Mindful Patients with Multiple Sclerosis Have Less Interference in Living from Pain
By John M. de Castro, Ph.D.
“Mindfulness practice appears to be a safe, drug-free approach to coping with stress and anxiety, which may in turn help reduce your MS symptoms.” – Amit Sood
Multiple Sclerosis (MS) is a progressive demyelinating disease which attacks the coating on the neural axons which send messages throughout the body and nervous system. It affects about 2 million people worldwide and about 400,000 in the U.S. It is most commonly diagnosed in people between the ages of 20 and 50 years. Unfortunately, there is no cure for multiple sclerosis. There are a number of approved medications that are used to treat MS but are designed to lessen frequency of relapses and slow the progression of the disease, but they don’t address individual symptoms.
Although there is a progressive deterioration, MS is not fatal with MS patients having about the same life expectancy as the general population. Hence, most MS sufferers have to live with the disease for many years. So, quality of life becomes a major issue. Quality of life with MS is affected by fatigue, cognitive decrements, physical impairment, depression, and poor sleep quality. For most MS patients pain accompanies the disease and in about a third of patients the pain is clinically significant. There is a thus a critical need for safe and effective methods to help relieve pain in MS sufferers. Mindfulness practices have been shown to relieve pain from a number of different conditions and also to improve the symptoms of multiple sclerosis. It has yet to be demonstrated that mindfulness can reduce the pain in MS patients.
In today’s Research News article “Association Between Pain and Mindfulness in Multiple Sclerosis: A Cross-sectional Survey.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5825983/ ), Senders and colleagues examine the relationship between the mindfulness of patients with Multiple Sclerosis (MS) and the interference of the pain with daily activities (pain interference). They recruited adult MS patients with average age of 50 years. They measured them for the degree to which pain interfered with their everyday lives and also their levels of mindfulness.
They found that there was a highly significant negative relationship between the MS patients’ levels of pain interference and levels of mindfulness such that patients with high levels of mindfulness tended to have low levels of pain interference and patients with low levels of mindfulness tended to have high levels of pain interference. It should be noted that this finding is correlative and causation cannot be concluded. But in previous research mindfulness training has been shown to cause pain reduction in other disorders. This makes it highly likely that mindfulness reduced the pain interference for MS patients.
Mindfulness involves an appreciation of the sensations and feelings in the present moment without judging them. This appears to be important to reduce the tendency to magnify the pain by reacting negatively to it and allows the patient to function effectively even with pain. It remains to be shown that training mindfulness in MS patients will reduce their suffering and its interference with everyday living.
“Living with the pain, discomfort, and the uncertainties of MS can lead to feelings of frustration, anger, anxiety, and depression. . . By becoming mindful and aware of our thoughts, feelings, and body sensations, we can better control situations, and we have more choices. It also means that we are less likely to end up striving for too long toward goals that it might be wiser to let go. Mindful awareness helps us to become fully conscious of the world as it is, rather than how we wish it could be.” – Regina Boyle Wheeler
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
Senders, A., Borgatti, A., Hanes, D., & Shinto, L. (2018). Association Between Pain and Mindfulness in Multiple Sclerosis: A Cross-sectional Survey. International Journal of MS Care, 20(1), 28–34. http://doi.org/10.7224/1537-2073.2016-076
Chronic pain is a common symptom in people with multiple sclerosis (MS) and often requires a multimodal approach to care. The practice of mindfulness has been shown to decrease the experience of pain in other conditions, yet little is known about the relationship between mindfulness and pain in people with MS. The objective of this study was to evaluate the association between pain interference and trait mindfulness in people with MS.
In this cross-sectional survey, 132 people with any type of MS completed the Patient-Reported Outcomes Measurement Information System Pain Interference scale and the Five Facet Mindfulness Questionnaire. Linear regression was used to test the association between pain and mindfulness while adjusting for demographic and MS-related characteristics.
The relationship between pain and mindfulness was clinically meaningful and highly significant (t = −5.52, P < .0001). For every 18-point increase in mindfulness scores, pain interference scores are expected to decrease by 3.96 (95% CI, −2.52 to −5.40) points (β = −0.22, P < .0001). The adjusted model, including age, type of MS, the interaction between mindfulness and age, and the interaction between mindfulness and MS type, explains 26% of the variability in pain interference scores (R2 = 0.26).
These results suggest a clinically significant association between mindfulness and pain interference in MS and support further exploration of mindfulness-based interventions in the management of MS-related pain.