Lessen Fibromyalgia Pain with Mindfulness

Lessen Fibromyalgia Pain with Mindfulness

 

By John M. de Castro, Ph.D.

 

“You’ve heard the expression “mind over matter,” but did you know that it’s a tried-and-true approach to easing many conditions, including fibromyalgia?” – Madeline Vann

 

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.

 

There are no completely effective treatments for fibromyalgia. Symptoms are generally treated with pain relievers, antidepressant drugs and exercise. But, these only reduce the severity of the symptoms and do not treat the disease directly. Mindfulness practices have also been shown to be effective in reducing pain from fibromyalgia. In today’s Research News article “Mindfulness Meditation for Fibromyalgia: Mechanistic and Clinical Considerations.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5693231/ ), Adler-Neal and Zeidan review and summarize the published research literature on the employment of mindfulness training for the relief of fibromyalgia symptoms.

 

They report that “mindfulness interventions . . . are generally premised on (a) developing sustained attention to arising sensory, affective, and cognitive events, (b) recognizing such experiences as momentary and fleeting, and (c) attenuating reactions/judgments to said experiences. Mindfulness training reliably improves catastrophizing, anxiety, depression, mood, and stress. Thus, improvements in mood and cognitive flexibility could lead to greater pain relief by altering the way patients interpret/contextualize pain-related ruminations.”

 

They report that the research finds that mindfulness training, especially if tailored for fibromyalgia, significantly improves fatigue, stress, sleep, pain, pain coping, positive emotions, family stress, loneliness and global well-being in fibromyalgia patients. In addition, these benefits appear to be sustained for at least 2 months after the completion of training. Hence, mindfulness training would appear to be a safe and effective treatment for fibromyalgia.

 

The improvements produced by mindfulness training appear to be mediated by changes in the nervous system. It heightens activity in the brain cortical areas that underlie the cognitional and emotional evaluation of pain and decreased activation of brain thalamic areas that process sensory information. Hence, mindfulness training appears to alter the brain to improve mechanisms underlying attention and emotions and decrease sensory sensitivity to pain. This can deaden pain itself plus improve the non-judgmental and non-reactive awareness of the pain, reducing the suffering of fibromyalgia pain.

 

People with fibromyalgia suffer to an extent where some contemplate suicide. It is wonderful to see that relatively simple and safe mindfulness training can effectively reduce the suffering.

 

So, lessen fibromyalgia pain with mindfulness.

 

“While being mindful did make them more aware of pain or a symptom of their condition, it also helped them be open to something good happening and they had the choice to focus on the good. Many people spoke of trying to negotiate a balance in their feelings,” – Jaqui Long

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Adler-Neal, A. L., & Zeidan, F. (2017). Mindfulness Meditation for Fibromyalgia: Mechanistic and Clinical Considerations. Current Rheumatology Reports, 19(9), 59. http://doi.org/10.1007/s11926-017-0686-0

 

Abstract

Purpose of Review

Fibromyalgia is a disorder characterized by widespread pain and a spectrum of psychological comorbidities, rendering treatment difficult and often a financial burden. Fibromyalgia is a complicated chronic pain condition that requires a multimodal therapeutic approach to optimize treatment efficacy. Thus, it has been postulated that mind-body techniques may prove fruitful in treating fibromyalgia. Mindfulness meditation, a behavioral technique premised on non-reactive sensory awareness, attenuates pain and improves mental health outcomes. However, the impact of mindfulness meditation on fibromyalgia-related outcomes has not been comprehensively characterized. The present review delineates the existing evidence supporting the effectiveness and hypothesized mechanisms of mindfulness meditation in treating fibromyalgia-related outcomes.

Recent Findings

Mindfulness-based interventions premised on cultivating acceptance, non-attachment, and social engagement may be most effective in decreasing fibromyalgia-related pain and psychological symptoms. Mindfulness-based therapies may alleviate fibromyalgia-related outcomes through multiple neural, psychological, and physiological processes.

Summary

Mindfulness meditation may provide an effective complementary treatment approach for fibromyalgia patients, especially when combined with other reliable techniques (exercise; cognitive behavioral therapy). However, characterizing the specific analgesic mechanisms supporting mindfulness meditation is a critical step to fostering the clinical validity of this technique. Identification of the specific analgesic mechanisms supporting mindfulness-based pain relief could be utilized to better design behavioral interventions to specifically target fibromyalgia-related outcomes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5693231/

Produce Lasting Improvement in Fibromyalgia with Yoga

Produce Lasting Improvement in Fibromyalgia with Yoga

 

By John M. de Castro, Ph.D.

 

“For the nearly 10 million people who suffer from this condition, the thought of any movement can be overwhelming. What makes yoga perfect though is that it can be adapted for each person’s individual needs. Additionally, yoga’s ability to calm the mind and reduce stress may also serve to reduce the main trigger of fibromyalgia attacks, as well as slowly loosen cramped muscles.” – Liz Rosenblum

 

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. There are no completely effective treatments for fibromyalgia. Symptoms are generally treated with pain relievers, antidepressant drugs and exercise. But, these only reduce the severity of the symptoms and do not treat the disease directly. Mindfulness practices have also been shown to be effective in reducing pain from fibromyalgia.

 

Yoga is both an exercise and a mindfulness practice. So, it would make sense to investigate the effectiveness of yoga practice in treating fibromyalgia. Indeed, in a previous study, Carson and colleagues (Insert Link to Prior study) found that, yoga practice produced significant improvements in overall fibromyalgia symptoms. These findings need to be replicated and follow-up needs to be performed to establish the duration of the benefits. In today’s Research News article “Follow-up of Yoga of Awareness for Fibromyalgia: Results at 3 Months and Replication in the Wait-list Group.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5568073/, Carson and colleagues follow up their previous study (Insert Link to Prior study) to replicate their findings and investigate whether the benefits last.

 

They recruited adult women who were diagnosed with fibromyalgia for at least a year. They were randomly assigned to receive either yoga practice or be on a wait-list control condition. The Yoga for Awareness training occurred in a group setting for 2 hours, once a week for 8 weeks. Participants were also encouraged to practice at home for 20-40 minutes, 5 to 7 days per week. Yoga for Awareness sessions consisted of yoga stretching poses, mindfulness meditation, breathing exercises, presentations on the application of yogic principles to optimal coping, and group discussions. Participants were measured before and after training for fibromyalgia symptoms and disability, including myalgic tender points, strength deficits, and balance deficits, and pain coping including acceptance, catastrophizing, and adaptive and maladaptive strategies. In addition, daily diaries were maintained of “pain, fatigue, emotional distress, and vigor, along with success at coping via acceptance and relaxation strategies.” In this follow-up study, the wait-list control was provided the yoga training for 8 weeks and the previous yoga group was followed for durability of the symptom relief.

 

They found that after treating the previous control group, like with the previous study, there were significant improvements in overall fibromyalgia symptoms and its impact, including pain, fatigue, stiffness, sleep problems, depression, anxiety, memory problems, tenderness, balance, environmental sensitivity, and strength. There were even improvements in the strategies that the patients used to cope with the pain, including increased engagement with the pain, pain problem solving, reappraisal and decreased pain catastrophizing, self-isolation, and disengagement. The daily diaries also revealed significant improvements as a result of yoga practice including reduced pain, fatigue, emotional distress and increased vigor, relaxation, and success with acceptance. The improvements were significantly related to the amount of home practice with the greater the number of days per week that yoga was practiced at home the greater the improvements in overall fibromyalgia symptoms. They also found that the group treated in the previous study maintained their improvements in fibromyalgia symptoms, functional deficits, and coping abilities with no benefit showing a significantly lessened benefit.

 

Hence, they were able to replicate their prior findings, demonstrating that they were not a one-time event, and they were able to demonstrate that the benefits last at least for 3 months after the end of formal treatment. This is important as fibromyalgia lasts a lifetime. So, having lasting benefit is a prerequisite for a treatment. Yoga practice appears to fulfill these prerequisites and is a safe and effective treatment for fibromyalgia.

 

So, produce lasting improvement in fibromyalgia with yoga.

 

“Yoga’s ability to shift the nervous system out of the stress response and into the relaxation response is vital to people whose central nervous systems are sensitive and naturally hyped way up. It also acts directly on the very muscles where fibromyalgia pain occurs.” – Catherine Guthrie

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Carson, J. W., Carson, K. M., Jones, K. D., Mist, S. D., & Bennett, R. M. (2012). Follow-up of Yoga of Awareness for Fibromyalgia: Results at 3 Months and Replication in the Wait-list Group. The Clinical Journal of Pain, 28(9), 804–813. http://doi.org/10.1097/AJP.0b013e31824549b5

 

Abstract

Objectives

Published preliminary findings from a randomized-controlled trial suggest that an 8-week Yoga of Awareness intervention may be effective for improving symptoms, functional deficits, and coping abilities in fibromyalgia. The primary aims of this study were to evaluate the same intervention’s posttreatment effects in a wait-list group and to test the intervention’s effects at 3-month follow-up in the immediate treatment group.

Methods

Unpaired t tests were used to compare data from a per protocol sample of 21 women in the immediate treatment group who had completed treatment and 18 women in the wait-list group who had completed treatment. Within-group paired t tests were performed to compare posttreatment data with 3-month follow-up data in the immediate treatment group. The primary outcome measure was the Fibromyalgia Impact Questionnaire Revised (FIQR). Multilevel random-effects models were also used to examine associations between yoga practice rates and outcomes.

Results

Posttreatment results in the wait-list group largely mirrored results seen at posttreatment in the immediate treatment group, with the FIQR Total Score improving by 31.9% across the 2 groups. Follow-up results showed that patients sustained most of their posttreatment gains, with the FIQR Total Score remaining 21.9% improved at 3 months. Yoga practice rates were good, and more practice was associated with more benefit for a variety of outcomes.

Discussion

These findings indicate that the benefits of Yoga of Awareness in fibromyalgia are replicable and can be maintained.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5568073/