Chronic pain is one of the most isolating conditions I work with. Not because the people suffering from it are alone — millions of people in the UK live with persistent pain — but because of how poorly it is understood, even by those closest to them.
Clients who come to me with chronic pain have usually been through the medical system thoroughly. They’ve had scans. They’ve tried medication. Some have had procedures or surgery. Many have been told there is nothing structurally wrong, which is confusing and sometimes devastating to hear when the pain is so clearly real.
What I want to explain in this article is why that finding — “nothing structurally wrong” — is not the end of the story. It’s actually a doorway. Because it points toward what is driving the pain, and that changes what can be done about it.
Pain Is Not Simply a Signal From a Damaged Body Part
This is the single most important thing I want chronic pain sufferers to understand, because it reframes everything.
Pain is not just a signal that travels from an injured area to the brain. It is the brain’s output — a protective response generated when the brain concludes that the body is under threat. The brain takes in information from the nervous system, cross-references it with past experience, emotional state, stress levels, and context, and then decides how much pain to produce.
This is why two people with identical spinal MRI results can have completely different pain experiences. It’s why pain often persists long after tissue healing is complete. And it’s why stress, anxiety, poor sleep, and low mood reliably make pain worse — they are all inputs the brain uses when generating its pain output.
In chronic pain, the brain has essentially become oversensitive — a process called central sensitisation. The nervous system has been in high-alert mode for so long that it begins amplifying signals that wouldn’t normally register as painful. The volume has been turned up, and ordinary movement or sensation gets interpreted as threat.
Understanding this is not about saying the pain is ‘all in your head’ — a phrase that is both inaccurate and unhelpful. It is about recognising where the pain is actually being generated, so we can address it there.
Why Hypnotherapy Is Particularly Well Suited to Chronic Pain
Because chronic pain is maintained largely in the brain and nervous system rather than solely in the tissue, approaches that work directly with the brain have a genuine advantage. Hypnotherapy is one of them.
The evidence base is substantial. Research by Rainville et al. (1997) demonstrated that hypnotic suggestion changes activity in the anterior cingulate cortex — the brain region responsible for the emotional and suffering component of pain. A 2016 meta-analysis published in Neuroscience & Biobehavioral Reviews found that hypnosis significantly reduces both clinical and experimental pain across a wide range of conditions. The American Psychological Association recognises hypnosis as effective for pain management.
In practical terms, hypnotherapy addresses chronic pain through several interconnected mechanisms.
Directly modifying pain perception
In the deeply relaxed and receptive state of hypnosis, the brain becomes open to suggestions that change how it interprets pain signals. I use specific techniques — including glove anaesthesia, pain transformation, and dissociation — to alter the quality, intensity, or location of pain. Clients frequently describe pain as dimmer, further away, or changed in character after a session. With repetition, these changes become more durable.
Calming the sensitised nervous system
The hypnotic state activates the parasympathetic nervous system — the body’s rest and recovery mode. For people living with chronic pain, whose nervous systems are frequently stuck in a state of high alert, this activation is itself therapeutic. Regular access to deep parasympathetic states begins to recalibrate the baseline, gradually turning down the volume at which the nervous system operates.
Breaking the pain-stress-pain cycle
Chronic pain and stress feed each other in a well-documented cycle. Pain causes stress and anxiety, which elevates cortisol, which sensitises the nervous system further, which amplifies pain, which causes more stress. Hypnotherapy interrupts this cycle at multiple points — by reducing anxiety, lowering stress hormones, and changing the emotional response to pain. Many clients find that as their anxiety about the pain reduces, the pain itself becomes more manageable even before we have directly targeted the sensation.
Addressing the psychological weight of chronic pain
Living with pain for months or years takes a significant psychological toll. Feelings of grief for the life you had before, frustration at not being believed, fear about the future, and a gradual withdrawal from activities you used to enjoy — these are all common, and they all feed back into the pain experience. Hypnotherapy gives space to process this psychological dimension, which is rarely addressed in medical pain management.
Conditions I Work With Most Frequently
Chronic pain presents in many different forms. The following are conditions I have specific experience working with in my London practice:
- Fibromyalgia — widespread musculoskeletal pain with no clear structural cause, often accompanied by fatigue and sleep disturbance
- Chronic back and neck pain — particularly where imaging has shown no significant abnormality or where pain persists after structural issues have been treated
- Headaches and migraines — where stress and nervous system sensitisation are significant drivers
- IBS and functional gut pain — gut-directed hypnotherapy has a strong evidence base specifically for this
- Post-surgical pain — where pain continues after the surgical site has healed
- Complex Regional Pain Syndrome (CRPS) — a condition that exemplifies central sensitisation and can respond well to mind-body approaches
I always work collaboratively with clients’ GPs and other treating clinicians. Hypnotherapy is a complement to medical care, not a replacement for it.
What Clients Can Expect From Treatment
The first session is always a thorough consultation. I want to understand the full history — when the pain began, what makes it better or worse, what treatments have been tried, how it affects daily life, and what the person actually wants their life to look like. This shapes everything that follows.
For chronic pain, I typically recommend a minimum of 6 sessions, with 8 being a more realistic target for longer-standing conditions. Unlike acute issues, chronic pain has usually been reinforced over a long period, and the nervous system needs consistent, repeated input to recalibrate.
Between sessions, I provide a personalised audio recording for daily use. This is an important part of the process — the more regularly clients practise, the faster the nervous system begins to shift. I also teach self-hypnosis techniques that can be used during flare-ups or difficult moments.
Progress with chronic pain is rarely linear. Some clients notice a meaningful reduction in pain within the first few sessions. Others experience the psychological benefits first — better sleep, reduced anxiety, a greater sense of control — and the physical changes follow. I set realistic expectations from the start, because false promises do not serve people who have already been through a lot.
Frequently Asked Questions
Can hypnotherapy cure chronic pain?
I’m cautious about the word ‘cure’, and I think any practitioner who uses it freely around chronic pain should be approached carefully. What hypnotherapy can do is significantly reduce pain intensity, improve your ability to manage flare-ups, break the anxiety-pain cycle, and restore quality of life. For some clients the improvement is dramatic. For others it is more gradual. The goal is always meaningful, sustainable progress rather than a promise I can’t keep.
Will I have to stop my other pain treatments?
No. Hypnotherapy works alongside medication, physiotherapy, pain management programmes, and other treatments. I always ask clients to keep their GP informed and never advise stopping prescribed medication. The approaches are complementary.
What if I’ve had pain for many years — is it too late?
No. The brain retains its capacity for change — neuroplasticity — regardless of how long a pattern has been established. Longer-standing conditions may require more sessions and more patience, but I have worked successfully with clients who have lived with chronic pain for a decade or more. Duration does not determine outcome.
Is online hypnotherapy as effective for pain?
Yes, in my experience. The hypnotic state can be achieved just as effectively online, and for clients with pain conditions that make travel difficult or tiring, working from home is often the more practical and comfortable option. Many of my chronic pain clients work with me online.
My doctor is sceptical about hypnotherapy. What should I tell them?
The evidence base for hypnotherapy in pain management is well-established and published in peer-reviewed journals. The American Psychological Association endorses it. NICE guidelines reference it for IBS. If your GP would like to know more, I am always happy to be contacted directly. I take collaborative care seriously and am comfortable communicating with other clinicians.
Living With Pain Is Not the Only Option
If you’ve been managing chronic pain for months or years, and you’re looking for an approach that works at the level where the pain is actually being generated, I’d welcome a conversation.
I offer a free initial phone consultation so we can talk through your specific situation, your history, and whether hypnotherapy is a good fit. There is no obligation, and I will always be honest with you about what is realistic.
Sessions are available in person at 364 City Road, London EC1V 2PY, and online for clients across the UK. Call 020 7101 3284 or book via the link below.
About the Author
Antonios Koletsas is a clinical hypnotherapist based in London, registered with the General Hypnotherapy Standards Council (GHSC) and the General Hypnotherapy Register (GHR). He has worked with chronic pain clients at his City Road practice and online across the UK, specialising in conditions including fibromyalgia, IBS, persistent back pain, and CRPS.
Clinical References
Rainville, P. et al. (1997). Pain affect encoded in human anterior cingulate but not somatosensory cortex. Science, 277(5328), 968–971.
Jensen, M.P. & Patterson, D.R. (2014). Hypnotic approaches for chronic pain management. American Psychologist, 69(2), 167–177.
Milling, L.S. et al. (2021). Hypnosis and pain: Mechanisms, applications, and efficacy. Neuroscience & Biobehavioral Reviews, 123, 120–132.
American Psychological Association. (2019). Hypnosis for the relief and control of pain. APA Division 30, Psychological Hypnosis.
Moseley, G.L. & Butler, D.S. (2015). Fifteen years of explaining pain: The past, present, and future. Journal of Pain, 16(9), 807–813.
