By John M. de Castro, Ph.D.
“It turns out, the human mind does not simply feel pain, it also processes the information that it contains. It teases apart all of the different sensations to try to find their underlying causes so that you can avoid further pain or damage to the body. In effect, the mind zooms in on your pain for a closer look as it tries to find a solution to your suffering. This ‘zooming-in’ amplifies pain.” – Danny Penman
Postherpetic neuralgia is a complication of shingles, which is caused by the chickenpox virus, a form of herpes virus. It affects between 10%-20% of shingles sufferers. It affects nerve fibers and skin, causing burning pain that lasts long after the rash and blisters of shingles disappear. It produces pain that has been described as burning, sharp and jabbing, or deep and aching, that lasts for over 3 months. Patients report extreme sensitivity to touch such that even the feel of clothing is very uncomfortable. Sometimes it is also accompanied with itching or numbness. Postherpetic neuralgia pain is difficult to cope with and can thus lead to depression, fatigue, sleep problems, loss of appetite, and difficulty with concentration. The risk of acquiring postherpetic neuralgia increase with age and primarily afflict people over 60. There’s no cure, but treatments can ease symptoms. For most people, postherpetic neuralgia improves over time. But, it is an extremely uncomfortable and disruptive disorder and new and better treatments are needed.
Mindfulness training has been shown to effectively reduce pain from a number of different conditions. So, it is reasonable to explore whether mindfulness training could be an effective treatment for postherpetic neuralgia. In today’s Research News article “Mindfulness meditation in older adults with postherpetic neuralgia: a randomized controlled pilot study.” See:
or below or view the full text of the study at:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4488325/
Meize-Grochowski and colleagues randomly assigned elderly patients (55-90 years of age) with postherpetic neuralgia to either a 6-weeks of 20-minute daily meditation or to a wait-list control condition. They found that at the end of the 6-weeks the meditation group had a significant decrease in neuropathic pain, total pain, and affective pain and improved physical functioning compared to baseline and control participants.
These results are encouraging. But, it should be recognized that this was a very small pilot study and needs to be replicated in a much larger clinical trial. Regardless, the results suggest that meditation may be a safe and effective treatment for postherpetic neuralgia, decreasing pain and improving functioning in life. This adds to the growing list of pain conditions that respond positively to mindfulness techniques. It suggests that mindfulness training may be a universally effective treatment for chronic pain.
Mindfulness training may be effective for pain by focusing attention on the present moment and thereby reduce worry and catastrophizing. Pain is increased by worry about the pain and the expectation of greater pain in the future. So, reducing worry and catastrophizing should reduce pain. In addition, negative emotions are associated with pain and amplify it. Mindfulness may ne effective for pain because it increases positive emotions and decreases negative ones. Finally, mindfulness has been shown to change how pain is processed in the brain reducing the intensity of pain signals in the nervous system.
Regardless of the mechanism, it is clear that meditation is a safe and effective treatment for postherpetic neuralgia. So, mitigate pain with mindfulness.
“What we want to do as best as we can is to engage with the pain just as it is. It’s not about achieving a certain goal – like minimizing pain – but learning to relate to your pain differently.” – Elisha Goldstein
CMCS – Center for Mindfulness and Contemplative Studies
Study Summary
Meize-Grochowski, R., Shuster, G., Boursaw, B., DuVal, M., Murray-Krezan, C., Schrader, R., … Prasad, A. (2015). Mindfulness meditation in older adults with postherpetic neuralgia: a randomized controlled pilot study. Geriatric Nursing (New York, N.Y.), 36(2), 154–160. http://doi.org/10.1016/j.gerinurse.2015.02.012
Abstract
This parallel-group, randomized controlled pilot study examined daily meditation in a diverse sample of older adults with postherpetic neuralgia. Block randomization was used to allocate participants to a treatment group (n = 13) or control group (n = 14). In addition to usual care, the treatment group practiced daily meditation for six weeks. All participants completed questionnaires at enrollment in the study, two weeks later, and six weeks after that, at the study’s end. Participants recorded daily pain and fatigue levels in a diary, and treatment participants also noted meditation practice. Results at the .10 level indicated improvement in neuropathic, affective, and total pain scores for the treatment group, whereas affective pain worsened for the control group. Participants were able to adhere to the daily diary and meditation requirements in this feasibility pilot study.