By John M. de Castro, Ph.D.
“For some people with chronic pain, mindful meditation is an appealing pain management option because it has an unusual benefit; it is something that you personally control. Unlike pain medications or medical procedures, meditation is not done to you, it is something you can do for yourself.” – Stephanie Burke
Pain can be difficult to deal with, particularly if it’s persistent. But, even short-term pain, acute pain, is unpleasant. Pain, however, is an important signal that there is something wrong or that damage is occurring. This signals that some form of action is needed to mitigate the damage. This is an important signal that is ignored at the individual’s peril. So, in dealing with pain, it’s important that pain signals not be blocked or prevented. They need to be perceived. Nevertheless, it would be useful to find ways to lower the intensity of perceived pain and improve recovery from painful stimuli. Pain signals are processed in the brain and the state of the brain can alter the perception of pain. Indeed, opioid drugs are very effective pain killers and they work by affecting opioid receptors in the brain that are important in the perception of pain.
Pain is affected by the mind. The perception of pain can be amplified by the emotional reactions to it and also by attempts to fight or counteract it. Pain perception can be reduced by aerobic exercise and mental states, including placebo effects, attention, and conditioning. Additionally, contemplative practices have been shown to reduce both chronic and acute pain. It has been shown that exercise and mental states affect pain perception via opioid receptors. Their effects on pain can be prevented by the injection of a drug, naloxone, that blocks opioid receptors. Hence, mental states appear to alter pain perception through effects on the opioid system in the brain. But, it is not known if contemplative practices act in the same way.
In today’s Research News article “Mindfulness-Meditation-Based Pain Relief Is Not Mediated by Endogenous Opioids.” See:
or see summary below or view the full text of the study at:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4792946/
Zeidan and colleagues examine the involvement of opioid receptors in the pain reduction produced by meditation practice. They recruited participants who had no experience with meditation and randomly assigned them to four groups. Two groups engaged in meditation for 20 minutes per day for four days, while two groups listened to an audiobook for 20 minutes per day for four days. One meditation group and one no-meditation group received a naloxone injection while the other two groups received injections of a non-active saline solution. Both participants and experimenters were blind as to whether they were receiving naloxone or saline. Before and after injection, participants were tested while meditating or resting for sensitivity to pain induced by heat to the skin. Participants rated their perceived pain to different levels of heat.
They found that mindfulness meditation reduced pain perception by 21% and pain unpleasantness by 36% relative to resting controls. This occurred for the meditation groups regardless of whether naloxone or saline was injected. So, the opioid receptor blocking drug naloxone had no effect on the reductions in pain produced by meditation. Hence, meditation, unlike other mental states, appears to reduce pain independent of the opioid pain system in the brain.
There are a number of effects of meditation that might underlie the reduction in pain perception. The stress, fear, and anxiety produced by pain tends to elicit responses that actually amplify the pain. So, reducing the emotional reactions to pain may be helpful in pain management. Meditation practices have been shown to reduce stress responses and anxiety, and to improve emotion regulation producing more adaptive and less maladaptive responses to emotions. So, it would seem reasonable that mindfulness practices would be helpful in pain management. In addition, pain is accompanied by, and frequently caused by, inflammation and meditation has been shown to reduce the inflammatory response. This may account for the mindfulness’ effects on the physical aspects of chronic pain.
So, reduce pain with meditation rather than drugs.
“Meditation teaches patients how to react to the pain. People are less inclined to have the ‘Ouch’ reaction, and are able to control their emotional reaction to pain.” – BRIAN STEINER
CMCS – Center for Mindfulness and Contemplative Studies
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Study Summary
Fadel Zeidan, Adrienne L. Adler-Neal, Rebecca E. Wells, Emily Stagnaro, Lisa M. May, James C. Eisenach, John G. McHaffie, Robert C. Coghill. Mindfulness-Meditation-Based Pain Relief Is Not Mediated by Endogenous Opioids. J Neurosci. 2016 Mar 16; 36(11): 3391–3397. doi: 10.1523/JNEUROSCI.4328-15.2016
Abstract
Mindfulness meditation, a cognitive practice premised on sustaining nonjudgmental awareness of arising sensory events, reliably attenuates pain. Mindfulness meditation activates multiple brain regions that contain a high expression of opioid receptors. However, it is unknown whether mindfulness-meditation-based analgesia is mediated by endogenous opioids. The present double-blind, randomized study examined behavioral pain responses in healthy human volunteers during mindfulness meditation and a nonmanipulation control condition in response to noxious heat and intravenous administration of the opioid antagonist naloxone (0.15 mg/kg bolus + 0.1 mg/kg/h infusion) or saline placebo. Meditation during saline infusion significantly reduced pain intensity and unpleasantness ratings when compared to the control + saline group. However, naloxone infusion failed to reverse meditation-induced analgesia. There were no significant differences in pain intensity or pain unpleasantness reductions between the meditation + naloxone and the meditation + saline groups. Furthermore, mindfulness meditation during naloxone produced significantly greater reductions in pain intensity and unpleasantness than the control groups. These findings demonstrate that mindfulness meditation does not rely on endogenous opioidergic mechanisms to reduce pain.
SIGNIFICANCE STATEMENT Endogenous opioids have been repeatedly shown to be involved in the cognitive inhibition of pain. Mindfulness meditation, a practice premised on directing nonjudgmental attention to arising sensory events, reduces pain by engaging mechanisms supporting the cognitive control of pain. However, it remains unknown if mindfulness-meditation-based analgesia is mediated by opioids, an important consideration for using meditation to treat chronic pain. To address this question, the present study examined pain reports during meditation in response to noxious heat and administration of the opioid antagonist naloxone and placebo saline. The results demonstrate that meditation-based pain relief does not require endogenous opioids. Therefore, the treatment of chronic pain may be more effective with meditation due to a lack of cross-tolerance with opiate-based medications.