Improve Quality of Life with Migraine Headaches with Mindfulness

Improve Quality of Life with Migraine Headaches with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Be mindful of your breathing. If you notice that your respirations are fast and shallow, concentrate on taking slower, deeper and longer breaths. As your breathing slows, your body will begin to relax. Tensions and stress slowly will ebb from your body, allowing you to release the some of the pain and discomfort associated with your headaches.” – National Headache Institute

 

Migraine headaches are a torment far beyond the suffering of a common headache. It is an intense throbbing pain usually unilateral, focused on only one side of the head and lasts from 4 hours to 3 days. They are actually a collection of neurological symptoms. Migraines often include: visual disturbances, nausea, vomiting, dizziness, extreme sensitivity to sound, light, touch and smell, and tingling or numbness in the extremities or face. Migraines are the 8th most disabling illness in the world. While most sufferers experience attacks once or twice a month, about 4% have chronic daily headaches. Migraines are very disruptive to the sufferer’s personal and work lives as most people are unable to work or function normally when experiencing a migraine.

 

There is no known cure for migraine headaches. Treatments are targeted at managing the symptoms. Prescription and over-the-counter pain relievers are frequently used. There are a number of drug and drug combinations that appear to reduce the frequency of migraine attacks. These vary in effectiveness but unfortunately can have troubling side effects and some are addictive. Behaviorally, relaxation and sleep appear to help lower the frequency of migraines. Mindfulness practices have been shown to reduce stress and improve relaxation. So, they may be useful in preventing migraines. Indeed, it has been shown that mindfulness practice can reduce headache pain.

 

In today’s Research News article “Mindfulness for female outpatients with chronic primary headaches: an internet-based bibliotherapy.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6036307/ ), Tavallaei and colleagues recruited women suffering with migraine headaches and randomly assigned them to receive either an on-line mindfulness training based upon the Mindfulness-Based Stress Reduction (MBSR) program or medical treatment as usual. The mindfulness training program was presented over the internet in 8 weekly sessions and included meditation, body scan, and didactic presentation. The participants were measured before and after treatment for mindfulness, migraine disability, pain, and distress including depression, anxiety, and stress.

 

They found that in comparison to the baseline and the treatment-as-usual control group that the group who received mindfulness training had significantly lower levels of migraine disability, distress, and pain and significantly higher levels of mindfulness. They found that the reductions in pain were due to changes in the emotional reactions to pain and not the sensory experiences of pain. So, the pain was perceived normally but the women did not react to the sensations emotionally and this resulted in a lower impact of the headache pain.

 

The results suggest that mindfulness training increases the quality of life and reduces the psychological distress of women with migraine headaches. Similar findings have been reported in other prior research studies. The importance of the present study resides in the presentation of the program over the internet. Presentation over the internet is important as in-person programs are inconvenient and expensive. Presentation over the internet allows for widespread, convenient, and inexpensive distribution of the therapy to affected populations. This makes mindfulness training more readily available to migraine sufferers.

 

So, improve quality of life with migraine headaches with mindfulness.

 

“mindfulness has been examined as a treatment for chronic pain and pain-related conditions, finding positive results such as reduction in medication usage, improved physical functioning, and physical-health-related quality of life.” – Monika Tomova

 

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

 

Tavallaei, V., Rezapour-Mirsaleh, Y., Rezaiemaram, P., & Saadat, S. H. (2018). Mindfulness for female outpatients with chronic primary headaches: an internet-based bibliotherapy. European Journal of Translational Myology, 28(2), 7380. http://doi.org/10.4081/ejtm.2018.7380

 

Abstract

Our aim was to investigate effectiveness of mindfulness by bibliotherapy on disability, distress, perceived pain and mindfulness in women with tension headaches and migraines. Primary headaches have been of great interest to mental health researchers because of the high prevalence, as well as significant disability and distress in the affected people. Despite the promising results of in-person treatment and some limitations that such interventions may cause, patients may be encountered with problems when using health care services. The present study is a quasi-experimental randomized design with pre-test, post-test, and control group. The study population consisted of 1396 women with migraine headache referring to headache clinic of Baqiyatallah Hospital in Tehran. Of these, 30 patients (including tboh experimental and control group) were selected by objective sampling method and were randomly assigned to the two groups. The experimental group, in addition to medical treatment as usual, was treated for a period of 8 sessions by Mindfulness-based Stress Reduction Internet-based Bibliotherapy, but the control group used only the medical treatment. The sample had no attritions. Data were collected by the four scales of (DASS-21), Migraine Disability Assessment Test (MIDAS), McGill’s Short Form Questionnaire (MPQ-SF), and Mindfulness Inventory (MAAS). We used covariance analysis to analyze the findings in the measured scales. MBSR-IBB treatment had no significant effect on pain sensory dimension (P <0.44), despite improvement of mindfulness (P <0.0001). In contrast, the greatest effect was on the level of disability (P <0.0001). We observed also a significant improvement in distress (P <0.0001). In conclusion, in spite of the presence of headaches, the mindfulness improved the quality of life and reduced the level of mental distress. In addition, using the Internet-based bibliotherapy method, these services can be used with easier access, lower cost, and more flexibility.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6036307/

 

Improve Headache Pain with Mindfulness

Improve Headache Pain with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness-based stress reduction (MBSR) can be a safe and effective means of lessening the effect of migraine headache and can be carried out while patients continue to take migraine medication.” – Pauline Anderson

 

Headaches are the most common disorders of the nervous system. It has been estimated that 47% of the adult population have a headache at least once during the last year. There are a wide variety of drugs that are prescribed for chronic headache pain with varying success. Headaches are treated with pain relievers, ergotamine, blood pressure drugs such as propranolol, verapamil, antidepressants, antiseizure drugs, and muscle relaxants. Drugs, however, can have some problematic side effects particularly when used regularly and are ineffective for many sufferers. So, almost all practitioners consider lifestyle changes that help control stress and promote regular exercise to be an important part of headache treatment and prevention. Avoiding situations that trigger headaches is also vital.

 

Individual studies have reported that mindfulness training is an effective treatment for headache pain. There is a need, however, to summarize and analyze the existing literature. In today’s Research News article “Mindfulness Meditation for Primary Headache Pain: A Meta-Analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5887742/ ), Gu and colleagues review, summarize, and perform a meta-analysis of the effectiveness of meditation practice for headache pain. They identified 11 published studies with adult patients. They find that the studies report that mindfulness meditation produces not only a significant reduction in headache pain but also a significant reduction in the frequency of headaches. Subgroup analysis revealed that Mindfulness-Based Stress Reduction (MBSR) was effective in reducing pain and 8 weeks of mindfulness meditation was effective in producing pain reduction.

 

Hence, the published research literature supports the conclusion that mindfulness meditation is a safe and effective treatment for headaches, reducing their number and intensity. Some of the effects of mindfulness practices are to alter thought processes, changing what is thought about. In terms of pain, mindfulness training, by focusing attention on the present moment has been shown to 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 can reduce headache pain. In addition, mindfulness improves self-efficacy, the belief that the individual can adapt to and handle headache pain. In addition, mindfulness training also has been shown to alter not only what is thought, but also how thoughts are processed. Central to this cognitive change is mindfulness and acceptance. By mindfully viewing pain as a present moment experience it can be experienced just as it is and by accepting it, the individual stops fighting against the pain which can amplify the pain.

 

So, improve headache pain with mindfulness.

 

“Mindfulness meditation is proving to be of significant help in not only reducing migraines or chronic pain, but improvements in mood, outlook on life and illness, increased coping skills, enhanced sense of well-being, changes in perception of pain, higher tolerance of pain, enhanced immune function, less fatigue and stress and better sleep. Beyond that, other benefits that are derived from mindfulness include improved cognitive functioning and memory, more inner peace, empathy and compassion, higher levels of self-awareness, joy, pleasure, creativity, insight and intuition, all of which result in a life that is deeper and more fulfilling on many levels.” – Cynthia Perkins

 

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

 

Gu, Q., Hou, J.-C., & Fang, X.-M. (2018). Mindfulness Meditation for Primary Headache Pain: A Meta-Analysis. Chinese Medical Journal, 131(7), 829–838. http://doi.org/10.4103/0366-6999.228242

 

Abstract

Background:

Several studies have reported that mindfulness meditation has a potential effect in controlling headaches, such as migraine and tension-type headache; however, its role remains controversial. This review assessed the evidence regarding the effects of mindfulness meditation for primary headache pain.

Methods:

Only English databases (PubMed, Cochrane Central Register of Controlled Trials [the Cochrane Library], PsycINFO, Psychology and behavioral science collection, PsyArticles, Web of Science, and Scopus) were searched from their inception to November 2016 with the keywords (“meditation” or “mindfulness” or “vipassana” or “dzogchen” or “zen” or “integrative body-mind training” or “IBMT” or “mindfulness-based stress reduction” or “MBSR” or “mindfulness-based cognitive therapy” or “MBCT” and “Headache” or “Head pain” or “Cephalodynia” or “Cephalalgia” or “Hemicrania” or “Migraine”). Titles, abstracts, and full-text articles were screened against study inclusion criteria: controlled trials of structured meditation programs for adult patients with primary headache pain. The quality of studies included in the meta-analysis was assessed with the Yates Quality Rating Scale. The meta-analysis was conducted with Revman 5.3.

Results:

Ten randomized controlled trials and one controlled clinical trial with a combined study population of 315 patients were included in the study. When compared to control group data, mindfulness meditation induced significant improvement in pain intensity (standardized mean difference, −0.89; 95% confidence interval, −1.63 to −0.15; P = 0.02) and headache frequency (−0.67; −1.24 to −0.10; P = 0.02). In a subgroup analysis of different meditation forms, mindfulness-based stress reduction displayed a significant positive influence on pain intensity (P < 0.000). Moreover, 8-week intervention had a significant positive effect (P< 0.000).

Conclusions:

Mindfulness meditation may reduce pain intensity and is a promising treatment option for patients. Clinicians may consider mindfulness meditation as a viable complementary and alternative medical option for primary headache.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5887742/

Improve Migraine Headaches with Spiritual Meditation

Improve Migraine Headaches with Spiritual Meditation

 

By John M. de Castro, Ph.D.

 

Meditation is an ancient spiritual practice that people are still using today to get headache relief. This mind-body practice seems to work by relieving stress associated with headache pain.” – Chris Iliades

 

Migraine headaches are a torment far beyond the suffering of a common headache. It is an intense throbbing pain usually unilateral, focused on only one side of the head and lasts from 4 hours to 3 days. They are actually a collection of neurological symptoms. Migraines often include: visual disturbances, nausea, vomiting, dizziness, extreme sensitivity to sound, light, touch and smell, and tingling or numbness in the extremities or face. Migraines are the 8th most disabling illness in the world. In the U.S. they affect roughly 40 million men, women and children. While most sufferers experience attacks once or twice a month, 14 million people or about 4% have chronic daily headaches. Migraines are very disruptive to the sufferer’s personal and work lives as most people are unable to work or function normally when experiencing a migraine.

 

There is no known cure for migraine headaches. Treatments are targeted at managing the symptoms. Prescription and over-the-counter pain relievers are frequently used. There are a number of drug and drug combinations that appear to reduce the frequency of migraine attacks. These vary in effectiveness but unfortunately can have troubling side effects and some are addictive. Behaviorally, relaxation and sleep appear to help lower the frequency of migraines. Mindfulness practices have been shown to reduce stress and improve relaxation. So, they may be useful in preventing migraines. Indeed, it has been shown that mindfulness practice can reduce headache pain.

 

There are a wide variety of meditation techniques. It is not known which kinds work best for migraine headaches. In today’s Research News article “Effect of Different Meditation Types on Migraine Headache Medication Use.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4600642/ ), Wachholtz and colleagues examine the effectiveness of spiritual focused vs. secular meditation techniques on treating migraine headaches. They recruited adult migraine sufferers who had at least 2 migraine headaches per month and who were naive to meditation. They were randomly assigned to one of four groups who meditated for 20 minutes per day for 30 days; Spiritual Meditation, Internally Focused Secular Meditation, Externally Focused Secular Meditation, or Progressive Muscle Relaxation.

 

The meditation techniques differed in a phrase that the participants repeated to themselves and used as a focus for their meditation during the 20-minute daily period. For the Spiritual Meditation group the participants chose one of four phrases; “God is peace,” “God is joy,” God is good,” and “God is love.” For the Secular Internal Meditation group the participants chose either; “I am content,” “I am joyful,” “I am good,” “I am happy.” For the Secular External Meditation group the participants chose either; “Grass is green,” “Sand is soft,” “Cotton is fluffy,” “Cloth is smooth.” The Relaxation group practiced progressive muscle relaxation, systematically tensing and relaxing muscles. Participants were measured before and after the 30 days of meditation for headache frequency, intensity, and usage of migraine medications, and for spiritual and religious experiences and activities. They also maintained daily headache diaries.

 

They found that while all groups showed some improvement in migraine frequency, the Spiritual Meditation groups had significantly greater improvement than the other groups. In addition, while all groups showed significant reduction in the use of migraine medications, the Spiritual Meditation groups had significantly greater reductions. There was, however, no change in the severity of the migraines. Hence, although there were fewer headaches, when they did occur they were just as intense as usual. It should be noted, however, that there wasn’t a no-treatment control. So, it is unclear that improvements would not have occurred without treatment.

 

The results suggest that meditation and relaxation, but especially spiritually focused meditation, can improve migraine frequency and medication use. Mindfulness practices, in the previous research have been shown to be effective in treating pain from a variety of sources including headaches. It is not clear, however, why meditating with a spiritual focus is superior to secular focused meditation or relaxation. Perhaps focusing on a greater power relieves the stress of searching for the sources of the headaches within the self or the environment, and the stress reduction, in turn, reduces the likelihood of a migraine.

 

So, improve migraine headaches with spiritual meditation.

 

“This kind of moment-to-moment, positive mindfulness is crucial for chronic pain sufferers. Pain is only ever exacerbated by depression and despair. And depression and despair most definitely intensify pain. Thus, the dark circle of chronic illness. Mindfulness can stop this cycle in its tracks by allowing the patient to take back control and climb out of the gloom, a single moment at a time. “ – Ashley Jonkman

 

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

 

Wachholtz, A. B., Malone, C. D., & Pargament, K. I. (2017). Effect of Different Meditation Types on Migraine Headache Medication Use. Behavioral Medicine (Washington, D.C.), 43(1), 1–8. http://doi.org/10.1080/08964289.2015.1024601

 

Abstract

Spiritual meditation has been found to reduce the frequency of migraines and physiological reactivity to stress. However, little is known about how introducing a spirituality component into a meditation intervention impacts analgesic medication usage. In this study, 92 meditation naïve participants were randomly assigned to four groups (Spiritual Meditation (N=25), Internally Focused Secular Meditation (N=23), Externally Focused Secular Meditation (N=22), Progressive Muscle Relaxation (N=22)) and practiced their technique for 20min/day over 30 days while completing daily diaries. Headache frequency, headache severity, and pain medication use were assessed. Migraine frequency decreased in the Spiritual Meditation group compared to other groups (p<.05). Headache severity ratings did not differ across groups (p=NS). After adjusting for headache frequency, migraine medication usage decreased in the Spiritual Meditation group compared to other groups (p<.05). Spiritual Meditation was found to not affect pain sensitivity, but it does improve pain tolerance with reduced headache related analgesic medication usage.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4600642/

Improve Migraine Headaches with Mindfulness

Improve Migraine Headaches with Mindfulness

 

By John M. de Castro, Ph.D.

 

“When we allow our minds, hearts, and bodies to be heard and felt through mindful attention, they will say back to us, “Thank you for listening,” not because we tried to fix anything but just because we paid attention with gentle, nonjudgmental awareness. This nurturing umbrella of awareness is the key. It is both a form of refuge and a means of really being able to take control of and managing our lives. It is a way we can cultivate and honor the wholeness of our being. It is how we heal.” – American Migraine Foundation

 

Migraine headaches are a torment far beyond the suffering of a common headache. It is an intense throbbing pain usually unilateral, focused on only one side of the head. They last from 4 hours to 3 days. They are actually a collection of neurological symptoms. Migraines often include: visual disturbances, nausea, vomiting, dizziness, extreme sensitivity to sound, light, touch and smell, and tingling or numbness in the extremities or face. Migraines are the 8th most disabling illness in the world. They disproportionately affect women with about 18% of American women and 6% of men suffering from migraine. In the U.S. they affect roughly 40 million men, women and children. While most sufferers experience attacks once or twice a month, 14 million people or about 4% have chronic daily headaches. Migraines are very disruptive to the sufferer’s personal and work lives as most people are unable to work or function normally when experiencing a migraine.

 

There is no known cure for migraine headaches. Treatments are targeted at managing the symptoms. Prescription and over-the-counter pain relievers are frequently used. There are a number of drug and drug combinations that appear to reduce the frequency of migraine attacks. These vary in effectiveness but unfortunately can have troubling side effects and some are addictive. Behaviorally, relaxation and sleep appear to help lower the frequency of migraines. Mindfulness practices have been shown to reduce stress and improve relaxation. So, they may be useful in preventing migraines. Indeed, it has been shown that mindfulness practice can reduce headache pain.

 

In today’s Research News article “Mindfulness and pharmacological prophylaxis after withdrawal from medication overuse in patients with Chronic Migraine: an effectiveness trial with a one-year follow-up.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5292107/

Grazzi and colleagues recruited patients who were diagnosed with chronic migraine headaches with accompanying overuse of medications. They were withdrawn from medications over a 45-day period. The patients then volunteered to participate in a research study and were assigned to receive and 8-week Mindfulness Based Stress Reduction (MBSR) program or prophylactic (preventive) migraine medication. They were measured before and after treatment and at 6-months and 12-months later for headache frequency, frequency of pain reliever use, headache impact, migraine disability, depression, and anxiety.

 

They found that both MBSR and prophylactic medication treatment produced clinically significant reductions in headache frequency, pain reliever use, headache impact, migraine disability, and depression. These benefits were maintained at 6-monmth and 1-year follow-ups. These are preliminary findings as there wasn’t a control group present. But, the findings are exciting and the effects large, suggesting that mindfulness training is as effective in treating migraine headaches as prophylactic medications. Since the MBSR training, unlike the drugs, has no known adverse effects, it would appear to be a preferred treatment for migraine headaches.

 

Some of the effects of mindfulness practices are to alter thought processes, changing what is thought about. In terms of pain, mindfulness training, by focusing attention on the present moment has been shown to 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 can reduce headache pain. In addition, mindfulness improves self-efficacy, the belief that the individual can adapt to and handle headache pain. Mindfulness training also has been shown to alter not only what is thought, but also how thoughts are processed. Central to this cognitive change is mindfulness and acceptance. By mindfully viewing pain as a present moment experience it can be experienced just as it is and by accepting it, the individual stops fighting against the pain which can amplify the pain.

 

So, improve migraine headaches with mindfulness.

 

“Can you namaste your migraines away? A new, small study published in the journal Headache suggests that meditation may help relieve the intensity and duration of migraines.” – Mandy Oaklander

 

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

Grazzi, L., Sansone, E., Raggi, A., D’Amico, D., De Giorgio, A., Leonardi, M., … Andrasik, F. (2017). Mindfulness and pharmacological prophylaxis after withdrawal from medication overuse in patients with Chronic Migraine: an effectiveness trial with a one-year follow-up. The Journal of Headache and Pain, 18(1), 15. http://doi.org/10.1186/s10194-017-0728-z

 

Abstract

Background

Chronic Migraine (CM) is a disabling condition, worsened when associated with Medication Overuse (MO). Mindfulness is an emerging technique, effective in different pain conditions, but it has yet to be explored for CM-MO. We report the results of a study assessing a one-year course of patients’ status, with the hypothesis that the effectiveness of a mindfulness-based approach would be similar to that of conventional prophylactic treatments.

Methods

Patients with CM-MO (code 1.3 and 8.2 of the International Classification of Headache Disorders-3Beta) completed a withdrawal program in a day hospital setting. After withdrawal, patients were either treated with Prophylactic Medications (Med-Group), or participated in a Mindfulness-based Training (MT-Group). MT consisted of 6 weekly sessions of guided mindfulness, with patients invited to practice 7–10 min per day. Headache diaries, the headache impact test (HIT-6), the migraine disability assessment (MIDAS), state and trait anxiety (STAI Y1-Y2), and the Beck Depression Inventory (BDI) were administered before withdrawal and at each follow-up (3, 6, 12 after withdrawal) to patients from both groups. Outcome variables were analyzed in separate two-way mixed ANOVAs (Group: Mindfulness vs. Pharmacology x Time: Baseline, 3-, 6-, vs. 12-month follow-up).

Results

A total of 44 patients participated in the study, with the average age being 44.5, average headache frequency/month was 20.5, and average monthly medication intake was 18.4 pills. Data revealed a similar improvement over time in both groups for Headache Frequency (approximately 6–8 days reduction), use of Medication (approximately 7 intakes reduction), MIDAS, HIT-6 (but only for the MED-Group), and BDI; no changes on state and trait anxiety were found. Both groups revealed significant and equivalent improvement with respect to what has become a classical endpoint in this area of research, i.e. 50% or more reduction of headaches compared to baseline, and the majority of patients in each condition no longer satisfied current criteria for CM.

Conclusions

Taken as a whole, our results suggest that the longitudinal course of patients in the MT-Group, that were not prescribed medical prophylaxis, was substantially similar to that of patients who were administered medical prophylaxis.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5292107/

 

 

Help Headaches in Adolescents with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness meditation is proving to be of significant help in not only reducing migraines or chronic pain, but improvements in mood, outlook on life and illness, increased coping skills, enhanced sense of well-being, changes in perception of pain, higher tolerance of pain, enhanced immune function, less fatigue and stress and better sleep.” – Cynthia Perkins

 

Headaches are the most common disorders of the nervous system. It has been estimated that 47% of the adult population have a headache at least once during the last year. There are a wide variety of drugs that are prescribed for chronic headache pain with varying success. Headaches are treated with pain relievers, ergotamine, blood pressure drugs such as propranolol, verapamil, antidepressants, antiseizure drugs, and muscle relaxants. Drugs, however, can have some problematic side effects particularly when used regularly and are ineffective for many sufferers. So, almost all practitioners consider lifestyle changes that help control stress and promote regular exercise to be an important part of headache treatment and prevention. Avoiding situations that trigger headaches is also vital.

 

Mindfulness training has been shown to be an effective treatment for headache pain in adults. It is not known whether it is also effective for adolescents. Yet, 60% of children and adolescents report headaches, with 20% having frequent or severe headaches. In today’s Research News article “Mindfulness-Based Intervention for Adolescents with Recurrent Headaches: A Pilot Feasibility Study.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1415631915127397/?type=3&theater

or see summary below or view the full text of the study at:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4700163/

Hesse and colleagues study the effectiveness of mindfulness training for recurrent headaches in adolescents. They recruited adolescent females with recurrent headaches. The teens received group mindfulness training once a week for 1 to 1.5 hours for 12 weeks. Before and after training the adolescents recorded their mindfulness practices and headaches, and completed scales measuring headache-related disability, anxiety, depression, and quality of life, while their parents also completed a report of the teens’ quality of life.

 

They found that mindfulness training did not produce any changes in the frequency or severity of headaches, headache-related disability, or anxiety, but a significant reduction in depression and an improvement in acceptance of headache pain. The parents reported that the adolescents had improved physical quality of life. Hence, mindfulness training improved the teen’s depression, quality of life, and acceptance of pain but not the headaches themselves. These are encouraging results that need to be followed up with a large randomized controlled clinical trial. But, they suggest that mindfulness training may be a useful treatment for headache pain in adolescents.

 

Mindfulness practices may be helpful with headache pain by focusing attention on the present moment. This has been shown to reduce worry and catastrophizing which, in turn, reduces depression. Pain is increased by worry about the pain and the expectation of greater pain in the future. So, reducing worry and catastrophizing can reduce headache pain. Mindfulness teaches the individual to view pain as a present moment experience that can be experienced just as it is and accept it. As a result, the individual accepts the pain and stops fighting against it, which can amplify the pain.

 

So, help headaches in adolescents with mindfulness.

 

“Years of research and clinical experience demonstrate that behavioral medicine methods can have a powerful effect on pain, especially when used in conjunction with medical treatment. Behavioral medicine examines and trains an individual to become aware of the power of the mind and emotions on physical health. One potent method for recovering health is meditation.” – Michigan Headache & Neurological Institute

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

Hesse, T., Holmes, L. G., Kennedy-Overfelt, V., Kerr, L. M., & Giles, L. L. (2015). Mindfulness-Based Intervention for Adolescents with Recurrent Headaches: A Pilot Feasibility Study. Evidence-Based Complementary and Alternative Medicine : eCAM, 2015, 508958. http://doi.org/10.1155/2015/508958

 

Abstract

Recurrent headaches cause significant burden for adolescents and their families. Mindfulness-based interventions (MBIs) have been shown to reduce stress and alter the experience of pain, reduce pain burden, and improve quality of life. Research indicates that MBIs can benefit adults with chronic pain conditions including headaches. A pilot nonrandomized clinical trial was conducted with 20 adolescent females with recurrent headaches. Median class attendance was 7 of 8 total sessions; average class attendance was 6.10 ± 2.6. Adherence to home practice was good, with participants reporting an average of 4.69 (SD = 1.84) of 6 practices per week. Five participants dropped out for reasons not inherent to the group (e.g., extracurricular scheduling); no adverse events were reported. Parents reported improved quality of life and physical functioning for their child. Adolescent participants reported improved depression symptoms and improved ability to accept their pain rather than trying to control it. MBIs appear safe and feasible for adolescents with recurrent headaches. Although participants did not report decreased frequency or severity of headache following treatment, the treatment had a beneficial effect for depression, quality of life, and acceptance of pain and represents a promising adjunct treatment for adolescents with recurrent headaches.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4700163/

 

Reduce Pain by Accepting it Mindfully

By John M. de Castro, Ph.D.

 

“They were able to have a sense of personal control over their migraines. It really makes us wonder if an intervention like meditation can change the way people interpret their pain.” – Rebecca Erwin Wells

 

Headaches are the most common disorders of the nervous system. It has been estimated that 47% of the adult population have a headache at least once during the last year. The most common type of headache is the tension headache with 80 to 90 percent of the population suffering from tension headaches at least some time in their lives. The second most common type of headache is the migraine headache. Around 16 to 17 percent of the population complains of migraines. It is the 8th most disabling illness in the world with more than 90% of sufferers unable to work or function normally during their migraine. American employers lose more than $13 billion each year as a result of 113 million lost work days due to migraine.

 

There are a wide variety of drugs that are prescribed for chronic headache pain with varying success. Most tension headaches can be helped by taking pain relievers such as aspirin, naproxen, acetaminophen, or ibuprofen. A number of medications can help treat and prevent migraines and tension headaches, including ergotamine, blood pressure drugs such as propranolol, verapamil, antidepressants, antiseizure drugs, and muscle relaxants. Drugs, however, can have some problematic side effects particularly when used regularly and are ineffective for many sufferers. So, almost all practitioners consider lifestyle changes that help control stress and promote regular exercise to be an important part of headache treatment and prevention. Avoiding situations that trigger headaches is also vital.

 

Mindfulness training has been shown to be an effective treatment for headache pain. Some of the effects of mindfulness practices are to alter thought processes, changing what is thought about. In terms of pain, mindfulness training, by focusing attention on the present moment has been shown to 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 can reduce headache pain. In addition, mindfulness improves self-efficacy, the belief that the individual can adapt to and handle headache pain. In addition, mindfulness training also has been shown to alter not only what is thought, but also how thoughts are processed. Central to this cognitive change is mindfulness and acceptance. By mindfully viewing pain as a present moment experience it can be experienced just as it is and by accepting it, the individual stops fighting against the pain which can amplify the pain.

 

It is not known whether it is the changes in the what or how, or both, of thoughts that is responsible for mindfulness training’s efficacy in treating headache pain. In today’s Research News article “The mediating role of pain acceptance during mindfulness-based cognitive therapy for headache.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1229081490449108/?type=3&theater

or see below

Day and Thorn investigate this question. They randomly assigned headache patients to receive either 8-weeks of Mindfulness Based Cognitive Therapy (MBCT) or treatment as usual as a wait-list control condition. Before and again after treatment measurements were obtained of pain, pain acceptance, pain catastrophizing, and pain self-efficacy.

 

They found, as has previously been shown, that the MBCT training significantly reduced the level of pain and pain catastrophizing, and increased the levels of pain self-efficacy and pain acceptance. Day and Thorn then went on to use a sophisticated statistical technique to assess whether the change in pain produced by mindfulness training was due to the changes in the what or how about thinking. They found that only the how aspect of thought, pain acceptance, significantly mediated the effect. Neither of the what aspects of thought, pain catastrophizing nor pain self-efficacy, were significantly related to the mindfulness training effects on pain.

 

These results are very interesting and potentially important. They suggest that mindfulness training reduces headache pain by altering how pain is thought about, increasing acceptance of the pain. Acceptance is defined as the “conscious willingness to stay in direct contact with experience.” This may operate by reducing the individual’s attempts to counteract the pain. Since, fighting against the pain can actually increase the level of pain, accepting the pain interferes with this amplifying process, thus lowering the pain level experienced. It is interesting that neither the pain catastrophizing nor pain self-efficacy were significant mediators as they have long been thought to be important mechanisms of mindfulness’ effectiveness for pain management. But, it is clear that how pain is thought about, in particular, the acceptance of pain, is the key.

 

So, reduce pain by accepting it mindfully.

 

“Awareness transforms emotional pain just as it transforms the pain that we attribute more to the domain of body sensations. When we are immersed in emotional pain, if we pay close attention, we will notice that there is always an overlay of thoughts and a plethora of different feelings about the pain we are in, so here too the entire constellation of what we think of as emotional pain can be welcomed in and held in awareness.”Jon Kabat-Zinn

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Study Summary

 

Day MA, Thorn BE. The mediating role of pain acceptance during mindfulness-based cognitive therapy for headache. Complement Ther Med. 2016 Apr;25:51-4. doi: 10.1016/j.ctim.2016.01.002. Epub 2016 Jan 13.

 

Highlights

  • Pain acceptance was a significant mediator of the MBCT-pain interference relation.
  • Specifically, activity engagement emerged as the critical component of acceptance.
  • Pain catastrophizing and self-efficacy did not meet criteria for mediation.
  • This is the first study to show acceptance is a key mediator of MBCT for headache.

Abstract

Objectives: This study aimed to determine if mindfulness-based cognitive therapy (MBCT) engenders improvement in headache outcomes via the mechanisms specified by theory: (1) change in psychological process, (i.e., pain acceptance); and concurrently (2) change in cognitive content, (i.e., pain catastrophizing; headache management self-efficacy).

Design: A secondary analysis of a randomized controlled trial comparing MBCT to a medical treatment as usual, delayed treatment (DT) control was conducted. Participants were individuals with headache pain who completed MBCT or DT (N = 24) at the Kilgo Headache Clinic or psychology clinic. Standardized measures of the primary outcome (pain interference) and proposed mediators were administered at pre- and post-treatment; change scores were calculated. Bootstrap mediation models were conducted.

Results: Pain acceptance emerged as a significant mediator of the group-interference relation (p < .05). Mediation models examining acceptance subscales showed nuances in this effect, with activity engagement emerging as a significant mediator (p < .05), but pain willingness not meeting criteria for mediation due to a non-significant pathway from the mediator to outcome. Criteria for mediation was also not met for the catastrophizing or self-efficacy models as neither of these variables significantly predicted pain interference.

Conclusions: Pain acceptance, and specifically engagement in valued activities despite pain, may be a key mechanism underlying improvement in pain outcome during a MBCT for headache pain intervention. The theorized mediating role of cognitive content factors was not supported in this preliminary study. A large, definitive trial is warranted to replicate and extend the findings in order to streamline and optimize MBCT for headache.

 

Improve Tension Headaches with Mindfulness

MBSR stress2 Omidi

By John M. de Castro, Ph.D.

 

“Stress is a known trigger for headaches, and mindfulness is a known combatant against stress. Several studies have shown that mindfulness meditation can curb stress responses” – Mandy Oaklander

 

The most common medical ailment is headaches. They affect about 16.5% of the population of the U.S., approximately 45 million Americans each year. Over eight million seek out medical attention for headaches each year. The most common type of headache is the tension headache. It is estimated that 80 to 90 percent of the population suffer from tension headaches at least some time in their lives, about 69% of males and 88% of females. They come in two categories. Episodic headaches appear occasionally, while chronic headaches occur more than 15 times per month. Headaches are associated with personal and societal burdens of pain, disability, damaged quality of life and financial cost.

 

Tension headaches are generally treated with over the counter analgesics. Opiates, or narcotics, are rarely used because of their side effects and potential for dependency. To prevent tension headaches antidepressants or muscle relaxers are sometimes prescribed. Some individuals learn to employ a non-drug method to prevent or reduce tension headaches by learning what causes the headaches and trying to avoid those triggers. Finally, recently it has been shown that mindfulness techniques are generally helpful with coping with pain and specifically can be effective for headache relief. These include Mindfulness Based Stress Reduction (MBSR). Hence, it makes sense to further investigate the relationship of MBSR with stress reduction and tension headache relief.

 

In today’s Research News article “Effects of mindfulness-based stress reduction on perceived stress and psychological health in patients with tension headache”

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4755092/

Omidi and colleagues randomly assigned tension headache sufferers to either a treatment as usual (TAU) group, treated with antidepressant medication and clinical management, or an MBSR group which received TAU plus 8-weeks of Mindfulness Based Stress Reduction. They found that the MBSR group had significantly lower headache pain and increased mindfulness, while the treatment as usual group had no significant change in either.

 

These results are impressive and demonstrate that MBSR training may be an effective treatment for tension headache when combined with treatment as usual. Because MBSR contains three primary components; body scan, meditation, and yoga, it is not possible to discern which component or which combination of components were responsible for the improvement in headache pain. It is also not possible to discern if MBSR might be effective alone without the associated treatment as usual.

 

MBSR is structured to reduce stress and has been empirically shown to significantly reduce both the physiological and psychological responses to stress. Since tension headaches are primarily produced by stress and migraine headaches are frequently triggered by stress, it would seem reasonable to conclude that the stress reduction contributed to the effectiveness of MBSR for chronic headaches. Mindfulness training, by focusing attention on the present moment has also been shown to 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 headache pain. In addition, negative emotions are associated with the onset of headaches. Mindfulness has been shown to increase positive emotions and decrease 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 MBSR is a safe and effective treatment for tension headaches. So, improve tension headaches with mindfulness.

 

“In the pain studies, people with chronic pain such as headaches, back pain, neck pain and fibromyalgia who participated in the Mindfulness-Based Stress Reduction Clinic reported a dramatic reduction in the average level of pain during the eight-week training period and for at least four years following the treatment.” – Mindful Living

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Study Summary

Omidi, A., & Zargar, F. (2015). Effects of mindfulness-based stress reduction on perceived stress and psychological health in patients with tension headache. Journal of Research in Medical Sciences : The Official Journal of Isfahan University of Medical Sciences, 20(11), 1058–1063. http://doi.org/10.4103/1735-1995.172816

 

Abstract

Background: Programs for improving health status of patients with illness related to pain, such as headache, are often still in their infancy. Mindfulness-based stress reduction (MBSR) is a new psychotherapy that appears to be effective in treating chronic pain and stress. This study evaluated efficacy of MBSR in treatment of perceived stress and mental health of client who has tension headache.

Materials and Methods: This study is a randomized clinical trial. Sixty patients with tension type headache according to the International Headache Classification Subcommittee were randomly assigned to the Treatment As Usual (TAU) group or experimental group (MBSR). The MBSR group received eight weekly classmates with 12-min sessions. The sessions were based on MBSR protocol. The Brief Symptom Inventory (BSI) and Perceived Stress Scale (PSS) were administered in the pre- and posttreatment period and at 3 months follow-up for both the groups.

Results: The mean of total score of the BSI (global severity index; GSI) in MBSR group was 1.63 ± 0.56 before the intervention that was significantly reduced to 0.73 ± 0.46 and 0.93 ± 0.34 after the intervention and at the follow-up sessions, respectively (P < 0.001). In addition, the MBSR group showed lower scores in perceived stress in comparison with the control group at posttest evaluation. The mean of perceived stress before the intervention was 16.96 ± 2.53 and was changed to 12.7 ± 2.69 and 13.5 ± 2.33 after the intervention and at the follow-up sessions, respectively (P < 0.001). On the other hand, the mean of GSI in the TAU group was 1.77 ± 0.50 at pretest that was significantly reduced to 1.59 ± 0.52 and 1.78 ± 0.47 at posttest and follow-up, respectively (P < 0.001). Also, the mean of perceived stress in the TAU group at pretest was 15.9 ± 2.86 and that was changed to 16.13 ± 2.44 and 15.76 ± 2.22 at posttest and follow-up, respectively (P < 0.001).

Conclusion: MBSR could reduce stress and improve general mental health in patients with tension headache.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4755092/

Add Spirituality to Meditation and Improve Migraines

 

“Migraine is a disorder of a hyper-excitable brain, and it makes sense for people with migraine to adopt a stress-reducing . . . One behavioral intervention that may be useful, not only for migraine, but also for life in general, is what is called mindfulness meditation.” – John Wendt

 

Migraine headaches are a torment far beyond the suffering of a common headache. It is an intense throbbing pain usually unilateral, focused on only one side of the head. They last from 4 hours to 3 days. They are actually a collection of neurological symptoms. Migraines often include: visual disturbances, nausea, vomiting, dizziness, extreme sensitivity to sound, light, touch and smell, and tingling or numbness in the extremities or face. Migraines are the 8th most disabling illness in the world. They disproportionately affect women with about 18% of American women and 6% of men suffering from migraine. In the U.S. they affect roughly 40 million men, women and children. While most sufferers experience attacks once or twice a month, 14 million people or about 4% have chronic daily headaches. Migraines are very disruptive to the sufferer’s personal and work lives as most people are unable to work or function normally when experiencing a migraine.

 

There is no known cure for migraine headaches. Treatments are targeted at managing the symptoms. Prescription and over-the-counter pain relievers are frequently used. There are a number of drug and drug combinations that appear to reduce the frequency of migraine attacks. These vary in effectiveness but unfortunately can have troubling side effects and some are addictive. Behaviorally, relaxation and sleep appear to help lower the frequency of migraines. Mindfulness practices have been shown to reduce stress and improve relaxation (see http://contemplative-studies.org/wp/index.php/category/research-news/stress/). So, they may be useful in preventing migraines. Indeed, it has been shown that Mindfulness Based Stress reduction (MBSR) practice can reduce tension headache pain (see http://contemplative-studies.org/wp/index.php/2015/09/07/headaches-are-a-headache-reduce-them-with-mindfulness/).

 

Wachholtz and colleagues have previously shown that adding a spiritual dimension to meditation can increase the effectiveness of meditation for increasing pain tolerance. In today’s Research News article “Effect of Different Meditation Types on Migraine Headache Medication Use”

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Wachholtz and colleagues randomly assigned migraine sufferers to four conditions, spiritual meditation, internal secular meditation, external secular meditation, and progressive muscle relaxation. The differences between the meditation groups was solely a phrase that the participants were asked to repeat a few times at the beginning of the meditation. The phrases were for spiritual meditation, “God is peace,” “God is joy,” God is good,” and “God is love,” or alternatively substituting the words “Mother Nature” for God; internal secular meditation, “I am content,” “I am joyful,” “I am good,” “I am happy;” and for external secular meditation, “Grass is green,” “Sand is soft,” “Cotton is fluffy,” “Cloth is smooth.” Practice continued 20 minutes once a day for 30 days.

 

They found that over the 30 days of practice all groups had a decrease in the frequency of migraines and the amounts of pain medications taken, but the spiritual meditation group had a significantly greater decrease in frequency and medication use than the other three groups. None of the treatments appeared to change the severity of the migraines. Hence, adding the spiritual dimension to the meditation enhanced its effectiveness with migraines. Unfortunately, once a migraine began, nothing altered its magnitude or duration.

 

There is evidence that meditation can reduce pain (see http://contemplative-studies.org/wp/index.php/category/research-news/pain/). But, it is not known how the addition of simple spiritual phrases at the beginning of the meditation might improve its effectiveness. It is possible that the spiritual phrases were more effective than the secular phrases in focusing attention for the meditation session and thereby making it more effective. It is also possible that the phrases increased the individual’s ability to let go of struggling by turning over responsibility to a higher power. But, these are pure speculations. It will take further research to clarify the mechanism of action. But, it is clear that adding a spiritual dimension to meditation increases its effectiveness against migraine headaches.

 

So, add spirituality to meditation and improve migraines.

 

“although mindfulness is often thought of as a method of spiritual enlightenment, the underlying principles for healing are based on science. In a nutshell, mindfulness is capable of changing our brain chemistry, which impacts each and every one of our systems and organs.” – Cynthia Perkins
CMCS – Center for Mindfulness and Contemplative Studies