The efficacy of hypnosis in chronic low back pain: Protocol for a systematic review and meta-analysis of randomized controlled trials

Introduction: Chronic low back pain (CLBP) is among the most prevalent musculoskeletal disorders that significantly affects the quality of life of those with this condition. Clinical hypnosis is a psychological intervention that can be used to reduce the intensity and impact of chronic pain. Systematic reviews and meta-analyses have concluded that clinical hypnosis is effective for general chronic pain conditions; however, meta-analytic research on its impact specifically on CLBP remains scarce. This study protocol describes a systematic review and meta-analysis aimed at evaluating the efficacy of hypnosis in reducing pain and associated symptoms in individuals with CLBP, as investigated in randomized controlled trials (RCTs). Methodology: The review will be conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. A comprehensive search of eight electronic databases (Scopus, PubMed, CINAHL, Cochrane Central Register of Controlled Trials, EMBASE, PEDro, ScieELO, and LILACS) will be conducted to retrieve relevant studies published up to the date that we conduct the primary analyses, and then repeated just before we submit the article (with any additional articles identified incorporated into the review). Studies with RCTs, involving adults with CLBP (≥3 months), where hypnosis intervention was used as monotherapy or an adjunct therapy, will be eligible for inclusion. The primary outcome will be pain intensity, while secondary outcomes will include disability, sleep disturbances, and adverse events. Selection of studies, extraction of relevant data, and assessing risk of bias using Cochrane risk of bias tool-2 will be performed by two independent reviewers. Any discrepancies will be addressed through mutual discussion or by consulting a third independent reviewer if required. Meta-analysis will be performed using standardized mean differences for pain and secondary outcomes. Heterogeneity will be assessed and subgroup analyses are planned. Conclusion: The review will provide an extensive overview of the available evidence on the efficacy of hypnosis on individuals with CLBP and identify knowledge. The results are intended to support the development of clinical recommendations and assist healthcare providers who are considering incorporating clinical hypnosis into interdisciplinary pain management strategies. Trial Registration: PROSPERO 2025 CRD420251016398 on 29th March 2025.