who is more or less likely to respond to different treatments.

For example, while people with more trait hypnotizability are more likely to respond to hypnosis treatments (a well-known finding), people who are more hypnotizable do not respond as well to cognitive therapy—a new finding. If more research replicates these results, this supports the idea that there is no such thing as a single, ‘gold-standard’ treatment. Instead, providers should offer patients a variety of treatments, and match the patient to the most-beneficial treatment.

The study, online in the Journal of Pain, was conducted by Mark P. Jensen, PhD; Dawn M. Ehde, PhD; Melissa A. Day, PhD; and Marcia A. Ciol, PhD, from our department; as well as Shahin Hakimian, MD, from the UW Department of Neurology and Mark Pettet, PhD, from the UW Integrated Brain Imaging Center (IBIC).