Hypnotherapy relieves chest pain not linked to heart disease

According to a small study in the UK, hypnotherapy was helpful in relieving the angina-like chest pain experienced by some people which is not caused by heart disease.

The condition is very debilitating and is difficult to treat and all the evidence indicates that patients with the condition and with normal coronary arteries have an excellent prognosis regarding life expectancy and have a low risk of developing coronary artery disease at a later stage.

Despite this knowledge such patients remain anxious and difficult to reassure, and continue to take anti-anginal medication and seek medical advice more often than individuals with proven coronary artery disease.

Dr. Peter Whorwell and colleagues of Wythenshawe Hospital in Manchester studied 28 patients with normal coronary angiography and no evidence of heartburn.

The group were given either twelve 30-minute sessions of hypnotherapy or "supportive therapy" plus a placebo medication over a 17 week period.

Patients were given a tutorial about their condition and the factors that might be involved, such as disturbances in motility and visceral sensation and stress.

Then, after progressive muscular relaxation, 'chest-focused' suggestions were introduced, "centered around normalization of function" of the esophagus.

More direct suggestions about pain reduction and health improvement were added.

Patients were also given an audio tape or CD of each session and were encouraged to practice at home.

The average age of the 15 hypnotherapy patients, including 10 women, was 60, while in the 13 controls, including eight women, it was 54.

Twelve of 15 of the hypnotherapy patients experienced an improvement in pain compared with only three of 13 of the controls.

The hypnotherapy also produced a significant improvement in well being and those patients were able to reduce their use of medications, whereas the controls increased their usage, creating a significant difference in favor of hypnotherapy, say the investigators.

Among the plethora of drugs taken by both groups were beta-blockers, calcium-channel blockers, potassium-channel activators, nitrates, aspirin, and statins.

Anxiety and depression levels were similar in both groups and remained unchanged, according to the study.

Supportive therapy was provided by a research assistant equal in status to the hypnotherapist and patients were encouraged to discuss their physical symptoms and emotional issues and were also given placebo medication to boost the effects.

The researchers have previously shown that hypnotherapy is a benefit to patients with irritable bowel syndrome, enabling the reduction of medication used and visits to the doctor.

The researchers say the therapy also appears to have good pain-relieving qualities, suggested by brain scans showing the treatment's effect on a brain region that processes the emotional content of painful stimuli.

Whorwell and his team acknowledge that hypnotherapy can be expensive, but say it could cut costs in the long run by reducing testing, medication, and visits to doctors.

The research is published in Gut, May 2006.