TMD Hypnosis Research

A temporomandibular disorder (or TMD) is a term used to describe chronic and or acute inflammation of the temporomandibular joint with sufferers reporting significant pain in and around the jaw, radiating pain across the shoulders and neck as well as also commonly reporting associated headaches, earaches and facial pain. Typically 5-7% of the population suffers from some form TMD which includes bruxism.

There are a number of different approaches in treating the condition and hypnotherapy is often said to be one of them. Since TMD in many cases is an unconscious sleep state action (teeth grinding), many report that traditional means of treatment simply do not work because a conscious awareness of the action is a prerequisite to treatment. Hypnosis is often seen as a possible option because it targets the unconscious driver behind the bruxism not requiring a conscious state of awareness to be of some benefit. Researchers from the University of Hawaii and the Tripler Regional Medical Center looked at the effectiveness of medical hypnosis in treating the pain symptoms of TMD to find out whether hypnotherapy could be a more mainstream approach to treat it.

28 patients were recruited for the study who at the onset, had not responded to more traditional means of treatment. The patient’s age ranged from 20 to 52 years with a mean age of 33. Of the original 28 patients, 23 patients were included in the final results of the study. Those 23 participants had at least 3 to 6 sessions of hypnosis treatment. The 5 not included in the study were classified as drop outs. Hypnosis treatment involved standard hypnotic treatment protocols including relaxation techniques, inductions, guided imagery, taught self hypnosis, convincers and post hypnotic suggestions. The patients were asked to fill out a relevant pain questionnaire four times – during a period on a wait list, immediately before treatment, post treatment, and finally, at a 6 month mark follow up.

71% of the patients reported improvement in daily functioning immediately after treatment and at the 6 month mark, this figure improved further to 80.45%. It should also be noted that patients exhibited far less wear and tear on their respective splints. The patients overall reported a significant reduction in pain frequency, duration, and intensity of pain post treatment. This study provides some promise to the argument that hypnosis and hypnotherapy can help alleviate the pain associated with TMD including bruxism and teeth grinding. Future studies should include a control group to provide a more evidentiary basis for this argument.

References

Simon E & Lewis D: Medical hypnosis for temporomandibular disorders: treatment efficacy and medical utilization outcome. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000;90:54-63.

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Effects of Self-Hypnosis Training & EMG Biofeedback Relaxation Training on Chronic Pain in Persons with Spinal Cord Injury

Researchers from the University of Washington compared the effect of self hypnosis training and biofeedback relaxation based training on pain levels in sufferers of spinal cord injury (Jensen M, et al., 2009). 37 adults were included in the study that all had spinal cord injury and high levels of associated chronic pain. Participants were either assigned to 10 sessions of self hypnosis training or EMG biofeedback relaxation training. Participants in both groups reported significant reductions in pain levels including intensity, however, those assigned to the self hypnosis training group reported greater decreases in their respective pain scores. These reductions in pain levels were consistent at the three month follow up. Future studies should include a control group with no intervention to provide a more accurate picture on the significance of both treatments. However, as with many hypnosis and pain studies that go before this one, hypnosis is shown once again to help those that suffer from high levels of chronic pain.

References
Ian Wickramasekera II: Effects of self-hypnosis training and EMG biofeedback relaxation training on chronic pain in persons with spinal cord injury American Journal of Clinical Hypnosis. Bloomingdale Oct 2009. 52:2; 158

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Hypnosis for Insomnia in Children

Researchers from the State University of New York Upstate Medical University looked at whether hypnosis was an effective means to treat insomnia in children. The following reviews this study. The researchers set out to document any medical conditions and or psychosocial stressors that were associated with insomnia as well as to report the effectiveness of hypnosis in treatment of the condition. Insomnia being defined by an inability to fall asleep, nighttime awakenings, lack of quality and or duration of sleep (Silber, 2005). It is suggested that the condition in children is not primary but secondary to medical or psychological conditions such as depression, anxiety, pain, cystic fibrosis or asthma (Stores, 1996). 

It has been found that insomnia affects a large proportion of school aged adolescents and children. In a study that was conducted in 1997, 987 students of New York elementary students were studied, of which 11% found it difficult to go to sleep, 7% woke up often for extended periods of time during the evening, more than 17% found it difficult to wake in the mornings and 17% reported being tired during the day (Blader et. al, 1997).

84% of the children and adolescents that were studied had either central or obstructive sleep apnea. We would like to thank The Snoring Mouthpiece Review (website here) for helping us with the sleep apnea data collection. All patients were given the opportunity to accept self hypnosis instruction, and did so for the treatment of their condition. After the first session of hypnosis 75 patients returned for the secondary session of hypnotherapy. The mean age of the group was 12 years with a range of 7 to 17. When it was found that the first session was not significantly effective, the second session was offered to provide more insight into the cause of their respective conditions.

The younger children of the study were more likely to report that their reported insomnia was related to fears and related fear related anxieties. For 68% of the patients, two or less hypnosis sessions were provided. More than 90% of the 70 patients, who initially reported a delay in sleep onset of more than 30 minutes, reported a reduction in sleep onset time following the hypnotherapy sessions. Furthermore of the 21 patients that initially reported nighttime awakenings, post study follow ups found that more than 52% reported resolution to the issue and 38% found improvement. The patients of the study that reported somatic complaints including chest pain, dyspnea, functional abdominal pain, headaches, habit cough and dysfunction of the vocal cord, 87% of which reported resolution or improvement. The use of hypnosis to treat the condition of insomnia in children has been shown to be effective in this study.

References

Anbar R & Slothower M: Hypnosis for treatment of insomnia in school-age children: a retrospective chart review BMC Pediatrics 2006, 6:23

Silber MH: Chronic insomnia. N Engl J Med 2005, 53:803-810.

Knutson K: The association between pubertal status and sleep duration and quality among a nationally representative sample of US adolescents. Am J Hum Biol 2005, 17:418-424.

Blader JC, Koplewicz HS, Abikoff H, Foley C: Sleep problems of elementary school children. A community survey. Arch Pediatr Adolesc Med 1997, 151:473-480.

Stores G: Practitioner review: assessment and treatment of sleep disorders in children and adolescents. J Child Psychol Psychiatry1996, 37:907-925.

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