meditation and pain

Marcus Aurelius: “If you are distressed by anything external, the pain is not due to the thing itself…”

Marcus Aurelius

We can’t choose what happens to us in life, but we can choose how to respond to it. This piece of practical wisdom is found in the Buddhist tradition, but was also a cornerstone of Stoic philosophy. Bodhipaksa explains how we can untangle ourselves from the stories we tell ourselves about our experience.

Marcus Aurelius is my favorite Stoic philosopher. The Stoics, if you’re not familiar with them, were a school of philosophy who started about 300 BCE and who continued teaching until 529 CE, when the Christian emperor Justinian I banned pagan philosophies.

Although we use the word “stoicism” to mean something like to “grin and bear it” or to “suck it up,” Stoicism wasn’t a macho pose of unemotional toughness but a well-developed practical philosophy based on living with an awareness of impermanence. For example Marcus said, “Reflect often upon the rapidity with which all existing things … sweep past us and are carried away”. The stoics worked to live ethically, to eliminate negative emotions such as ill will and jealousy from their lives, and they even meditated. Marcus again: “Allow yourself a space of quiet … and learn to curb your restlessness”. Sounds like Buddhism? Yes it does. I think it’s a tragedy that Stoicism was killed off before it had a chance to encounter Buddhism; I think Buddhists and Stoics would have had a lot in common.

Marcus Aurelius: “If you are distressed by anything external, the pain is not due to the thing itself but to your own estimate of it; and this you have the power to revoke at any moment.”

Marcus Aurelius’ advice to look to our responses to events in order to pinpoint the cause of suffering in order to eliminate suffering parallels some important Buddhist teachings. And here’s the crucial thing: It’s not what happens to us that causes most of our suffering, but how we respond. In the end, we cause virtually all of our own suffering: not all, but most of it. A Buddhist analogy is the man who is shot by an arrow, and who responds by shooting himself with yet another arrow. It sounds weird, but that’s what we do all the time.

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Some things in life are going to be painful, but we amplify and repeat the pain through the way we respond to it. Let’s say that something painful happens, like someone saying something unkind to us. Without mindfulness, the mind is likely to proliferate thoughts: blaming the other person; thinking about their faults; wondering over and over, why me?; telling ourselves we’re stupid for having got hurt; wishing things were otherwise; repeating the painful words we heard over and over. There seem to be endless possibilities for multiplying thoughts. This proliferation of thoughts adds yet more pain, but this time it’s self-inflicted.

We don’t just witness events, we automatically create stories about them.

With more mindfulness we’re able simply to accept that we experienced pain in response to another person’s words. If necessary, we respond appropriately without obsessing about it. We might tell the other person how we feel, for example, or suggest another perspective. Or we might decide that no action is the most appropriate action. We let the matter go quickly without obsessing. The mind doesn’t take the original arrow and plunge it into our bodies repeatedly.

Marcus says that “the pain is not due to the thing itself but to your own estimate of it.” We create distress in response to external events because of the way we interpret them. We don’t just witness events, we automatically create stories about them, based on our habitual tendencies. We assign meaning to them. So when we say hello to someone and they don’t seem to acknowledge us we might jump to some assumption about how rude they’re being and how they’re trying to snub us and think they’re too important to reply and so on and so on, and then those thoughts may lead to memories of similar incidents and we move on to telling ourselves stories about who we are and our importance or lack of importance in the world. Proliferation!

Every time we think a hateful thought we hurt ourselves.

A lot of the time these stories we make up bear little resemblance to reality. And we know this (or should) because we’re often characters in other people’s dramas. You know, where you have one of those weird conversations where everything you say and do is taken the wrong way? What’s going on there can be more obvious for us. It can be easier to see that a story is being made up that doesn’t match with reality. But we do this ourselves all the time.

One thing that’s really ironic is when we get into thinking hateful thoughts about another person in response to something they’ve done, or that we think they’ve done. Every time we think a hateful thought we hurt ourselves. Isn’t it crazy? To “defend” ourselves we hurt ourselves!

To notice the stories that we tell ourselves is an important practice

To notice the stories that we tell ourselves is an important practice. When we start watching them unfolding we can quickly see that they are repetitive. It’s like we have a limited repertoire of stories that we tell ourselves about the world and our place in it. And when something goes wrong we automatically put on a “recording” of one of those stories. It might be the “poor me” story or the “why am I surrounded by jerks” story, or one of a thousand others. When something hurts us we often reach for one of these stories. They’re comforting, in a way. They give us a reassuring sense of who we are in relation to the world. But they’re also a cause of pain.

So noticing these stories is a good first step in moving towards a more satisfying way of living. Eventually, as we hear these stories for the umpteenth time, we start to take them less seriously. They still may have an effect on us, but it doesn’t go as deep. Part of us is unaffected by the narrative, and we’ve become more free. Eventually, particular stories can just die away. They’re just not needed any more. Something painful happens in life, we notice it compassionately, and we move on. We’ve stopped interpreting life and started living it.

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Study shows brief training in meditation may help manage pain

PsychOrg.com: Living with pain is stressful, but a surprisingly short investment of time in mental training can help you cope.

A new study examining the perception of pain and the effects of various mental training techniques has found that relatively short and simple mindfulness meditation training can have a significant positive effect on pain management.

Though pain research during the past decade has shown that extensive meditation training can have a positive effect in reducing a person’s awareness and sensitivity to pain, the effort, time commitment, and financial obligations required has made the treatment not practical for many patients. Now, a new study by researchers at the University of North Carolina at Charlotte shows that a single hour of training spread out over a three day period can produce the same kind of analgesic effect. Read more here.

The research appears in an article by UNC Charlotte psychologists Fadel Zeidan, Nakia S. Gordon, Junaid Merchant and Paula Goolkasian, in the current issue of The Journal of Pain.

“This study is the first study to demonstrate the efficacy of such a brief intervention on the perception of pain,” noted Fadel Zeidan, a doctoral candidate in psychology at UNC Charlotte and the paper’s lead author. “Not only did the meditation subjects feel less pain than the control group while meditating but they also experienced less pain sensitivity while not meditating.”

Over the course of three experiments employing harmless electrical shocks administered in gradual increments, the researchers measured the effect of brief sessions of mindfulness meditation training on pain awareness measuring responses that were carefully calibrated to insure reporting accuracy. Subjects who received the meditation training were compared to controls and to groups using relaxation and distraction techniques. The researchers measured changes in the subjects’ rating of pain at “low” and “high” levels during the different activities, and also changes in their general sensitivity to pain through the process of calibrating responses before the activities.

While the distraction activity – which used a rigorous math task to distract subjects from the effects of the stimulus – was effective in reducing the subject’s perception of “high” pain, the meditation activity had an even stronger reducing effect on high pain, and reduced the perception of “low” pain levels as well.

Further, the meditation training appeared to have an effect that continued to influence the patients after the activity was concluded, resulting in a general lowering of pain sensitivity in the subjects – a result that indicated that the effect of the meditation was substantially different from the effect of the distraction activity.

The finding follows earlier research studies that found differences in pain awareness and other mental activities among long-time practitioners of mindfulness meditation techniques.

“We knew already that meditation has significant effects on pain perception in long-term practitioners whose brains seem to have been completely changed — we didn’t know that you could do this in just three days, with just 20 minutes a day,” Zeidan said.

In assessing the first experiment, the researchers were not terribly surprised to discover that meditation activity appeared to be affecting the experimental subjects’ perception of pain because the researchers assumed that the change was mainly due to distraction, a well-known effect. However, subsequent findings began to indicate that the effect continued outside of the periods of meditation.

” When we re-calibrated their pain thresholds after the training had started and we found that they felt less pain, compared to the control subjects,” Zeidan noted. “This was totally surprising because a change in general sensitivity was not part of our hypothesis at all.

“We were so surprised after the first experiment that we did two more. We thought that no one was going to listen to us because no one had done this before… and we got a robust finding across the three experiments.”

Zeidan stresses that the effect the researchers measured in the meditation subjects was a lessening of pain but not a lessening of sensation. The calibration results showed little change in the meditation subjects’ sensitivity to the sensation of electricity, but a significant change in what level of shock was perceived to be painful.

“The short course of meditation was very effective on pain perception,” Zeidan said. “We got a very high effect size for the periods when they were meditating.

“In fact, it was kind of freaky for me. I was ramping at 400-500 milliamps and their arms would be jolting back and forth because the current was stimulating a motor nerve. Yet they would still be asking, ‘A 2?’ (‘2′ being the level of electrical shock that designates low pain) It was really surprising,” he said.

Zeidan suspects that the mindfulness training lessens the awareness of and sensitivity to pain because it trains subjects’ brains to pay attention to sensations at the present moment rather than anticipating future pain or dwelling on the emotions caused by pain, and thus reduces anxiety.

“The mindfulness training taught them that distractions, feelings, emotions are momentary, don’t require a label or judgment because the moment is already over,” Zeidan noted. “With the meditation training they would acknowledge the pain, they realize what it is, but just let it go. They learn to bring their attention back to the present.”

Though the results are in line with past findings regarding mindfulness practitioners, Zeidan says that the findings are important because they show that meditation is much easier to use for pain management than it was previously believed to be because a very short, simple course of training is all that is required in order to achieve a significant effect. Even self-administered training might be effective, according to Zeidan.

“What’s neat here is that this is the briefest known way to promote a meditation state and yet it has an effect in pain management. People who want to make use of the technique might not need a meditation facilitator – they might be able to get the necessary training off the internet, ” Zeidan said. “All you have to do is use your mind, change the way you look at the perception of pain and that, ultimately, might help alleviate the feeling of that pain.”

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Meditation helps reduce stress, pain

Courier Post Online: Research has shown that 10 minutes spent in meditation once or twice a day “will make a huge difference in all aspects of your life — in your relationships, your memory, your creativity and your health,” says Jane Fox, a psychotherapist and licensed clinical social worker at Temenos in Moorestown. It’s good for reducing stress and anxiety, she says. It’s also useful for dealing with chronic pain. Read more here.

Some have told Fox it’s more relaxing than sleep.

She teaches people how to practice mindfulness meditation during a six-week course offered through the psychotherapy center. (The next session begins this spring.) It is simple to express and teach; the hard part is remembering to do it.

“People need to figure out how to integrate it into their lives,” says Fox.

The practice can be done while sitting in a chair or cross-legged on a pillow, or just sitting in a car. You can focus on breathing or on your own body, or on something external like a candle. The idea is to be still and aware of the present moment. Ideally, it should be done for 45 minutes a day, but shorter stints are also beneficial.

There is no right or wrong way to do it, Fox says. The mind constantly wanders, she said, and that’s just part of the deal. Like a glass of water dipped from a river, the longer the mind sits still, the clearer it will get.

However, it is important to do meditate with gentleness and loving kindness, says Fox. Meditation isn’t about fixing yourself or transforming yourself into something you aren’t. It’s about coming home to our real selves.

Mindfulness can be done, even in the midst of crisis, pain, fear or aggression. Though that’s when it’s hardest to do, Fox says, it’s also when it is needed the most.

“The present moment is the only place we can experience life and love,” says Fox. “If we’re religious or spiritual, it’s the only place we experience God.”

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Unweaving pain’s tapestry

There are three main approaches that can help make meditation enjoyable and sustainable when meditating with pain.

1. Learning to deal with resistance

The first hurdle is actually getting down to meditation. Even after meditating for 20 years I almost always have to overcome resistance — and I’m not alone. This tendency is especially pronounced if you’re living with pain. When you meditate you turn towards your experience in an honest and open way, including your pain. That takes courage, but often I don’t feel so brave and when I contemplate meditating suddenly I find many other things that need doing instead. I’ll make that phone call, I’ll have another cup of tea, I’ll check my emails. Alternatively, I may think, I can’t bear to sit with myself and my pain — I’m too tired. Then I roll over in bed and go back to sleep.

But I always regret it when I give in to the resistance and I always feel better when I find the energy and courage to meditate. Even if I struggle in a particular session, I still end up feeling more honest and aware, which leads to more confidence and stability as I learn to be with my pain in a clean way. It’s important to persevere and to recognize resistance rather than to be ruled by it.

2. Examining your agenda

Even when you’ve got down to meditating, attitudes still affect the practice and it’s important to investigate them. Most of us living with pain or illness long for our pain to go away and you’ll probably bring this desire with you when you start to practice meditation and mindfulness. No matter how much you think you’ve accepted your pain, many of us retain a secret hope that meditation will reduce or even eliminate it. On the face of it, this is entirely reasonable, but for people with intractable pain, mindfulness means coming to terms at the deepest level with the aspects of pain you can’t avoid and making peace with the situation.

When I first encountered meditation in my mid-twenties I definitely brought an escapist agenda to my practice. I had intolerable pain and I wasn’t coping well; I wanted to escape my body and dwell in states of calm and bliss and I hoped meditation would be a quick fix. That fantasy was understandable if you consider the ideas that circulate about meditation. I’d read books on Buddhism and meditation — and selectively remembered certain parts. Most of the literature gives a rounded picture of the human condition and describes how meditation can help you to be more awake. But instead I focused on descriptions of people who achieved meditative states in which they no longer experienced their body or described having a heart and mind that was vast, clear and boundless, or described the body becoming so spacious and diffuse that it was like having a body of light. Fantastic, I thought, I want some of that.

These descriptions of higher meditative states were very attractive and each time I meditated, I strained to be magically transported to a pain-free, blissful state. I even became adept at generating similar states through willpower and fantasy. At this stage, I would gather my awareness in my head, away from my painful body or outside my body altogether, and for a time the pain would lessen and I felt calm and joyful. But there was also a lot of strain and as soon as the meditation ended, I crash-landed back in my body and felt worse than before I’d started.

Many of us who learn to meditate when living with pain are motivated by a similar wish to escape the experience of the body — friends who are experienced meditators and also live with painful bodies have told me they had experiences of strain and escapism in their early meditation experiences that were very like my own. One woman, who has a great deal of pain, told me how her practice has finally become much deeper and quieter:

Eileen
My body is aging and stiffening. More and more, I’m seeing this as an advantage as I simply can’t be very active and the frustrations just have to be faced and accepted. My life has greatly simplified this year, internally as well as externally … I’m seeing more clearly how I’ve pushed against life! Relaxation is what I’m learning right now (and I’m discovering how unrelaxed I am at a deep level). I’m meditating much more than ever before, but without pushing at it. Life is more painful, but more real and therefore more rich.

Another friend suffers from a degenerative spinal condition that causes him a great deal of pain and stiffness. He describes the end of an escapist meditation session as, “crash-landing back in hell,” which was very confusing and unpleasant. All three of us have now moved on to the next phase: using meditation to dwell ever more deeply within the body and using the experience of pain to cultivate equanimity and peace with life as it is.

One of the wonderful things about meditation is that it seems to bring out one’s native intelligence and wisdom. If you meditate with sincerity and bring an unrealistic agenda, you’ll realize that something’s not quite right. In my case it took many years to realize this, but eventually instead of trying to move away from my experience, I turned to face it. I began the journey of engaging with my body with awareness.

3. Understanding the paradox of pain

Rather than trying to move out of the body in a vain attempt to escape pain, the answer seems to lie in moving towards it, going more and more deeply into the body. This might seem a bitter pill to swallow — it’s certainly counterintuitive. It may sound as if I’m suggesting that day after day, your whole meditation experience will involve sitting with awareness of pain. Hardly an inspiring prospect! But what I’m actually suggesting goes far deeper than that. To a large extent my meditation practice consists of simply sitting with an experience that includes the discomfort and pain, noticing the thoughts and emotions that arise and working with my reactions to avoid piling on secondary suffering. But there are also times when I become awake to my experience in a very accurate and refined way. My awareness sinks deeply into my body, which starts to feel diffuse and spacious. The sense of space and translucence that fills me comes not from going outside myself into space, but from sinking so far inside that space and light seem to arise from within.

As a metaphor for this experience, consider the image of a tapestry such as those you might you see in country mansions and châteaux. From a distance the tapestry depicts a complex scene that looks dense and solid, but as you come closer you realize it’s made up of thousands of colored threads. If you looked into the weave of the threads with a microscope, you’d see millions of tiny spaces in between the threads. Through meditation, you develop this open, expansive perspective and you find the spaces in the weave of your experience and gently rest there.

These experiences of profound spaciousness are part of the world opened up by meditation. They are the states that I’d read about and been drawn to when I first learned to meditate but then I made the mistake of trying to bypass my body to achieve them. Only by sitting with the pain can one access intense joy. I like to say that the open sky lies beneath the earth. Feeling supported by the earth, you can take your awareness so far inside the body that you come to a place of peace and calm.

This article is extracted and adapted from her book, “Living Well with Pain and Illness: the mindful way to free yourself from suffering,” published by Little, Brown in November of 2008.

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Looking into our fetters — and finding freedom

Sky reflected in a mirror that's lying on grass.
As we practice meditation it’s inevitable that we’ll outgrow some of our initial understandings, and sometimes an aspect of practice that at first seemed straightforward is revealed to be richer and more textured than we’d assumed.

For me, mindfulness at first seemed clear enough; one simply notices one’s actions and one’s experience. A person who is being mindful remembers where he has left his car keys, while a person (maybe the same person) who is being unmindful may not even remember where he parked the car. We know we’re angry when we’re angry, and we know we’re content when we’re content. It’s that simple — or so it seemed.

A few years ago my understanding of mindfulness started to undergo a shift. Mindfulness is no longer simply knowing what one is experiencing, or remembering where one has put things. It is richer and more multifaceted than that. As my practice has evolved there are four aspects of mindfulness that I’ve particularly come to appreciate: acceptance, curiosity, lovingkindness, and insight.

Acceptance

Acceptance leads to integration and wholeness. By “acceptance” I mean being with one’s experience without reacting, without experiencing craving or aversion towards it, without experiencing elation or despondency. In order to deepen our mindfulness we have to practice sitting with experiences, even if they’re unpleasant or involve unskillful emotions.

Sometimes we can be quick to jump in with various tools we’ve learned to deal with the various emotional states that that arise and take us away from the object of our meditation practice — emotions such as ill will, craving, despondency, embarrassment, and anxiety — not allowing time to really be with the distraction and to see what we can learn from it.

But if we can patiently sit with our experiences, unexpected transmutations can take place. Ill will can evaporate to reveal tender sadness, or beneath craving we can come to see a wholesome yearning for completeness.

However, the habitual use of antidotes to distractions can lead to a subtle form of repression in which these parts of ourselves are forced out of consciousness, and when reaching for antidotes becomes a habit we’ve lost our freedom — and all meditation practice is about finding greater levels of freedom.

Curiosity

Mindfulness is active rather than passive. Mindfulness doesn’t have to merely notice experiences, but can explore them. For example, an experience to which we apply the label “pain” can be seen not as one thing but as a series of processes becoming and un-becoming.

As we investigate an experience of physical pain we can see interweaving currents of pressure,
heat, cold, tingling, throbbing, and pulsing — and sometimes the pain seems to vanish altogether. An experience we may have wished to escape now becomes a source of fascination and an object of concentration.

We can also come to see pain as part of an interconnected system, noticing how the body responds by tensing up, how the emotions respond with aversion, how thoughts of self-pity arise. And as we bring those responses into mindful awareness we realize that we don’t have to amplify our suffering through reacting to pain but instead can simply experience it as it is.

Lovingkindness

The Persian poet Rumi writes of how when dark thoughts appear we can “Meet them at the door laughing / And invite them in”. I often recall those words when challenging experiences arise. If a friend turned up on my doorstep full of self-doubt, anger, or hurt, how would it be most helpful to meet him? Would I want to try to cheer him up, or send him away, or even to try solving his problems for him?

Although I confess that trying to solve people’s problems can be hard to resist, what I’d ideally like to do is to greet him with compassion: inviting him in, sitting him down, and listening. Ideally I’d like mostly to just listen, and to provide the curiously, love and encouragement that my friend needs to let his story unfold.

When I take this approach with myself and my own dark thoughts, embracing troubling experiences with loving mindfulness and sensing the often unacknowledged pain that accompanies each one, a profound sense of relief and gratitude often emerges; the kind of sense you might have if you’d been lost without hope in a dark wood and had at last found a path home.

Insight

The Buddhist tradition offers us the paradox that freedom comes not from trying to escape our inner fetters, but from looking deeply into them and seeing their impermanence and insubstantiality.

As mindfulness develops it becomes permeated with insight. As we notice pleasant and unpleasant experiences, skillful and unskilful emotions, as they arise and fall, we come to appreciate the transience of all our experiences, and we can further come to see that those experiences – pleasant or unpleasant, skillful or unskilful — are not an inherent part of who we are.

Our sense of who we are starts to shift, and a greater degree of freedom, spaciousness, and contentment begins to emerge as our fetters dissolve into emptiness.

Mindfulness has many facets — many more than those I’ve touched upon here — and I’d encourage you to let your mindfulness reveal these and other hidden aspects, not simply noticing your experiences, but accepting them with equanimity, actively exploring their texture with an inquiring mind, embracing them with metta, and looking deeply into them with an awareness of impermanence and insubstantiality. The more deeply you look into your inner fetters the more you will find yourself to be free.

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A student asks: Sometimes when scanning my body during mindfulness practice, I come across some pain or discomfort…

A student asks: Sometimes when scanning my body during mindfulness practice, I come across some pain or discomfort. Do I try to stay with it until it goes away? And if it doesn’t go away, do I move on?

Sunada replies: Well, first of all, if the pain seems to be an indication of something wrong –- like an aggravated injury –- please do something to address it right away! You’ll have to be the judge of what’s really going on, of course.

But otherwise, mindfulness is about getting to know ourselves and our world better, not to escape into a feel-good state or to get rid of unpleasant/painful things. It’s a useful practice to stay with our discomfort, make it the object of our concentration, and observe what happens as it waxes and wanes. If we just let it be, in many cases, it will pass away on its own.

But other times it won’t go away — like chronic physical conditions or emotional issues like depression or anxiety. So yes, it’s a good question — what to do when it doesn’t go away?

Let me share my experience of walking outdoors recently on a bitterly cold New England winter day. My body’s natural reaction to being out in the cold is to hunch up my shoulders, cave my chest in, and get into a protective sort of posture. But as I was observing myself, I realized that my responses were doing nothing to make me feel warmer or more protected from the cold. It was just making me tense up (shoulders up around my neck, for instance), and if anything was making me feel worse –- not so much from the cold but from all the tension I was carrying around. I also noted that if I dropped my shoulders and stood up straight and faced the cold, it really didn’t feel that bad. And if I brought my attention more closely to the raw sensation of the wind on my face, and setting aside any judgments about how cold it was, it wasn’t nearly as uncomfortable as I had thought it was. So I’d say at least 75% of that feeling of “cold and uncomfortable” was an inflated judgment I had made up in my mind, and was not the reality.

I think this is one of the lessons of mindfulness. If we stay with our experiences, we can begin to separate out the bare reality from what’s a fabrication of our minds –- in this case, exaggerated thoughts of discomfort that served no purpose other than make me feel worse! Being mindful of my discomfort didn’t make it go away –- I couldn’t make the cold weather go away, of course -– but I WAS able to find a way to be in the cold without piling unnecessary suffering on myself. That realization alone made the coldness much easier to live with.


Editor’s note: The student with whom this exchange took place has granted permission to publish this journal entry, and will remain anonymous. Wildmind treats all student journals as strictly private, and never allows outside parties to read them without explicit permission from the student.

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Beyond standard pain relievers (Newswise)

oga, massage or plain old exercise? It could be just what the doctor ordered to minimize pain from chronic conditions such as rheumatoid arthritis, osteoarthritis, neck pain, low back pain or fibromyalgia, according to the September issue of Mayo Clinic Women’s HealthSource.

Given recent news about the risk of some pain relieving medications, many people are considering other ways to manage chronic pain. While not a quick fix, therapies such as massage, ice, heat and even acupuncture can be very effective if you give them time to work and use them consistently.

The September issue of Mayo Clinic Women’s HealthSource explores alternative ways to manage chronic pain.

Exercise: Most people with chronic pain feel better if they are physically active every day. But don’t overdo. Exercising too much or too intensely can make pain worse.

Ice and heat: Applying ice or heat provides short-term pain relief. Ice reduces pain and swelling. Heat is useful for reducing joint stiffness and for muscle spasm, back pain and arthritis.

Acupuncture: Extremely thin needles inserted at one or more of about 350 strategic points on your body may relieve low back pain and pain from fibromyalgia and osteoarthritis.

Electrical stimulation: Electrically stimulating the nerves that control muscles is a safe, easy and effective way to control many types of pain. One example is transcutaneous electrical stimulation, where a small device directs mild electric pulses to nerve endings beneath the skin. A physical therapist can teach you how to do this therapy at home.

Relaxation: Meditation, deep breathing, guided visualization, biofeedback and self-hypnosis can reduce stress, pain, anxiety and depression.

Manual therapy and massage: Osteopathic doctors, physical therapists, chiropractors and massage therapists use various techniques to improve movement and function and relieve pain in muscles and joints.

Before you try alternative therapies, learn all you can about the safety and effectiveness. If nothing seems to work, talk to your doctor, who may refer you to a pain management program to suggest other ways to cope with long-term pain.

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Meditation helping arthritis patients (Kansas City Star)

Dalia Isicoff knows pain. A lifelong sufferer of rheumatoid arthritis, she has had seven hip replacement surgeries.

Since leaving the hospital in February following her latest operation, however, she hasn’t taken any painkillers. Not because the pain isn’t there — it is. But Isicoff, 52, said she has learned to accept the pain, the disease, and herself, thanks to meditation.

“When you have an illness like this, what one tends to do is say, ’Oh, my God! Here we go again, this is going to render me disabled, I’m going to wind up in a wheelchair!’ and you rush to the medicine cabinet,” she said. “This has allowed me to have the patience to deal with these flare-ups and become relaxed enough so the need for pain medication is almost not there.”

The 52-year-old Clarksville resident said meditation has made her symptoms less severe, helping relieve stress that she said made the condition worse.

“With this type of approach, you learn to acknowledge you have pain and, by realizing it and by being in this relaxed state, the pain is less,” she said.

Researchers at the University of Maryland School of Medicine in Baltimore are studying others like Isicoff to see if meditation helps sufferers of the autoimmune disorder, which affects about 2.1 million Americans, mostly women. Those with the disease often have general fatigue, soreness, stiffness and aches at first. Joints may swell and become damaged over time.

‘Mindfulness’ technique counters stress

Groups of rheumatoid arthritis patients are being trained in “mindfulness,” a form of stress reduction meditation developed 30 years ago at the University of Massachusetts. Their progress is being compared to patients not in the program.

Mindfulness is similar to many meditation techniques. Participants are taught to focus on breathing to quiet the mind and become aware of the moment.

The method has been used successfully to help patients with chronic pain from a variety of conditions, but this marks the first time it is being studied to see if it can help the physical and psychological symptoms of rheumatoid arthritis patients, said Lisa Pradhan, one of the study leaders for the University of Maryland’s Center for Integrative Medicine.

Evidence suggests flare-ups of the disease are associated with stress, she said.

Thirty-six patients took an eight-week course that started in March and will be given their third and final evaluation later this month. Participants are being sought for a second group of a similar size, which will take the course beginning later this month and be tracked for six months.

Results from the first group are not available yet, but “the people who have come through the study have been very pleased to have been involved with it,” Pradhan said.

Trish Magyari, director of the mindfulness program, said participants are taught to “quiet the mind and feel more connected to your body.”

Isicoff said she tries to meditate in the morning and at night, although mindfulness can be as simple as being aware of feeling the wind on your skin. Such a simple process, however, can be difficult to put into practice, she said.

“Most of us have this crazy internal dialogue,” she said. “For me, it was difficult to say, ’I want to relax’ and, ’I don’t want to think.’ You learn to be an observer of the thought. It’s sort of best to acknowledge it: ’Oh, there you are,’ there’s a judgment, there’s an angry thought, and the moment you acknowledge them, they go away.”

Eventually, she said she learned to be patient — with herself and the situation.

“Yes, I have the arthritis and the suffering, but it doesn’t have to be so negative, so devastating, focusing on that thing day in and day out and not knowing, not believing that it can get better,” Isicoff said.

“You learn to cultivate other areas of your life that are there, that are untapped. When someone is in that frame of mind you can handle anything, you can be more compassionate. You don’t put yourself down so much, you don’t have to struggle with yourself trying to be perfect.”

Original article no longer available…

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Back to the Future for Pain Management (eMedia Wire)

eMedia Wire: More and more pain sufferers are turning to traditional alternatives such as acupuncture, herbal medicine and meditation. In addition to pain relief, these alternatives are seen to provide general health benefits without serious side effects. This article examines some of the popular treatment options.

The ancient Chinese Practice of acupuncture is based on the belief that health is determined by the level of chi (vital life energy) that is in the body. This energy is thought to move through the body through pathways called meridians, which connect to specific organs in the body. Acupuncturists insert needles into points on the body that connect to these channels to release blocked “chi” that might be the cause of pain. During treatment, the acupuncturist inserts thin needles for anywhere from a few minutes to a half an hour into specific points on the body. This practice is thought to stimulate endorphins, the body’s natural painkillers and is useful for the treatment of a variety of disorders including backache, sinus pain, jaw pain, spinal disorders, withdrawal and mental disorders.

Also known as “contact healing”, acupressure is based on the same principles as acupuncture, except hand-pressure and finger pressure is applied to specific points on the body to release neurotransmitters that alleviate pain.

Another aspect of traditional Chinese medicine is herbal medicine. Herbs have been used for centuries for their pain relieving qualities. Here are some herbs that are recommended for common disorders:

Cramps & Spasms: angelica, cramp bar, kava, rosemary. Nerve Pain: capsaicin, chamomile, gotu kola, licorice. Back Pain: hops, wood betony, passionflower. Migraine: feverfew, linden, skullcap. Headaches: peppermint, spearmint. Joint pain: ginger, sea cucumber.

Aromatherapy (sniffing or applying essential oils) is yet another popular option. Aromatherapy is thought to change an individual’s brain chemistry so that pleasurable neuro-transmitters are released to relieve pain. Geranium, jasmine, juniper, lavender, peppermint, rose, rosemary and thyme are oils commonly used for this purpose.

Homeopathy, which has been popularized by the British Royal Family since Victorian times is based on the principle of “like repels like.” The theory is that miniscule amounts of chemicals, irritants or elements that mimic or resemble the main ailment will send a large message to the brain to repel pain and discomfort.

Meditation, which has also been practiced for thousands of years, is a conscious attempt to calm the mind so that it is not cluttered with thoughts and anxieties that might be contributing to an unnecessary belief in the existence of pain. There are hundreds of different meditation techniques, but mostly they all into three categories: concentrative, mindful and transcendental meditation. During concentrative meditation, focusing on a single sound, object or one’s breath, produces a tranquil mind that facilitates the production of pain-relieving endorphins. During mindful meditations, the mind is encouraged to become aware of, but not reactive to thoughts, feelings and sensations in order to achieve a tranquil state of mind. During transcendental meditation, the mind settles down to a state that transcends thought altogether.

Therapies that focus on the mind are becoming increasingly popular. Guided Imagery research has indicated that bodily functions that were previously thought to be beyond conscious control, such as chronic pain, can be controlled through the use of visualization. Guided imagery encourages the sufferer to think in pictures that eliminate negative thoughts thus raising levels of pleasurable brain chemicals, such as serotonin, decreasing anxiety and increasing the effectiveness of the immune system. Through guided imagery, the mind conjures up mental scenes in order to better direct the body’s energy. For instance, if an individual is suffering from a stabbing pain, he or she might want to imagine a knife being removed from the spot and a subsequent glowing feeling of relief.

The current popularity of traditional treatments is likely to continue for some time. Even major pharmaceutical manufacturers are jumping on the bandwagon by manufacturing such herbs as willow bark and feverfew and marketing them as natural alternatives to ibuprofen and aspirin.

It is important to note that the above suggestions do not represent cures for conditions, but more represent strategies and opportunities to manage your chronic pain. It is also recommended that you consult with your health practitioner before embarking on any new pain management program.

Original article no longer available…

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