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Background/Objectives: Hypnosis shows great potential for managing patients suffering from fibromyalgia and chronic pain. Several studies have highlighted its efficacy in improving pain, quality of life, and reducing psychological distress. Despite its known feasibility and efficacy, the mechanisms of action remain poorly understood. Building on these insights, this innovative study aims to assess neural activity during hypnosis in fibromyalgia patients using high-density electroencephalography (EEG) and self-reported measures. Methods: Thirteen participants with fibromyalgia were included in this study. EEG recordings were done during resting state and hypnosis conditions. After both conditions, levels of pain, comfort, absorption, and dissociation were assessed using a numerical rating scale. Time perception was collected via an open-ended question. The study was prospectively registered in the ClinicalTrials.gov public registry (NCT04263324). Results: Neural oscillations showed increased theta power during hypnosis in the left parietal and occipital electrodes, increased beta power in the frontal and left temporal electrodes, and increased slow-gamma power in the frontal and left parietal electrodes. Functional connectivity using pairwise-phase consistency measures showed decreased connectivity in the frontal electrodes during hypnosis. Graph-based measures, the node strength, and the cluster coefficient were lower in frontal electrodes in the slow-gamma bands during hypnosis compared to resting state. Key findings indicate significant changes in neural oscillations and brain functional connectivity, suggesting potential electrophysiological markers of hypnosis in this patient population. [ABSTRACT FROM AUTHOR]

The majority of non-specific low back pain has a favourable evolution within a short period of time but in some cases the pain becomes persistent or recurrent. These chronic forms are responsible for most of the social and economic burden of low back pain. The crucial role of psycho-social factors in the chronicisation of low back pain justifies a thorough bio-psycho-social assessment. An active semi-intensive ambulatory multidisciplinary programme (Spine Unit Center) that complies with international and national recommendations (KCE and INAMI) has demonstrated its effectiveness in chronic low back pain in terms of algo-functional, physical and psycho-social components. In contrast to intensive programmes requiring hospitalisation, this outpatient treatment allows the patient to remain in his/her social and professional network. The active participation and motivation of the patient are essential for the success of the treatment. The multidisciplinary team will help the patient to define his/her functional objectives and to manage, via the psychologist, emotional aspects. The programme includes therapeutic education and physical reconditioning sessions including progressive aerobic training, group exercises, and individualised and progressive strengthening of the trunk muscles. The introduction of physical activity at home will be encouraged in order to sustain the changes in the patient's behaviour.

Objective: To identify profiles of patients who are at risk of dropping out from biopsychosocial approaches to chronic pain management., Patients: A total of 575 patients were included in the study. Of these, 203 were randomized into 4 treat-ment groups: self-hypnosis/self-care; music/self-care; self-care; and psychoeducation/cognitive behavioural therapy. The remaining 372 patients were not randomized, as they presented with the demand to learn self-hypnosis/self-care, and therefore were termed a "self-hypnosis/self-care demanders" group., Methods: Socio-demographics and behavioural data were included in the analyses. Univariates analyses, comparing early drop-outs (never attended treatment), late drop-outs (6/9 sessions' treatment) and continuers were conducted in order to select variables to include in a multivariate logistic regression., Results: Univariate analyses yielded 8 variables, out of 18 potential predictors for drop-out, which were eligible for inclusion in the multivariate logistic regression. The model showed that having an intermediate or high educational level protects against dropping out early or late in the pain management process. Having to wait for more than 4 months before starting the treatment increases the risk of never starting it. Being randomized increases the risk of never starting the treatment., Conclusion: In a context in which randomization is considered a "gold standard" in evidence-based practice, these results indicate that this very principle could be deleterious to pain management in patients with chronic pain.

Background: Patients' changing attitudes and beliefs about pain are considered as improvements in the treatment of chronic pain. Multidisciplinary approaches to pain allow modifications of coping strategies of patients, from passive to active., Methods: We investigate how two therapeutic treatments impact patients' attitudes and beliefs regarding pain, as measured with the Survey of Pain Attitudes (SOPA). We allocated 415 patients with chronic pain either to psychoeducation combined with physiotherapy, self-hypnosis combined with self-care learning, or to control groups. Pain intensity, global impression of change, and beliefs and attitudes regarding pain were assessed before and after treatment., Results: Our main results showed a significant effect of psychoeducation/physiotherapy on control, harm, and medical cure SOPA subscales; and a significant effect of self-hypnosis/self-care on control, disability and medical cure subscales. Correlation results showed that pain perception was negatively associated with control, while positively associated with disability, and a belief that hurt signifies harm. Patients' impression of improvement was associated with greater control, lower disability, and lower belief that hurt signifies harm., Conclusions: The present study showed that self-hypnosis/self-care and psychoeducation/physiotherapy were associated with patients' evolution of coping strategies from passive to active, allowing them to reduce pain perception and improve their global impression of treatment effectiveness.