meditation and pain

If you’re among the tens of millions of North Americans living with chronic pain, we’ve got news about a drug-free “om remedy” worth trying: easy meditation.

Plenty of research shows that your brain’s superpowers can help conquer the most stubborn of miseries, including bad backs, cancer pain, arthritis, tension headaches and inflammatory bowel disease. The best part? You don’t have to move to a mountaintop, sit on a rock-hard meditation cushion or shell out big bucks for a meditation instructor to get results.

In a new study from the University of North Carolina at Charlotte, people who meditated for just 20 minutes a day saw their pain tolerance rise in four days. Volunteers learned an ultra-easy technique called mindfulness meditation, which teaches you to focus on your breath and stay in the present moment, and not to worry about what’s ahead. Researchers tested the volunteers’ pain thresholds with mild electric shocks and found that shocks considered “high pain” before meditating felt mild afterward. Volunteers who didn’t learn the meditation had unchanged responses to the shocks. (No, we can’t imagine why anyone volunteered for this, though we’re grateful that they did.)

Please don’t try this at home! But once you’ve finished reading this column, take a few minutes to test-drive our supersimple instructions (see below) for mindfulness meditation and two other pain-soothing techniques. You’ll feel calm, centered and Zenfully refreshed, fast.

But first, let’s get something straight: Meditation doesn’t work because your pain is “all in your head.” Chronic pain is all too real. Too many people live with it every day. When pain won’t quit, stress and worry kick in, boosting levels of stress hormones, which tricks your brain into thinking the pain is worse than it is. De-stressing with meditation or similar mind/body techniques (progressive muscle relaxation, guided imagery) dials back stress hormones, which in turn diminishes pain. The difference may be enough for you to reduce your pain meds or to get relief when drugs alone fall short.

There’s more. In other new research, this time from England’s University of Manchester, meditation eased pain by helping your brain to stop anticipating it — another stress trigger. Less stress and less pain also can mean better sleep, more motivation to exercise and even less depression, all of which also make you relax more and hurt less.

Ready to get started? Find a quiet place where you can sit or lie down comfortably for 10 to 15 minutes. Tape a “do not disturb” sign on the door. Then give these brain-powered pain-busters a whirl:

Mindfulness meditation. Close your eyes; it will help you stay focused. Breathe in and out, slowly and naturally (no need to hyperventilate), paying attention to how each inhale and exhale feels. Acknowledge your thoughts, feelings and the physical sensations in your body but don’t get wrapped up in them. Keep gently returning your focus to your rhythmic breathing. After 10 minutes or so, begin to notice your surroundings as you breathe calmly. Then plan to go about your day with this feeling of calm awareness.

Guided imagery. Send your brain on a journey to a beautiful, soothing place. This technique works by distracting you, although it helps ease pain in ways similar to meditation. Shut your eyes and imagine an idyllic “happy place” for you. It might be a beach, a beautiful room or a favorite childhood spot. Use all of your senses to put yourself in it, remembering scents, colors, air, mood, anything that makes it come alive for you. Stay there, relaxing and enjoying.

Progressive muscle relaxation. Your whole body will feel deeply relaxed with this tension-melting exercise. Throughout, breathe slowly from your abdomen. First, isolate and tighten each muscle group, but without straining, for seven to 10 seconds; then release the muscles abruptly, resting for 15 to 20 seconds as stress ebbs away. Start with your fists; move on to your forearms, biceps, face, neck, shoulders, upper back, chest, stomach, lower back, buttocks, thighs, lower legs, and finally, your feet. Ahhhhhh!

[via the Washington Examiner]

Controlling pain with alternative remedies

July 4, 2010

Meditation, Alexander Technique exercises and video games are some of the complementary therapies being practiced to keep pain in check.

Beyond drugs, beyond exercise, beyond simply getting better are other ways to control pain. Typically referred to as complementary alternative medicine, many people consider their use to be common sense.

At the top of the list is the ancient practice of meditation. A number of studies suggest it can help people feel less pain. In one study, published in May in the journal Pain, people who had some experience with mindful meditation were subjected to bouts of pain. Those who had more experience with meditating showed less activity in certain parts of their brain as they anticipated pain.
The Alexander Technique, which emphasizes body coordination and awareness, was shown to reduce pain in people with chronic or recurring low back pain. In that study, published in the British Journal of Medicine in 2008, 579 patients with lower back pain were randomly assigned to receive normal care, massage, six Alexander Technique lessons or 24 Alexander Technique lessons. Half of each group were also randomly assigned to an exercise program. Those who combined exercise with Alexander Technique lessons had less pain than those in other groups.
Video games presented in a virtual reality format have potential as well, helping children feel less pain while being stuck with an intravenous needle. In that research, some children wore a helmet that covered their head and showed an engaging game while a control group of kids went through standard care. All children were blocked from seeing their arms. The control group had a fourfold increase in pain intensity compared with the children who watched the video games.

Jeffrey Gold, director of the Pediatric Pain Management Clinic at Childrens Hospital Los Angeles, presented the study at the American Pain Society’s annual scientific conference last year and says there may be more at work than a significant distraction. Gold is now conducting a study, funded by the National Institutes of Health, that uses functional MRIs to test the effects of virtual reality on the brain.

“Virtual reality is not a panacea — you’re going to have to practice this and create new patterns in the brain,” Gold says. “If you’re able to train a person over several sessions, you may change the neurochemistry, and that’s going to have a more permanent effect on the brain’s ability to modulate pain.”

[Jeannine Stein, Los Angeles Times]

How the mind controls pain

June 23, 2010

Science is beginning to investigate and support the role of therapies such as biofeedback and meditation in pain control. The idea that the mind has power over the body may be especially useful to chronic pain patients who often find themselves without satisfactory medical treatments.

The emotional response to pain

Pain travels along two pathways from a source, such as an injury, back to your brain. One is the sensory pathway, which transmits the physical sensation. The other is the emotional pathway, which goes from the injury to the amygdala and the anterior cingulate cortex areas of the brain that process emotion.

“You may not be aware of it, but you’re having a negative emotional reaction to chronic pain as well as a physical reaction,” says Natalia Morone, M.D., assistant professor of general internal medicine at the University of Pittsburgh School of Medicine. Mind-body treatments that involve meditation and relaxation probably affect these emotional pathways. However, Dr. Morone admits that many doctors don’t put much stock in this theory. “Anything to do with mind-body medicine around pain is going to be controversial. This is all very new.”

Research is beginning to show the connection

In a 2005 study, researchers at Stanford University in Palo Alto, Calif., used functional magnetic resonance imaging (fMRI), which measures activity in different areas of the brain, to see whether subjects could learn to control a brain region involved in pain and whether that could be a tool for altering their pain perception.

Laura Tibbitts, 34, an event planner from San Francisco who severely injured her arm, shoulder and back when she was thrown off of a horse, participated in the study. In describing her pain, she says: “My muscles and nerves feel like a bunch of snakes that are all intertwined, but then I also get a stabbing and shooting pain. So you have that horrible, achy, uncomfortableness, but then you get these jolts of pain.”

In the study, Tibbitts was asked to increase her pain and as she did, an image of a flame on a computer monitor became stronger and more vibrant. Then she was told to decrease her pain, which caused the flame to die down. “Sometimes I would imagine that the pain was literally being scooped out from me, taken away and carried off. Other times I used water imagery, like it was flowing through me and taking it away,” says Tibbitts. After the test, she learned that she had been able to produce a 30 percent to 40 percent reduction in her overall pain.

Giving control to pain patients

For Sean Mackey, M.D., director of the pain management division at Stanford University School of Medicine and one of the study’s researchers, the research revealed a striking element of empowerment. “Patients would say, ‘A-ha! For the first time I could see the pain in my brain, and I could control it. And that was a very powerful experience,” he says.

Dr. Mackey believes pain medicine is moving away from the concept of strict mind-body separation toward a more unified—and ancient-sounding—view in which “mind and body are really one.”

The bottom line for pain patients is that they may want to pursue pain-control techniques such as biofeedback, yoga, and meditation. But they also need to be on the alert for scams and beware of claims made by therapists seeking to exploit their desperation. Before turning to one of these therapies, it’s best to thoroughly research the practitioner you choose.

[via MSN Health]

Brain scans show how meditation calms pain

June 10, 2010

People who routinely practice meditation may be better able to deal with pain because their brains are less focused on anticipating pain, a new British study suggests.

The finding is a potential boon to the estimated 40 percent of people who are unable to adequately manage their chronic pain. It is based on an analysis involving people who practice a variety of meditation formats, and experience with meditation as a whole ranged from just a few months to several decades.

Only those individuals who had engaged in a long-term commitment to meditation were found to have gained an advantage with respect to pain relative to non-meditators.

“Meditation is becoming increasingly popular as a way to treat chronic illness such as the pain caused by arthritis,” study author Dr. Christopher Brown, from the University of Manchester’s School of Translational Medicine, said in a university news release.

“Recently,” he noted, “a mental health charity called for meditation to be routinely available on the NHS [National Health Service of Great Britain] to treat depression, which occurs in up to 50 percent of people with chronic pain. However, scientists have only just started to look into how meditation might reduce the emotional impact of pain.”

The findings were released online recently in advance of publication in an upcoming print issue of the journal Pain.

All the forms of meditation that Brown looked at included mindfulness meditation practices, which form the basis of mindfulness-based cognitive therapy, which has been recommended for recurrent depression since 2004.

By using a laser to induce pain, Brown and his team found that activity in certain parts of the brain seemed to dip when the study participants anticipated pain. With that observation he was able to establish that those with upwards of 35 years of meditation under their belt anticipated pain the least.

In particular, meditators also seemed to display unusual activity in the prefrontal cortex region of the brain that is known for regulating attention and thought processes when a person feels threatened.

“The results of the study confirm how we suspected meditation might affect the brain,” explained Brown. “Meditation trains the brain to be more present-focused and therefore to spend less time anticipating future negative events. This may be why meditation is effective at reducing the recurrence of depression, which makes chronic pain considerably worse.”

However, he added that “although we found that meditators anticipate pain less and find pain less unpleasant, it’s not clear precisely how meditation changes brain function over time to produce these effects.

[via US News]

Meditation reduces the emotional impact of pain, making it easier to bear

June 2, 2010

People who meditate regularly find it easier to cope with pain because their brains anticipate it less, a study has found.

The findings could help develop new treatments from those who suffer from conditions that cause chronic pain.

Scientists from Manchester University compared non-meditators with a group who had meditated. Although they had varying levels of experience they had all tried mindfulness meditation, which seeks to anchor the person in the present.

Brain scans revealed that the most advanced meditators were the least likely to anticipate pain induced by a laser device, which made the experience more bearable.

Lead researcher Dr Christopher Brown, said: ‘Meditation is becoming increasingly popular as a way to treat chronic illness such as the pain caused by arthritis.

‘Recently, a mental health charity called for meditation to be routinely available on the NHS to treat depression, which occurs in up to 50 per cent of people with chronic pain.

‘However, scientists have only just started to look into how meditation might reduce the emotional impact of pain.’

The study, to be published in the journal Pain, found that participants who meditated showed unusual activity in the brain region known to be involved in controlling attention and thought processes when potential threats are perceived.

Dr Brown said: ‘The results of the study confirm how we suspected meditation might affect the brain.

‘Meditation trains the brain to be more present-focused and therefore to spend less time anticipating future negative events. This may be why meditation is effective at reducing the recurrence of depression, which makes chronic pain considerably worse.’

Dr Brown said the findings should encourage further research into how the brain is changed by meditation practice.

He said: ‘Although we found that meditators anticipate pain less and find pain less unpleasant, it’s not clear precisely how meditation changes brain function over time to produce these effects.

‘However, the importance of developing new treatments for chronic pain is clear: 40 per cent of people who suffer from chronic pain report inadequate management of their pain problem.’

In the UK, more than 10 million adults consult their GP each year with arthritis and related conditions. The estimated annual direct cost of these conditions to health and social services is £5.7billion.

Study co-author Professor Anthony Jones said: ‘There may also be some types of patient with chronic pain who benefit more from meditation-based therapies than others.

‘If we can find out the mechanism of action of meditation for reducing pain, we may be able to screen patients in the future for deficiencies in that mechanism, allowing us to target the treatment to those people.’

[via the Daily Mail]

“Mindfulness for Pain Relief: Guided Practices for Reclaiming Your Body and Your Life,” by Jon Kabat-Zinn

June 1, 2010

Vidyamala

reviews

Vidyamala, a long-term pain sufferer, rejoices in a new offering from Jon Kabat-Zinn, but experiences regret it wasn’t available years ago.

I was delighted to to be asked to review this new offering from the founder of mindfulness in healthcare: Dr Jon Kabat-Zinn. It is a two-CD audio book combining extensive background information with guided meditations.

Disc One (session one)

The first CD (or session as the CD is labeled) is entirely taken up with short lectures on various aspects of applying mindfulness to chronic pain of any sort. I listened avidly and welcomed everything he had to say and feel. Jon comes across with real depth and understanding of what it is like to apply mindfulness to pain.

As someone who uses mindfulness and meditation to manage chronic back pain myself, I felt a pang that this material was not available 25 years ago when I was first learning to meditate. I’m sure it would have made my journey a lot easier and more effective as he deals very directly with the mystery of how to be with experience when it is painful. One phrase I particularly liked was “tuning IN trumps tuning OUT”. In other words: if we can resist the natural response of endless distraction and aversion to pain and engage with the pain directly, then the overall suffering will diminish greatly.

Title: Mindfulness for Pain Relief: Guided Practices for Reclaiming Your Body and Your Life
Author: Jon Kabat-Zinn
Publisher: Sounds True
Content: 2 CDs
ISBN: 1-59179-740-3
Available from: Sounds True and Amazon.com.

He also makes the crucial distinction between pain and suffering: Pain is the sensations of discomfort that may be unavoidable; suffering is the ways we react to pain that just makes it worse. All the information on the CD offers deep and profound ways to learn to be with the pain and to eliminate the suffering. He also draws on his own experience of applying mindfulness to pain within a clinical setting at the University of Massachusetts Medical Center. He refers to research studies and this gives the CD credibility. I was particularly interested to hear about studies that show mindfulness is more effective than distraction when trying to live with severe pain.

The tracks on Disc one are as follows:
Track 1: Introduction
Track 2: Diving right in – Jon begins with an awareness of your body and everything around you.
Track 3: Learning to live with pain – Living with pain is a workable process if you are willing to do daily work. Pain may be unavoidable, but suffering is optional. You have nothing to lose in walking this path.
Track 4: Mindfulness-based stress reduction (MBSR) – a detailed description of the MBSR programme and scientific basis of this work as part of new field of medicine: Mind/body or Integrative medicine.
Track 5: Seven principles for working with pain –

Principle 1: There is more right with you than wrong with you and mindfulness will help mobilize inner resources.
Principle 2: The Power of Now (vs living in the past or future.)
Principle 3: The “Now” is not always exactly what we want. We usually want something different.
Principle 4: If experience is not what we want, we usually respond in two ways –- either denial or overwhelm.
Principle 5: Mindfulness offers a third way – turning toward what we most fear to feel and open gradually to its experiences. Learn resilience.
Principle 6: Open to experience moment-to-moment with kindness toward oneself without judging the experience (try not to judge or react automatically), Working with mindfulness helps it to become our new default setting.
Principle 7: we are not “fixing” anything, we are just dealing with it in the present moment.

Track 6: Cultivating mindfulness – Jon suggests we listen to this CD until it becomes second nature to us, along with using the second CD to practice with. He offers some tips in terms of finding a quiet place to practice, etc.

Disc Two (session two)

The second session is devoted to guided practices with instruction. Jon has a very pleasant voice and his many years experience of meditation teaching are immediately obvious. The content is precise and subtle. He does talk a lot, but there is a period of silence at the end of each track where the listener can try to put the instructions in to practice for themselves.

The tracks on Disc two are as follows:
Track 1: Introduction
Track 2: The power of disciplined practice – some comments on how to deal with boredom and impatience. Just actively participate in the meditation process, even if you don’t feel like it. The value will come with the repetitive practice.
Track 3: Mindfulness of breathing guided meditation with introduction as to how to best engage with the breath. This track may be particularly useful to those learning to meditate.
Track 4: Working with pain meditation – showing you how to work with your pain through meditation. These are brief meditations in between instructions. Various strategies are introduced and then there is a silent period to try putting them into practice.
Track 5: Working with thoughts and emotions meditation – particularly thoughts and emotions about the pain.
Track 6: Resting in awareness: a three-minute mindful pause meditation
Track 7: A 20 minute body scan.
Track 8: Mindfulness in everyday life.

I highly recommend this 2 CD set for anyone wanting to learn powerful and effective ways to work with chronic pain, or indeed any manifestation of the difficult side of life.

Researcher finds link between meditative breathing and pain relief

May 7, 2010

We’ve all been told to “just breathe.” But a few psychology researchers at ASU and the Barrow Neurological Institute in Phoenix took that a step further in a study that took a closer look at the actual value of breathing.

The study, more specifically, looked at how meditative breathing affects the way women with fibromyalgia respond to pain in the form of heat pulses.

College Times met with Alex Zautra, the lead author of the study and a foundation professor of psychology at ASU, to talk about what this study means to the public, the idea of pain and pain treatments and the value of meditation.

College Times: From what I gather, this study was about the mind-body relationship. Can you talk a little about that?

Zautra: One of the methods by which a person can regain a kind of physiological balance and homeostatic state is through a relaxation method, and some are more valuable than others. One of the methods people have been doing since ancient times in the Eastern world is meditation, whether it’s local or mindfulness meditation, and breathing is a big part of that; slowing down your breathing rate. And that’s what we tried to put into the laboratory.

Does meditative breathing really have a physiological effect on people?

We did measure that; that’s not reported in the study yet. We’ll report it in later studies … The premise of the study is that slower breathing does activate the parasympathetic nervous system, slows the heart, reduces blood pressure and leads to greater, what is called, heart-rate variability, which is a greater sense of capacity to be both alert and relaxed.

That’s kind of a paradox though; awareness while trying to forget one’s pain.

It seems paradoxical doesn’t it? Well, what we teach with chronic pain patients is, ‘Yes, you’re in pain, but that’s not all you feel. What else are you feeling at the time?’ It expands their horizons to allow themselves to do more than be embattled with the pain they have and to see many other emotions; some they can appreciate more if they can allow themselves a greater latitude to understand their own feelings.

Why did you decide to make half of the study’s population fibromyalgia patients?

First of all, it’s a population in pain that’s troubled by their condition. So we think that this group could benefit greatly from meditation interventions. When that study started we didn’t have that, but we do now have a five-year study to examine whether meditative practices could benefit somebody with fibromyalgia. We don’t have the results yet, because we’re in the middle of it.

Do you worry about the way the pharmaceutical industry might respond to research like this being successful?

I don’t worry about that. I think the pharmaceutical companies have their own business, but they’re also interested in methods that can accent, elaborate on or facilitate benefits to patients that are on the medications they have. So, when we talk to rheumatologists, who are prescribing meds for people with fibromyalgia or some other chronic pain condition, they’re eager to support [and] participate by helping us learn [and] they find ways for their patients to learn about our studies because they see it as meds-plus as being what’s going to be most beneficial for their patients.

[via College News]

Meditation techniques effective for pain relief

March 16, 2010

Meditation has analgesic benefits associated with creating a relaxed state of mind and enhancing the ability to moderate reactions to pain, according to new research published in The Journal of Pain, the peer review publication of the American Pain Society.

Researchers from the University of North Carolina measured pain ratings in students interested in learning meditation who recruited for the study. Subjects were trained in meditation for three consecutive days and were given experimental pain stimuli.

Results of the trial showed that relaxed states promoted by the brief mindfulness meditation sessions reduced the reported pain ratings. Participants had less pain to both low and high pain intensities and showed significant reductions in anxiety after each meditation stimulation. The authors concluded that decreases in anxiety and increases in the ability to sustain personal focus can attenuate the feeling of pain.

In assessing their findings, the authors noted that the analgesic effects of meditation can be realized even after a short period of time learning the technique. Also, the results provide additional validation of the benefits of cognitive techniques for controlling pain. [via The American Pain Society]

Slow breathing may soothe pain

February 9, 2010