By John M. de Castro, Ph.D.
“Meditation, particular mindfulness techniques, can lead to improvements in pain intensity when compared to standard care for many chronic pain patients. It also may help improve pain-related disability, pain acceptance, feelings of control over the pain, depression, anxiety, and quality of life, immediately after treatment as well as at follow up later on.” – University Health News
Fibromyalgia is a mysterious disorder whose causes are unknown. It is very common affecting over 5 million people in the U.S., about 2% of the population with about 7 times more women affected than men. It is characterized by widespread pain, abnormal pain processing, sleep disturbance, and fatigue that lead to psychological distress. Fibromyalgia may also have morning stiffness, tingling or numbness in hands and feet, headaches, including migraines, irritable bowel syndrome, sleep disturbances, thinking and memory problems, and painful menstrual periods. The symptoms are so severe and debilitating that about half the patients are unable to perform routine daily functions and about a third have to stop work. Although it is not itself fatal, suicide rates are higher in fibromyalgia sufferers.
Many studies have linked fibromyalgia with depression. In fact, people with fibromyalgia are up to three times more likely to be depressed at the time of their diagnosis than someone without fibromyalgia. In addition, the stress from pain and fatigue can cause anxiety and social isolation. As a result, many patients experience intense anger regarding their situation. The emotions are understandable, but can act to amplify the pain. Hence, controlling the emotions may reduce the perceived pain. Mindfulness practices have been shown to be effective in reducing pain from fibromyalgia. This may occur directly or indirectly by reducing emotions or both.
In today’s Research News article “Fibromyalgia Impact and Mindfulness Characteristics in 4986 People with Fibromyalgia.” See:
or see summary below or view the full text of the study at:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4552195/
Jones and colleagues obtained measures of mindfulness and fibromyalgia impact from a national sample of nearly 5000 fibromyalgia sufferers. They found that the approximately 20% of the sample who meditated had small but statistically lower fibromyalgia impact and symptoms scores than those who did not meditate. They also found that the higher the level of the mindfulness facets of Describing, Non-Reacting, Non-Judging, and Acting with Awareness the lower the fibromyalgia symptoms and the greater the mindfulness facet of Observing the greater the fibromyalgia symptom scores. These relationships still remained significant for all facets regardless of whether a univariate or a multiple regression were employed to document the relationships.
These findings confirm with a large national sample and a correlational study what has been previously found that mindfulness improves the symptoms of fibromyalgia. The one exception was with mindfully Observing which was positively correlated with fibromyalgia symptoms. This may have occurred due to a reverse causation such that individuals with more severe fibromyalgia symptoms become more observing of them in the present moment.
There are a number of potential explanations for the relationship between high mindfulness and low fibromyalgia symptoms. Mindfulness has been shown to improve emotion regulation which allows the individual to experience the emotions fully but to respond to them in a constructive, productive fashion, thus taking away the amplifying effect of the emotions on pain. Mindfulness training also improves the individual’s ability to focus on the present moment and this has been shown to reduce rumination and catastrophizing which can produce anxiety and depression also amplifying the symptoms. Regardless of the mechanism it is clear the mindfulness can be beneficial in controlling the emotional sequela of fibromyalgia pain.
So, lower fibromyalgia pain with higher mindfulness.
“People often increase the pain experience by adding to the physical sensations with a host of thoughts and feelings, like catastrophizing the pain or trying to suppress and ignore the pain. Mindfulness is a practice of attending to pain — or body sensations — and thoughts and feelings with that present-moment attention in an accepting and curious manner. With mindfulness practice you learn to relate to anxiety differently, with an open curiosity. Learning to do that leads to a reduction in the fear response itself,” – Susan Smalley
CMCS – Center for Mindfulness and Contemplative Studies
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Study Summary
Jones, K. D., Mist, S. D., Casselberry, M. A., Ali, A., & Christopher, M. S. (2015). Fibromyalgia Impact and Mindfulness Characteristics in 4986 People with Fibromyalgia. Explore (New York, N.Y.), 11(4), 304–309. http://doi.org/10.1016/j.explore.2015.04.006
Abstract
Context and Objective: A growing body of literature suggests that mindfulness techniques may be beneficial in fibromyalgia. A recent systematic review and meta-analysis of six trials indicated improvement in depressive symptoms and quality of life, calling for increased rigor and use of standardized measures in future trials. The purpose of the study was to examine the relationship between mindfulness [as measured by the Five Facet Mindfulness Questionnaire (FFMQ)] and fibromyalgia impact [as measured by the Revised Fibromyalgia Impact Questionnaire (FIQR)].
Design, Setting, and Participants: A cross-sectional survey was conducted with adults diagnosed with fibromyalgia from a national fibromyalgia advocacy foundation e-mail list.
Results: A total of 4986 respondents represented all 50 states in the United States and 30 countries. FIQR scores demonstrated moderate to severe fibromyalgia with the majority of subjects (59%) scoring ≤60. Scores on the FFMQ subscales ranged from 20.8 to 27.3, with highest scores for the observe subscale. All subscale correlations were small to moderate and indicated that more severe fibromyalgia impact was associated with less mindfulness except in the observe scale (r = .15, P > .000). No clinical or demographics explained as much variance in the FIQR total as any of the mindfulness subscales.
Conclusions: Fibromyalgia patients experience symptoms that may be alleviated by mindfulness interventions. Baseline values for the observe subscale of the FFMQ were unexpectedly high. Further research is needed to know if this may be due to non-mindful observations and should be noted when the FFMQ is used in fibromyalgia clinical trials.