by Nicole Evans M.D.

Created on: April 13, 2010   Last Updated: April 25, 2010

Fibromyalgia is a chronic, painful condition that has few effective treatment options.  The majority of individuals with fibromyalgia are women, many of whom experience depression and/or anxiety in addition to the widespread pain, fatigue and stiffness common in fibromyalgia.  With this knowledge, researchers have begun evaluating psychotherapeutic approaches to fibromyalgia treatment.  In particular, hypnosis and guided imagery may be able to improve the symptoms of fibromyalgia. 

The prevalence of comorbid psychological symptoms in individuals with fibromyalgia has led many health care practitioners to look for guidance on the use of psychotherapeutic treatment options.  Cognitive behavioral therapy (CBT) and operant behavioral therapy (OBT) are known to have benefit in fibromyalgia patients.  However, these time intensive and costly therapies may prohibit their use in many individuals.

In addition to these more traditional psychotherapies, current research suggests that hypnosis and guided imagery may have a role in treating fibromyalgia.  This interesting treatment option was discussed in a recent review of the literature investigating the effectiveness of psychotherapeutic treatments in fibromyalgia.

The review focused on two randomized controlled trials evaluating the use of hypnotherapy and three studies evaluating the use of guided imagery in people with fibromyalgia.  These five randomized controlled trials, the gold standard experimental design in clinical research, found consistent positive results in the treated patients as compared to the control patients.

In one study, 40 patients with fibromyalgia were treated with eight hypnotherapy sessions over the course of 3 months.  These hypnosis sessions focused on sensory and affective (emotion-based) approaches to fibromyalgia pain control.  The results show that pain intensity was reduced, there was less fatigue on awakening, and the participants sleep patterns were improved.

A second study evaluated the effect of up to five hypnosis sessions on 53 fibromyalgia patients.  This study also found that hypnotherapy improved sleep quality in the fibromyalgia patients.  In addition, participants who received hypnosis had less morning stiffness.

The three studies which evaluated the effectiveness of guided imagery in treating fibromyalgia found that pain was reduced in intensity and anxiety was lessened.  In particular, one study compared guided imagery that used pleasant imagery with guided imagery focused upon the “active workings of the internal pain control systems”.  The pleasant guided imagery was significantly more effective in reducing fibromyalgia pain.

Individuals with fibromyalgia have precious few effective treatment options.  Fortunately, research is beginning to discover the effectiveness of certain psychotherapeutic treatment options.  Hypnosis and guided imagery may be one effective option to improve the mental, emotional, and physical symptoms of fibromyalgia.

Source:

Thieme K, Gracely RH.  Are psychological treatments effective for fibromyalgia pain? Curr Rheumatol Rep. 2009 Dec;11(6):443-50.

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