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Conventional Approaches

Psychological/Mind-Body Therapies

Mind/body therapies have a significant role to play in the management of all chronic pain syndromes. Cognitive behavioral therapy, biofeedback, relaxation training and hypnosis, while not studied specifically for PHN pain, have all demonstrated benefit in chronic pain conditions, including neuropathic pain (Kanazi, 2000). In addition, numerous case studies have been reported in the medical literature on the effectiveness of mind/body strategies in treating PHN pain.

  • Biofeedback: Clinical trials have supported the effectiveness of biofeedback in treating a number of chronic pain conditions. However, for neuropathic pain, only case series of successful treatment using biofeedback have been reported in the medical literature, with none focused specifically on PHN pain (Haythornthwaite, 2001). The addition of biofeedback training to other treatment strategies might be worthwhile, given that this is a safe form of treatment and training in relaxation strategies is virtually always beneficial (although the expenditure of time and money is a serious consideration).

  • Cognitive Behavioral Therapy (CBT): While there is no specific research on the use of cognitive behavioral techniques for PHN pain per se, CBT is known to have a broad impact on pain and function in chronic pain syndromes (Morley, 1999). Various mental and emotional factors, such as feeling a lack of control, distress, hopelessness, fear, anxiety and depression, can strongly influence the experience of pain. In general, CBT can lead to better pain control and coping through learned relaxation, restructuring of beliefs about pain and function, and in some cases reducing depression. In addition studies with 6-month follow up periods have demonstrated that further improvements can occur even after completion of cognitive behavioral sessions (Haythornthwaite, 2001)

  • Hypnosis: The use of hypnosis in the management of PHN is limited to case reports by individual practitioners (Gainer, 1992) (Haythornthwaite, 2001). These case studies suggest that hypnosis can be effective in the treatment of PHN, but that the longer the condition has lasted, the poorer the treatment response is likely to be (Dane, 1998). It is felt that when used by properly trained clinicians, hypnosis can have a beneficial effect in reducing PHN pain in selected patients (Shenefelt, 2000).

   

 

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