Chronic Idiopathic Orofacial Pain; Effect of Hypnosis & Psychosocial Findings

Objectives: To test the effect of hypnosis on chronic idiopathic orofacial pain in terms of clinical and psychosocial findings. Methods: Forty-one patients (mean age 54.6±12.2 yrs) suffering from chronic idiopathic pain (CIP) with mean duration of 9.5±6.7 yrs were randomised to active hypnotic intervention (A) or simple relaxation (N) for six individual one-hour sessions. Pain intensity was scored 3 times daily on a visual analogue scale (VAS). In addition, pain was assessed by McGill Pain Questionnaire (MPQ), psychological symptoms by Symptom Check List (SCL), life quality by SF36, as well as sleep quality and the current consumption of analgesics. All scores were compared between groups before and after treatment using an analysis of variance (ANOVA). Triggering, exacerbating, and relieving factors for pain as well as mental and general health history, social status, and access to social support were registered. Results: Significant difference in VAS pain scores between groups (P = 0.03) with a significant reduction for A (5.8 ± 2.1 to 3.9 ± 2.6; P < 0.01). The area of perceived pain from the MPQ also differed between groups (P = 0.03) and was significantly smaller in A (31.4 ± 31.9 arbitrary units) compared to before (64.9 ± 70.2 units; P < 0.01). Sleep was improved in A and N (P = 0.02). No difference was found in other MPQ, SCL, SF36 scores or use of medication. High prevalence of somatization symptoms (90.2%), depression (80.5%), and obsessive compulsive disorder (78%) was found. CPIs had tried various kind of standard treatment without success. Conclusions: Treatment with hypnosis seems to offer some pain relief in conditions with idiopathic orofacial pain, however, stress coping skills, and unresolved psychological problems need to be dealt with as well. Acknowledgement: Supported by Danish Dental Association and ViFAB, Danish Ministry of the Interior and Health.