A Randomized Controlled Trial of Hypnosis to Manage Musculoskeletal Pain in Breast Cancer Survivors Taking Aromatase Inhibitors

The aim of this study was to test the efficacy of a three-session hypnosis intervention to manage musculoskeletal pain (MSP) in breast cancer survivors taking aromatase inhibitors (AIs). We hypothesized that patients in the hypnosis group would have lower levels of pain than patients in an attention control group. A secondary outcome was to examine intervention effects on AI adherence. Patients (n = 154) were randomly assigned to a hypnosis (n = 76) or to an attention control (n = 78) group. MSP was measured at five time points (baseline, 3, 6, 9, and 12 months) using the Brief Pain Inventory-Short Form (BPI-SF; severity, primary outcome), the BPI-SF (interference), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Australian/Canadian Osteoarthritis Hand Index and the Breast Cancer Prevention Trial-Musculoskeletal Symptom. AI adherence was measured using eCAPs and self-report (Medication Adherence Report Scale). The hypnosis group had significantly lower BPI-SF severity (p < .01) and interference (p < .03) scores across assessment points. The Australian/Canadian Osteoarthritis Hand Index (total [p < .01], pain [p < .01], stiffness [p < .04], and function [p < .04]) and the Breast Cancer Prevention Trial-Musculoskeletal Symptom (p < .001) scales showed similar results in favor of hypnosis. WOMAC pain (p < .02) and stiffness (p < .01) subscales were also in favor of the hypnosis group, but differences on WOMAC function were nonsignificant (p > .11). AI adherence scores did not differ between the groups (eCAP, p > .80; Medication Adherence Report Scale, p > .18). Results support hypnosis as efficacious for controlling MSP in breast cancer survivors taking AIs. Hypnosis is brief, has no specific side effects, can be taught to patients to use on their own, and its beneficial effects persist long after the last intervention session.