The following is a table from Biological Psychology, by Rosenzweig, Breedlove and Lehman, reproduced by kind permission of the publishers, Sinauer. This is not a book about hypnosis and, indeed, hypnosis isn't mentioned anywhere else in its 650 academic pages so it's not in any sense a flag waver for the hypnotherapy profession.
It compares various types of pain relief intervention, and hypnosis is the only one with no negative comment.
Measure | Mechanism | Limitations/Comments |
PSYCHOGENIC | ||
Placebo | May activate endorphin-mediated pain control system | Sometimes inhibited by opiate antagonists |
Hypnosis | Alters brain's perception of pain | Control unaffected by opiate antagonists |
Stress | Both opioid and non-opioid mechanisms | Clinically impractical and inappropriate |
Cognitive (learning, coping strategies) | May activate endorphin-mediated pain control system | Limited usefulness in severe pain |
PHARMACOLOGICAL | ||
Opiates | Bind to opioid receptors in peri-aqueductal gray and spinal cord | Severe side effects due to binding in other brain regions |
Spinal Block | Drugs block pain signals in spinal cord | Avoids side effects of systematic administration |
Anti-inflammatory drugs | Blocks prostaglandin and leukotriene synthesis at site of injury | Major side effects |
Aspirin | Blocks prostaglandin synthesis at site of injury | Does not block leukotriene synthesis |
STIMULATION | ||
TENS/Mechanical | Tactile or electrical stimulation of large fibres blocks or alters pain signal to brain | Segmental control; must be applied at site of pain |
Acupuncture | Similar to TENS | Sometimes affected by opiate antagonists |
Central gray | Electrical stimulation activates endorphin-mediated pain control systems, blocking pain signal in spinal cord | Control inhibited by opiate antagonists |
SURGICAL | ||
Cut peripheral nerve cord | Create physical break in pain pathway | Considerable risk of failure or return of pain |
Rhizotomy (cutting dorsal root) | ||
Cord hemisection | ||
Frontal lobotomy |