Improve Chronic Pain with Mindfulness
By John M. de Castro, Ph.D.
“The last thing we want to do is pay more attention to our pain. But that’s the premise behind mindfulness, a highly effective practice for chronic pain (among other concerns).” – Margarita Tartakovski
We all have to deal with pain. It’s inevitable, but hopefully it’s mild and short lived. For a wide swath of humanity, however, pain is a constant in their lives. At least 100 million adult Americans have common chronic pain conditions. It has to be kept in mind that pain 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. But, methods are needed to mitigate the psychological distress produced by chronic pain.
The most common treatment for chronic pain is drugs. These include over-the-counter analgesics and opioids. But opioids block pain, eliminating this important signal. They are, also, dangerous. Prescription opioid overdoses kill more than 14,000 people annually. So, there is a great need to find safe and effective ways to lower the psychological distress and improve the patient’s ability to cope with the pain.
Pain is both physical and mental, affected by damage to the body but also 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, mindfulness has been shown to reduce both chronic and acute pain. Importantly, mindfulness training is safe. So, mindfulness training may be an effective treatment to be used in combination with other treatments for chronic pain. Hence, it is important to study mindfulness practice effects on chronic pain and the psychological distress it produces.
In today’s Research News article “Mindfulness Meditation for Chronic Pain: Systematic Review and Meta-analysis.” See summary below or view the full text of the study at:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5368208/?report=classic
Hilton and colleagues review and summarize the published research literature on the application of mindfulness training to treating chronic pain, pain lasting more than 3 months. They identified 38 randomized controlled trials that compared the effectiveness of mindfulness training to treatment as usual, support groups, education, stress management, or waitlist controls. They found that the published research reported small but significant reductions in pain after mindfulness training that were still present 3 months later. They also reported significant improvements in depression and quality of life.
Hence, the up-to-date research literature suggests that mindfulness training is a safe and effective treatment for chronic pain., both reducing the pain itself as well as depression and the pain produced impairments in quality of life. In general, they found that the studies tended to be of low quality. So, better designed studies are still needed. It is not known exactly how mindfulness training may reduce pain. But, it is suspected that it changes the mental components of pain improving emotional regulation, including reducing anxiety and worry about pain. This reduces the mind’s amplification of pain. Importantly, it still leaves the signal of pain intact. So, the individual, can respond to the pain adaptively, reducing further physical damage.
So, improve chronic pain with mindfulness.
“Mindfulness soothes the circuits that amplify … In effect, mindfulness teaches you how to turn down the volume control on your pain. And as you do so, any anxiety, stress and depression that you may be feeling begins to melt away too. Your body can then relax and begin to heal.” – Danny Penman
CMCS – Center for Mindfulness and Contemplative Studies
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Study Summary
Hilton, L., Hempel, S., Ewing, B. A., Apaydin, E., Xenakis, L., Newberry, S., … Maglione, M. A. (2017). Mindfulness Meditation for Chronic Pain: Systematic Review and Meta-analysis. Annals of Behavioral Medicine, 51(2), 199–213. http://doi.org/10.1007/s12160-016-9844-2
Abstract
Background
Chronic pain patients increasingly seek treatment through mindfulness meditation.
Purpose
This study aims to synthesize evidence on efficacy and safety of mindfulness meditation interventions for the treatment of chronic pain in adults.
Method
We conducted a systematic review on randomized controlled trials (RCTs) with meta-analyses using the Hartung-Knapp-Sidik-Jonkman method for random-effects models. Quality of evidence was assessed using the GRADE approach. Outcomes included pain, depression, quality of life, and analgesic use.
Results
Thirty-eight RCTs met inclusion criteria; seven reported on safety. We found low-quality evidence that mindfulness meditation is associated with a small decrease in pain compared with all types of controls in 30 RCTs. Statistically significant effects were also found for depression symptoms and quality of life.
Conclusions
While mindfulness meditation improves pain and depression symptoms and quality of life, additional well-designed, rigorous, and large-scale RCTs are needed to decisively provide estimates of the efficacy of mindfulness meditation for chronic pain.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5368208/?report=classic