Relieve Chronic Low Back Pain with Tai Chi

Relieve Chronic Low Back Pain with Tai Chi

 

By John M. de Castro, Ph.D.

 

“Tai Chi has demonstrated usefulness in the prevention and treatment of certain problems such as back pain. Importantly, Tai Chi is non-invasive, relatively inexpensive, and gentle on the spine, so many people with back pain are starting to try it as an adjunct to (or sometimes instead of) traditional medical approaches to manage back pain. Furthermore, Tai Chi does not require any expensive equipment and can be practiced anywhere.” – Robert Humphreys

 

Low Back Pain is the leading cause of disability worldwide and affects between 6% to 15% of the population. It is estimated, however, that 80% of the population will experience back pain sometime during their lives. There are varied treatments for low back pain including chiropractic care, acupuncture, biofeedback, physical therapy, cognitive behavioral therapy, massage, surgery, opiate pain killing drugs, steroid injections, and muscle relaxant drugs. These therapies are sometimes effective particularly for acute back pain. But, for chronic conditions the treatments are less effective and often require continuing treatment for years and opiate pain killers are dangerous and can lead to abuse, addiction, and fatal overdoses.

 

Obviously, there is a need for safe and effective treatments for low back pain that are low cost and don’t have troublesome side effects. Mindfulness practices are effective in treating pain and have been shown to be safe and effective in the management of low back painTai Chi is a mindfulness practice that is safe and gentle and has been shown to improve spinal health and reduce pain. So, it would seem reasonable to examine the ability of Tai Chi practice to treat chronic low back pain.

 

In today’s Research News article “Chen-Style Tai Chi for Individuals (Aged 50 Years Old or Above) with Chronic Non-Specific Low Back Pain: A Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388249/), Liu and colleagues recruited older adults (aged 50 and over) who were diagnosed with chronic low back pain and randomly assigned them to receive Chen Style Tai Chi training, deep core stabilization exercise, or a no-treatment control condition. Tai Chi and core stabilization exercise practice occurred for 60 minutes three times per week for 12 weeks. They were measured before and after training for lower back pain intensity and for knee and ankle joint position matching ability (proprioception).

 

They found that in comparison to baseline and the control group both Tai Chi training and core stabilization exercise produced a significant decrease in lower back pain, with Tai Chi training producing the greatest relief of the pain. There were, however, no significant effects of training on knee and ankle joint proprioception.

 

The study is significant in that it demonstrates that Tai Chi practice is a safe and effective treatment to relieve chronic low back pain in older adults. This pain is a major problem decreasing their ability to fully engage in daily and work activities. So the relief of the pain by Tai Chi practice should contribute to a marked increase in their quality of life.

 

Tai Chi is not strenuous, involving slow gentle movements, and is safe, having no appreciable side effects, it is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion. It can also be practiced without professional supervision and in groups making it inexpensive to deliver and fun to engage in. This makes Tai Chi practice an excellent means to treat with chronic low back pain.

 

So, relieve chronic low back pain with Tai Chi.

 

Some solid research shows that tai chi can benefit people with osteoarthritis, rheumatoid arthritis, fibromyalgia, tension headache, and other ongoing, painful conditions.”  – Harvard Health

 

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

 

Liu, J., Yeung, A., Xiao, T., Tian, X., Kong, Z., Zou, L., & Wang, X. (2019). Chen-Style Tai Chi for Individuals (Aged 50 Years Old or Above) with Chronic Non-Specific Low Back Pain: A Randomized Controlled Trial. International journal of environmental research and public health, 16(3), 517. doi:10.3390/ijerph16030517

 

Abstract

Tai Chi (TC) can be considered safe and effective intervention to improve pain and pain-related functional disability. However, it is unclear that whether aging individuals with Chronic Non-Specific Low Back Pain (CNS-LBP) can achieve positive results. This study, therefore, attempted to explore the effects of TC on pain and functional disability in CNS-LBP patients aged 50 years old or above. Forty-three individuals (aged 50 years old or above) with CNS-LBP were randomly assigned into three groups: Chen-Style TC group (n = 15), Core Stabilization training (CST) group (n = 15), and control group (n = 13). Participants in the TC group participated in Chen-style TC training program (three 60-min sessions per week for 12 weeks), individuals in CST group received 12-week Core Stabilization exercise on the Swiss ball, whereas individuals in the control group maintained their unaltered lifestyle. Pain intensity as primary outcome was measured using the Visual Analogue Scale (VAS), A BiodexSystem 3 isokinetic dynamometer was used to measure knee and ankle joint position sense (JPS) as secondary outcomes at baseline and after the 12-week intervention. TC and CST have significant effects in VAS for CNS-LBP patients (p< 0.01, TC group OR CST group versus control group in mean of the post-minus-pre assessment). However, the feature of joint position sense (JPS) of ankle inversion, ankle eversion and knee flexion did not occur, it showed no significant effects with TC and CST. TC was found to reduce pain, but not improve lower limb proprioception in patients with CNS-LBP. Future research with larger sample sizes will be needed to achieve more definitive findings on the effects of TC on both pain and lower limb proprioception in this population.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388249/

 

Improve Psychopathology with Meditation

Improve Psychopathology with Meditation

 

By John M. de Castro, Ph.D.

 

“The research is strong for mindfulness’ positive impact in certain areas of mental health, including stress reduction, emotion and attention regulation, reduced rumination, for reducing mild to moderate depression and anxiety, and preventing depressive relapse.” – Kelle Walsh

 

There are vast numbers of people who suffer with mental illnesses; psychopathology. In the United states it has been estimated that in any given year 1 in 5 people will experience a mental illness. Many are treated with drugs. But drug treatment can produce unwanted side effects, don’t work for many patients, and often can lose effectiveness over time. Mindfulness practices provide a safe alternative treatment. They have been found to be helpful with coping with these illnesses and in many cases reducing the symptoms of the diseases. Hence, it appears that mindfulness practices are safe and effective treatments for a variety of psychiatric conditions including anxietydepressionpsychosesaddictions, etc.. Since there has accumulated a large amount of research, it makes sense to step back and summarize what has been discovered.

 

In today’s Research News article “Mindfulness Meditation and Psychopathology.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6597263/), Wielgosz and colleagues review and summarize the published research studies investigating the efficacy of mindfulness meditation practices for the treatment of a variety of psychopathologies.

 

They report that mindfulness meditation produces significant improvements in depression and in anxiety disorders in comparison to inactive and active control conditions. Efficacy is equivalent to that of other evidence-based treatments. The research suggests that meditation reduces depression by decreasing rumination and anxiety by reducing repetitive negative thinking. Hence, meditation training is an excellent safe and effective treatment for these prevalent mental illnesses.

 

They also report that mindfulness meditation produces significant improvements in chronic pain intensity and unpleasantness in comparison to inactive but not active control conditions. Efficacy is equivalent to that of other evidence-based treatments. This is true for chronic low back pain fibromyalgia, migraine, and chronic pelvic pain. Meditation also appears to improve the quality of life of chronic pain patients. The research suggests that meditation reduces chronic pain by decreasing negative emotional reactivity. Such reactivity appears to intensify pain and meditation reduces this reactivity and thereby reduces pain.

 

They report that mindfulness meditation produces significant improvements in substance abuse disorders in comparison to inactive and active control conditions and even in comparison to other evidence-based treatments. It appears to reduce substance use frequency, use-related problems, and craving. This is important as addictions are very difficult to treat and frequently relapse.

 

There is evidence that mindfulness meditation is effective in the treatment of attention deficit hyperactivity disorder (ADHD) both in children and adults and also post-traumatic stress disorder (PTSD). But there are currently no comparisons to the effects of other active or evidence-based treatments. It will be important to have randomized controlled trials with active controls to better assess the efficacy of meditation for the treatment of ADHD and PTSD.

 

There is emerging evidence that mindfulness meditation may be effective for eating disorders, and major mental illnesses such as bipolar disorder, major depression, and psychosis. But there is a need for more, better controlled research.

 

Hence, this comprehensive review suggests that mindfulness meditation is a useful treatment for a variety of types of psychopathology. It is amazing that such a simple practice as meditation can have such wide-ranging benefits for such diverse mental illnesses. Meditation appears to act indirectly by strengthening cognitive, emotional, and stress related process that in turn have beneficial effects on the psychopathologies. Hence, it is clear that mindfulness meditation is a safe and effective treatment for psychopathologies that can be used alone or in combination with other treatments.

 

So, improve psychopathology with meditation.

 

“When they’re depressed, people are locked in the past. They’re ruminating about something that happened that they can’t let go of. When they’re anxious, they’re ruminating about the future — it’s that anticipation of what they can’t control. In contrast, when we are mindful, we are focused on the here and now. Mindfulness trains individuals to turn their attention to what is happening in the present moment.” – Carolyn Gregoire

 

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

 

Wielgosz, J., Goldberg, S. B., Kral, T., Dunne, J. D., & Davidson, R. J. (2019). Mindfulness Meditation and Psychopathology. Annual review of clinical psychology, 15, 285–316. doi:10.1146/annurev-clinpsy-021815-093423

 

Abstract

Mindfulness meditation is increasingly incorporated into mental health interventions, and theoretical concepts associated with it have influenced basic research on psychopathology. Here, we review the current understanding of mindfulness meditation through the lens of clinical neuroscience, outlining the core capacities targeted by mindfulness meditation and mapping them onto cognitive and affective constructs of the Research Domain Criteria matrix proposed by the National Institute of Mental Health. We review efficacious applications of mindfulness meditation to specific domains of psychopathology including depression, anxiety, chronic pain, and substance abuse, as well as emerging efforts related to attention disorders, traumatic stress, dysregulated eating, and serious mental illness. Priorities for future research include pinpointing mechanisms, refining methodology, and improving implementation. Mindfulness meditation is a promising basis for interventions, with particular potential relevance to psychiatric comorbidity. The successes and challenges of mindfulness meditation research are instructive for broader interactions between contemplative traditions and clinical psychological science.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6597263/

Improve Chronic Low Back Pain with Mindful Movement Practices

Improve Chronic Low Back Pain with Mindful Movement Practices

 

By John M. de Castro, Ph.D.

 

Tai chi helps with back pain in several ways. It strengthens the muscles in your abdomen and pelvic area that are crucial to supporting the lower back; it improves your balance and flexibility; and it makes you more aware of your posture when you sit, stand, and walk.” – Benjamin Kligler

 

Low Back Pain is the leading cause of disability worldwide and affects between 6% to 15% of the population. It is estimated, however, that 80% of the population will experience back pain sometime during their lives. The pain interferes with daily living and with work, interfering with productivity and creating absences. There are varied treatments for low back pain including chiropractic care, acupuncture, biofeedback, physical therapy, cognitive behavioral therapy, massage, surgery, opiate pain killing drugs, steroid injections, and muscle relaxant drugs. These therapies are sometimes effective particularly for acute back pain. But, for chronic conditions the treatments are less effective and often require continuing treatment for years and opiate pain killers are dangerous and can lead to abuse, addiction, and fatal overdoses. Obviously, there is a need for safe and effective treatments for low back pain that are low cost and don’t have troublesome side effects.

 

Pain involves both physical and psychological issues. Physically, exercise can be helpful in strengthening the back to prevent or relieve pain. Psychologically, 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. Mindfulness practices have been shown to improve emotion regulation producing more adaptive and less maladaptive responses to emotions. Indeed, mindfulness practices are effective in treating pain and have been shown to be safe and effective in the management of low back pain. Tai Chi, Qigong, and yoga  are both exercises and mindfulness practices that have been found to be effective for back pain. There is accumulating evidence. So, it is useful to take a step back and summarize what has been found.

 

In today’s Research News article “Are Mindful Exercises Safe and Beneficial for Treating Chronic Lower Back Pain? A Systematic Review and Meta-Analysis of Randomized Controlled Trials.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6571780/), Zou and colleagues review, summarize, and perform a meta-analysis of the effects of the mindful movement practices of Tai Chi, Qigong, and yoga on chronic low back pain. The identified 17 randomized controlled trials that included a total of 2022 participants.

 

They report that the published research found that both Tai Chi and yoga practices produced significant reductions in pain intensity and back specific disability in patients with chronic low back pain. There were no reported adverse events with Tai Chi practice but there were a few adverse events reported with yoga practice. So, although both are effective in treating chronic low back pain, more care must be taken with yoga practice to protect against injury.

 

The results of the published research strongly suggests that Tai Chi  practice should be prescribed for chronic low back pain, reducing pain and disability. In addition, Tai Chi is a gentle and safe mindfulness practice. It is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion. It is inexpensive to administer, can be performed in groups or alone, at home or in a facility, and can be quickly learned. In addition, it can be practiced in social groups. This can make it fun, improving the likelihood of long-term engagement in the practice. So, Tai Chi practice would appear to be an excellent gentle practice to chronic low back pain.

 

So, improve chronic low back pain with mindful movement practices.

 

“On the physical side, tai chi supports or improves balance, coordination, flexibility, muscle strength, and stamina. On the mental side, tai chi helps relieve stress, improves body awareness and, when done in a group setting, reduces social isolation.” – Harvard Health

 

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

 

Zou, L., Zhang, Y., Yang, L., Loprinzi, P. D., Yeung, A. S., Kong, J., … Li, H. (2019). Are Mindful Exercises Safe and Beneficial for Treating Chronic Lower Back Pain? A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Journal of clinical medicine, 8(5), 628. doi:10.3390/jcm8050628

 

Abstract

Background: Chronic low back pain (CLBP) is a common health issue worldwide. Tai Chi, Qigong, and Yoga, as the most widely practiced mindful exercises, have promising effects for CLBP-specific symptoms. Objective: We therefore conducted a comprehensive review investigating the effects of mindful exercises versus active and/or non-active controls while evaluating the safety and pain-related effects of mindful exercises in adults with CLBP. Methods: We searched five databases (MEDLINE, EMBASE, SCOPUS, Web of Science, and Cochrane Library) from inception to February 2019. Two investigators independently selected 17 eligible randomized controlled trials (RCT) against inclusion and exclusion criteria, followed by data extraction and study quality assessment. Standardized mean difference (SMD) was used to determine the magnitude of mindful exercises versus controls on pain- and disease-specific outcome measures. Results: As compared to control groups, we observed significantly favorable effects of mindful exercises on reducing pain intensity (SMD = −0.37, 95% CI −0.5 to −0.23, p < 0.001, I2 = 45.9 %) and disability (SMD = −0.39, 95% CI −0.49 to −0.28, p < 0.001, I2 = 0 %). When compared with active control alone, mindful exercises showed significantly reduced pain intensity (SMD = −0.40, p < 0.001). Furthermore, of the three mindful exercises, Tai Chi has a significantly superior effect on pain management (SMD= −0.75, 95% CI −1.05 to −0.46, p < 0.001), whereas Yoga-related adverse events were reported in five studies. Conclusion: Findings of our systematic review suggest that mindful exercises (Tai Chi and Qigong) may be beneficial for CLBP symptomatic management. In particular, Tai Chi appears to have a superior effect in reducing pain intensity irrespective of non-control comparison or active control comparison (conventional exercises, core training, and physical therapy programs). Importantly, training in these mindful exercises should be implemented with certified instructors to ensure quality of movement and injury prevention.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6571780/

 

Improve Mobility and Quality of Life in Patients with Chemotherapy-Induced Peripheral Neuropathy with Yoga

Improve Mobility and Quality of Life in Patients with Chemotherapy-Induced Peripheral Neuropathy with Yoga

 

By John M. de Castro, Ph.D.

 

“Exercise can increase blood flow to the hands and feet and may offer temporary relief from pain. People should discuss the exercises that are best for them with their doctor. Low-impact activities, such as swimming, low-impact aerobics, or yoga, are the safest options.” – Zawn Villines

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. But, surviving cancer carries with it a number of problems. Painful Chemotherapy-induced peripheral neuropathy is a frequent side effect of cancer treatment. This Neuropathy is characterized by damage to the nervous system resulting from chemotherapy. Between 30-100% of patients can experience this neuropathy.  It can affect patients motor abilities including walking, and balance. But it can also affect driving, relationships, work, writing, exercise, sleep and sexual activity.

 

Mindfulness training has been shown to help with cancer recovery and help to relieve chronic pain. It can also help treat the residual physical and psychological symptoms, including stress,  sleep disturbance, and anxiety and depression. Yoga practice is a form of mindfulness training that has been shown to help relieve chronic pain and be beneficial for cancer patients.  So, it makes sense to examine the ability of yoga practice to help relieve the symptoms of chemotherapy-induced peripheral neuropathy.

 

In today’s Research News article “Impact of Somatic Yoga and Meditation on Fall Risk, Function, and Quality of Life for Chemotherapy-Induced Peripheral Neuropathy Syndrome in Cancer Survivors.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6537287/), Galantino and colleagues recruited cancer survivors who had completed all treatments but who had some degree of peripheral neuropathy. They participated in a 90 minute, twice a week for 8-weeks, Hatha yoga program including postures, breathwork, and meditation. They were also asked to practice at home. They were measured before and after treatment for motor functions, balance, lower extremity flexibility, pain, neurotoxicity, perceived stress, sleep quality, spiritual efficacy, fear of falling, vibration sense, and salivary cortisol. The participants were asked to record their reflections on their yoga practice in a diary.

 

They found that at the completion of the yoga training the patients had significantly improved mobility, flexibility, balance, risk of falling, perceived pain, pain interference with life activities, sensory systems, muscular weakness, foot vibration sensitivity, and perceived stress. They did not find any adverse effects of the yoga practice on the patients. Qualitative analysis of the patient diaries revealed that the patients noted improvements in enhanced sensations in the extremities, that the yoga practice helped them in managing their symptoms, that the improvement in physical function allowed return to work and re-engagement in hobbies, greater ability to relax, and enjoyment of the social aspects of the yoga practice.

 

It should be noted that this was a small pilot study and there wasn’t a control condition so the results need to be interpreted with caution. But the results are very encouraging and suggest that a large randomized controlled trial is justified and needed to verify the efficacy of the yoga program. But prior to the program there was no improvement over time, so participation in the program likely produced the benefits. The benefits obtained in this study are significant and important contributing to the daily functions, mental and physical health of the patients.

 

Chemotherapy-induced peripheral neuropathy is painful, persistent, disruptive, and debilitating. The degree of improvement seen in the patients after yoga practice markedly improved their symptoms and greatly reduced their suffering. Importantly, after yoga practice the symptoms of peripheral neuropathy were greatly reduced allowing the patients to better function and to enjoy their lives.

 

So, improve mobility and quality of life in patients with chemotherapy-induced peripheral neuropathy with yoga.

 

“They may also benefit from exercise programs such as water exercise, a strength & balance class, Tai Chi, and yoga.  Although patients survived their cancer, giving them their quality of life back should be a priority for those that are suffering from CIPN.” – Pam McMillan

 

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

 

Galantino, M. L., Tiger, R., Brooks, J., Jang, S., & Wilson, K. (). Impact of Somatic Yoga and Meditation on Fall Risk, Function, and Quality of Life for Chemotherapy-Induced Peripheral Neuropathy Syndrome in Cancer Survivors. Integrative cancer therapies, 18, 1534735419850627. doi:10.1177/1534735419850627

 

Abstract

Objective. Chemotherapy-induced peripheral neuropathy (CIPN) syndrome causes significant pain as an adverse effect of treatment, with few nonpharmacological interventions tested. A somatic yoga and meditation (SYM) intervention on functional outcomes and quality of life (QOL) was investigated. Design and methods. Individuals diagnosed with CIPN were enrolled in an open-label, single-arm, mixed-methods feasibility trial. Participants and Setting. In an outpatient rehabilitation center, ten participants with median age 64.4 years (47-81) attended 61% of the sessions with no adverse events. Intervention. SYM twice a week for 8 weeks for 1.5 hours, with home program and journaling. Main outcome measures. Primary functional outcomes included Sit and Reach (SR), Functional Reach (FR), and Timed Up and Go (TUG). Self-reported Patient Neurotoxicity Questionnaire (PNQ) and Functional Assessment of Cancer Therapy—Neurotoxicity (FACT-GOG-NTX) were secondary CIPN outcomes. Biomarkers included salivary cortisol (stress) and bioesthesiometer (vibration). Results: Quantitative findings. Significant improvements were found in flexibility (SR; P = .006); balance (FR; P = .001) and fall risk (TUG; P = .004). PNQ improved significantly (P = .003) with other measures improving non-significantly. Qualitative findings. Five themes emerged: (1) vacillation of CIPN pain perception over time; (2) transferability of skills to daily activities; (3) improvement in physical function; (4) perceived relaxation as an effect of SYM; and (5) group engagement provided a social context for not feeling isolated with CIPN. Conclusion. Preliminary data suggest SYM may improve QOL, flexibility, and balance in cancer survivors with CIPN, with a fully powered randomized controlled trial indicated.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6537287/

 

Relieve Low Back Pain with Yoga

Relieve Low Back Pain with Yoga

 

By John M. de Castro, Ph.D.

 

“reductions in disability and pain intensity were found despite the reductions in opioid use and other medical and self-help pain treatments at six months. The trial confirms the findings of two prior randomized controlled trials with non-veterans showing that yoga is safe and can reduce pain and disability among adults with chronic low back pain.” – National Pain

 

Low Back Pain is the leading cause of disability worldwide and affects between 6% to 15% of the population. It is estimated, however, that 80% of the population will experience back pain sometime during their lives. But active military and veterans have a higher rate than the general population. There are varied treatments for low back pain including chiropractic care, acupuncture, biofeedback, physical therapy, cognitive behavioral therapy, massage, surgery, opiate pain killing drugs, steroid injections, and muscle relaxant drugs. These therapies are sometimes effective particularly for acute back pain. But, for chronic conditions the treatments are less effective and often require continuing treatment for years and opiate pain killers are dangerous and can lead to abuse, addiction, and fatal overdoses. Obviously, there is a need for safe and effective treatments for low back pain that are low cost and don’t have troublesome side effects.

 

Pain involves both physical and psychological issues. 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. Mindfulness practices have been shown to improve emotion regulation producing more adaptive and less maladaptive responses to emotions. Indeed, mindfulness practices are effective in treating pain and have been shown to be safe and effective in the management of low back painYoga practice has been shown to have a myriad of health benefits. These include relief of chronic painYoga practice has also been shown to be effective for the relief of chronic low-back pain.  Many forms of yoga focus on the proper alignment of the spine, which could directly address the source of back and neck pain for many individuals. So, it makes sense to further explore the effectiveness of yoga practice for chronic low back pain in military veterans.

 

In today’s Research News article “Yoga for Military Veterans with Chronic Low Back Pain: A Randomized Clinical Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399016/), Groessl and colleagues recruited military veterans with chronic low back pain and randomly assigned them to receive either 12 weeks, twice a week, 60-minutes of hatha yoga practice or to a wait-list control condition. Yoga practice consisted of postures, breathing practice, and focused meditation. They were measured for back-specific functional limitations, pain intensity, and medication use before and after treatment and 3 months later.

 

They found that the veterans who practiced yoga had decreases in functional limitations due to back pain and pain intensity that were significant 3 months after the end of formal yoga practice. Opiate use declined over the trial period, but this was true for both yoga and control groups. Hence, yoga practice was found to be a safe, effective, and lasting treatment for back pain and disability in military veterans who have high rates of chronic low back pain. These results are similar to those seen in other groups of patients suffering from chronic low-back pain. It would be interesting in future research to compare yoga practice to other forms of exercise in relieving back-related disability and pain in a similar group.

 

So, relieve low back pain with yoga.

 

By demonstrating that yoga is an evidence-based treatment for cLBP in military veterans, complementary and integrative health researchers and [Veterans Affairs] administrators are in a position to begin implementing yoga programs more formally,” – Erik Groessl

 

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

 

Groessl, E. J., Liu, L., Chang, D. G., Wetherell, J. L., Bormann, J. E., Atkinson, J. H., … Schmalzl, L. (2017). Yoga for Military Veterans with Chronic Low Back Pain: A Randomized Clinical Trial. American journal of preventive medicine, 53(5), 599–608. doi:10.1016/j.amepre.2017.05.019

 

Abstract

Introduction:

Chronic low back pain (cLBP) is prevalent, especially among military veterans. Many cLBP treatment options have limited benefits and are accompanied by side effects. Major efforts to reduce opioid use and embrace nonpharmacological pain treatments have resulted. Research with community cLBP patients indicates that yoga can improve health outcomes and has few side effects. The benefits of yoga among military veterans were examined.

Design:

Participants were randomized to either yoga or delayed yoga treatment in 2013–2015. Outcomes were assessed at baseline, 6 weeks, 12 weeks, and 6 months. Intention-to-treat analyses occurred in 2016.

Setting/Participants:

One hundred and fifty military veterans with cLBP were recruited from a major Veterans Affairs Medical Center in California.

Intervention:

Yoga classes (with home practice) were led by a certified instructor twice weekly for 12 weeks, and consisted primarily of physical postures, movement, and breathing techniques.

Main outcome measures:

The primary outcome was Roland–Morris Disability Questionnaire scores after 12 weeks. Pain intensity was identified as an important secondary outcome.

Results:

Participant characteristics were mean age 53 years, 26% were female, 35% were unemployed or disabled, and mean back pain duration was 15 years. Improvements in Roland–Morris Disability Questionnaire scores did not differ between the two groups at 12 weeks, but yoga participants had greater reductions in Roland–Morris Disability Questionnaire scores than delayed treatment participants at 6 months −2.48 (95% CI= −4.08, −0.87). Yoga participants improved more on pain intensity at 12 weeks and at 6 months. Opioid medication use declined among all participants, but group differences were not found.

Conclusions:

Yoga improved health outcomes among veterans despite evidence they had fewer resources, worse health, and more challenges attending yoga sessions than community samples studied previously. The magnitude of pain intensity decline was small, but occurred in the context of reduced opioid use. The findings support wider implementation of yoga programs for veterans.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399016/

 

 

 

Improve Pain, Mental Health and Quality of Life in Cancer Patients with Mindfulness

Improve Pain, Mental Health and Quality of Life in Cancer Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Results show promise for mindfulness-based interventions to treat common psychological problems such as anxiety, stress, and depression in cancer survivors and to improve overall quality of life.” – Linda E. Carlson

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. But cancer diagnosis is not necessarily a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly increasing. But, surviving cancer carries with it a number of problems. Pain, anxiety, depression, fatigue and insomnia and reduced quality of life are common symptoms in the aftermath of surviving cancer.

 

Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including fatiguestress,  sleep disturbance, and anxiety and depression. The research is accumulating. So, it is useful to take a step back and look at what has been learned.

 

In today’s Research News article “A Systematic Review: Mindfulness Intervention for Cancer-Related Pain.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6371675/), Ngamkham and colleagues review and summarize the high quality published research literature on the application of mindfulness training for the treatment of cancer related pain. They found 6 randomized controlled clinical trials (RCTs). These studies used Mindfulness-Based Stress Reduction (MBSR), Mindfulness-Based Cognitive Therapy (MBCT), Breathing Meditation, or Mindful Awareness Practice (MAP) programs as treatments.

 

They found that the published research reports that mindfulness training produces a significant reduction in cancer related pain that was still present 6-months after the training. The research also found significant reductions in anxiety and depression and significant increases in the patient’s quality of life. Hence, mindfulness training was found to be a safe and effective treatment for patients suffering with cancer related pain.

 

It is not known exactly how mindfulness training produces these benefits. It has been shown, however, that in healthy individuals, mindfulness training also produces reductions in pain, anxiety, and depression. It is thought that one way mindfulness training reduces is by reducing worry and rumination which is thought to amplify pain. Mindfulness training has also been shown to improve emotion regulation and reduce response to stress that may also contribute to pain reduction. Regardless mindfulness training should be recommended for cancer patients to reduce pain and improve their well-being.

 

So, improve pain, mental health and quality of life in cancer patients with mindfulness.

 

“Fear. Uncertainty about the future. Some of the most difficult elements of the cancer experience are well-suited for mindfulness.” – Lu Hanessian

 

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

 

Ngamkham, S., Holden, J. E., & Smith, E. L. (2019). A Systematic Review: Mindfulness Intervention for Cancer-Related Pain. Asia-Pacific journal of oncology nursing, 6(2), 161–169. doi:10.4103/apjon.apjon_67_18

 

Abstract

Moderate-to-severe pain is a common problem experienced by patients with cancer. Although analgesic drugs are effective, adverse side effects are common and some analgesic drugs are addictive. Nonpharmacological treatment may be a way to treat cancer pain without causing negative side effects. Mindfulness is used as an effective nonpharmacological treatment to improve quality of life (QoL) and to address psychological problems including distress, anxiety, stress, and depression. However, the effect of mindfulness on pain severity has not been sufficiently investigated. Therefore, a systematic review was undertaken to describe the effectiveness of mindfulness interventions for pain and its underlying pathophysiologic mechanisms. The search was conducted in PubMed, Ovid MEDLINE, and CINAHL and included only empirical studies published from 2008 to 2017. Search terms included mindfulness, mindfulness-based intervention, meditation, cancer, pain, and cancer-related pain. Six studies met the search criteria. These studies tested several types of intervention including mindfulness-based stress reduction, mindfulness-based cognitive therapy, meditation with massage, and mindful awareness practices. Study outcomes include improved pain severity, anxiety, stress, depression, and QoL. However, most studies reviewed were conducted in the United States and Denmark. Further research is needed to test culturally appropriate mindfulness interventions to reduce pain.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6371675/

 

Improve Chronic Neck Pain with Yoga

Improve Chronic Neck Pain with Yoga

 

By John M. de Castro, Ph.D.

 

“yoga may be an effective treatment for people dealing with chronic neck pain, and that it may also result in improved psychological effects.” – Nicole Joseph

 

We all have to deal with pain. It’s inevitable, but hopefully mild and short lived. But, for many, pain is a constant in their lives. The most common forms of chronic pain are back and neck pain. Neck pain is the number three cause of chronic pain; affecting more than a quarter of Americans.

There is a myriad of causes for chronic neck pain, including something as simple as improper positioning while sleeping, or even sitting or standing with bad posture. It can also occur due to injuries, accidents, heavy lifting or other spinal issues.

 

Just as there are many different causes there are also a plethora of treatments for neck pain. The most common is the use of drugs, including over –the-counter pain relievers and at times opiates. These are helpful but have limited effectiveness and opiates can lead to addiction and even death. Sometimes the pain can lead to surgical interventions that can be costly and are not always effective. So, alternative treatments such as acupuncture have also been used with some success. Physical therapy and chiropractic care have also been shown to be effective. Mindfulness practices, in general, are effective in treating pain and specific practices such as yoga can be effective for the relief of chronic low-back pain.  Many forms of yoga focus on the proper alignment of the spine, which could directly address the source of neck pain for many individuals.

 

There has been a considerable amount of research on the effects of yoga practice on chronic neck pain. So, it makes sense to step back and summarize what has been discovered. In today’s Research News article “Effects of yoga on patients with chronic nonspecific neck pain: A PRISMA 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/PMC6407933/ ), Li and colleagues review, summarize, and perform a meta-analysis of the 10 published randomized controlled trials of the application of yoga practice for chronic neck pain.

 

They report that the published research found that yoga practice significantly reduced neck pain and neck pain related disability in comparison to other exercises except Pilates which produced an equivalent relief of pain and disability. These studies also found that yoga practice significantly improved the range of motion in the neck, the physical and mental quality of life, anxiety, and depression. They summarized only on short-term studies. But there were 3 studies that found significant improvements in the chronic neck pain patients that were still present 3 month later.

 

Hence, the published controlled research studies found that yoga practice was safe and effective for the treatment of chronic neck pain with suggestions that the benefits are long lasting. These are very promising results that suggest that yoga practice should be recommended for the treatment of patients with chronic neck pain, relieving the pain and disability, improving motion, quality of life, and mood.

 

So, improve chronic neck pain with yoga.

 

“yoga might enhance both the toning of muscles and releasing of muscle tension. Relaxation responses, therefore, could reduce stress related muscle tension and modify neurobiological pain perception. . .  lyengar yoga can be a safe and effective treatment option for chronic neck pain.” – Science Daily

 

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Study Summary

 

Li, Y., Li, S., Jiang, J., & Yuan, S. (2019). Effects of yoga on patients with chronic nonspecific neck pain: A PRISMA systematic review and meta-analysis. Medicine, 98(8), e14649.

 

Abstract

Background:

Chronic nonspecific neck pain (CNNP) has a high prevalence and is more common among younger people. Clinical practice suggests that yoga is effective in relieving chronic pain.

Objectives:

This meta-analysis aimed to quantitatively summarize the efficacy of yoga for treating CNNP.

Data sources:

We searched for trials in the electronic databases from their inception to January 2019. English databases including PubMed, MEDLINE, Cochrane Library, Embase, Scopus, the Cochrane Central Register of Controlled Trials, and Ind Med; Chinese databases including China National Knowledge Infrastructure (CNKI), WanFang Database, and VIP Information. We also conducted a manual search of key journals and the reference lists of eligible papers to identify any potentially relevant studies we may have missed. We placed no limitations on language or date of publication.

Study eligibility criteria:

We included only randomized controlled trials (RCTs) and q-RCTs evaluating the effects of yoga on patients with CNNP. The primary outcomes for this review were pain and disability, and the secondary outcomes were cervical range of motion (CROM), quality of life (QoL), and mood.

Participants and interventions:

Trails that examined the clinical outcomes of yoga intervention in adults with CNNP compared with those of other therapies except yoga (e.g., exercise, pilates, usual care, et al) were included.

Study appraisal and synthesis methods:

Cochrane risk-of-bias criteria were used to assess the methodological quality, and RevMan 5.3 software was used to conduct the meta-analysis.

Results:

A total of 10 trials (n = 686) comparing yoga and interventions other than yoga were included in the meta-analysis. The results show that yoga had a positive effects on neck pain intensity (total effect: SMD = −1.13, 95% CI [−1.60, −0.66], Z = 4.75, P < .00001), neck pain-related functional disability (total effect: SMD = −0.92, 95% CI [−1.38, −0.47], Z = 3.95, P < .0001), CROM (total effect: SMD = 1.22, 95% CI [0.87, 1.57], Z = 6.83, P < .00001), QoL (total effect: MD = 3.46, 95% CI [0.75, 6.16], Z = 2.51, P = .01), and mood (total effect: SMD = −0.61, 95% CI [−0.95, −0.27], Z = 3.53, P = .0004).

Conclusions and implications of key findings:

It was difficult to make a comprehensive summary of all the evidence due to the different session and duration of the yoga interventions, and the different outcome measurement tools in the study, we draw a very cautious conclusion that yoga can relieve neck pain intensity, improve pain-related function disability, increase CROM, improve QoL, and boost mood. This suggests that yoga might be an important alternative in the treatment of CNNP.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6407933/

 

Reduce Pain Catastrophizing and Pain with Mindfulness

Reduce Pain Catastrophizing and Pain with Mindfulness

 

By John M. de Castro, Ph.D.

 

People often increase the pain experience by adding to the physical sensations with a host of thoughts and feelings, like catastrophizing the pain or trying to suppress and ignore the pain. Mindfulness is a practice of attending to pain — or body sensations — and thoughts and feelings with that present-moment attention in an accepting and curious manner.” – Susan Smalley

 

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. 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, mindfulness may reduce worry and catastrophizing and thereby reduce fibromyalgia pain.

 

In today’s Research News article “Interactive effects of pain catastrophizing and mindfulness on pain intensity in women with fibromyalgia.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6198401/ ), Dorado and colleagues recruited adult women suffering with fibromyalgia and had them complete questionnaires measuring mindfulness, pain, pain catastrophizing and fibromyalgia interference in daily activities and keeping a 7-day diary of their daily levels of pain and pain catastrophizing. They then examined predictors of the daily pain intensity and pain catastrophizing.

 

They found a strong positive relationship between pain catastrophizing and pain intensity indicating that the higher the daily levels of catastrophizing the greater the levels of pain. They also found that the higher the levels of mindfulness the lower the levels of daily pain catastrophizing and daily levels of pain. They found that this relationship was modified by facets of mindfulness. In particular, the greater the observing facet of mindfulness the smaller the relationship between daily pain catastrophizing and daily pain intensity. On the other hand, when the mindfulness facets of non-judging and acting with awareness were high then the greater the daily levels of catastrophizing the greater the levels of pain.

 

These relationships suggest that observing mindfully tends to mitigate the relationship of catastrophizing to pain while mindfully non-judging and acting with awareness tends to amplify the relationship. But, overall, mindfulness tends to be associated with lower catastrophizing. It has been shown in other work that mindfulness tends to lower fibromyalgia pain, The present study suggests that it may do so by reducing pain catastrophizing. Even though mindfulness, in general lowers pain and catastrophizing not judging the situation and acting toward it with awareness can actually heighten the effects of catastrophizing on pain.

 

It should be kept in mind that these results are correlational and conclusions about causation cannot be made. In addition, the results are complicated suggesting complex relationships between mindfulness and daily pain and catastrophizing levels. This indicates that further research is needed especially work in which mindfulness is altered by training and then observing the effects of this change on pain levels and catastrophizing and their relationships with each other.

 

So, reduce pain catastrophizing and pain with mindfulness.

 

When pain is consistently part of your day, you can start to dwell on it. You may feel stress and anxiety about the pain you’re feeling now, as well as pain that may occur in the future. Mindfulness may lead to changes in the brain that provide benefits for those with fibromyalgia.” – Peggy Pletcher

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are available at the Contemplative Studies Blog http://contemplative-studies.org/wp/

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Study Summary

 

Dorado, K., Schreiber, K. L., Koulouris, A., Edwards, R. R., Napadow, V., & Lazaridou, A. (2018). Interactive effects of pain catastrophizing and mindfulness on pain intensity in women with fibromyalgia. Health psychology open, 5(2), 2055102918807406. doi:10.1177/2055102918807406

 

Abstract

The objective of this study was to examine the association between facets of trait mindfulness, pain catastrophizing, and pain severity in a sample of patients with fibromyalgia. Patients with fibromyalgia completed validated baseline and diary assessments of clinical pain, mindfulness, and pain catastrophizing. Multilevel modeling analyses indicated that the daily association between catastrophizing and pain intensity was moderated by certain mindfulness facets. Our findings suggest that various aspects of mindfulness may interact differently with pain and catastrophizing, which may have implications for the design and testing of interventions targeting mindfulness and catastrophizing in fibromyalgia patients.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6198401/

 

Meditation’s Reduction of Pain is Independent of Brain Opioid Systems

Meditation’s Reduction of Pain is Independent of Brain Opioid Systems

 

By John M. de Castro, Ph.D.

 

Bit by bit, as I sat noticing my breath and body sensations, I began to feel the deep knots of pain in my body start to untie themselves.” – Avi Craimer

 

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 chronic pain conditions. The most common treatment for chronic pain is drugs. These include over-the-counter analgesics and opioids. Opioids act on a system in the brain that contains receptors that respond to these drugs. But opioids are dangerous and highly addictive. 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 individual’s ability to cope with the pain.

 

Pain involves both physical and psychological issues. 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. There is an accumulating volume of research findings to demonstrate that mind-body therapies have highly beneficial effects on the health and well-being of humans. Mindfulness practices have been shown to improve emotion regulation producing more adaptive and less maladaptive responses to emotions. Indeed, mindfulness practices are effective in treating pain in adults. It is not known whether meditations effects on pain are mediated by the same system that responds to opioids.

 

In today’s Research News article “Enhancement of Meditation Analgesia by Opioid Antagonist in Experienced Meditators.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6162167/  ), May and colleagues recruited adult experienced meditators who were free of chronic pain and not taking opioid drugs. They were measured for pain responses to an electric shock delivered to the ring finger of the non-dominant hand. They rated the level of pain on a 10-point scale. The participants first rated pain under normal conditions and later while meditating. Those participants who demonstrated a 15% or more reduction in pain while meditating (meditation analgesia) participated in the second half of the experiment. Half the participants received a saline injection and half an injection of Naloxone (an opioid receptor blocker) and repeated the pain testing while meditating. In the next session the participants received either the saline or Naloxone injection that they did not receive in the first session. So, all participants received both saline and Naloxone injections and were tested for their pain sensitivity.

 

They found in the initial test that 85% of the participants demonstrated a 15% or more reduction in pain while meditating (meditation analgesia). This high rate suggests that meditation routinely produces a reduced experience of pain in experienced meditators. In the second phase they found that meditation analgesia was not only not reduced by Naloxone injection but actually significant increased, with larger reductions in both pain intensity and pain unpleasantness to the electric shock after Naloxone injection than after saline injections.

 

The opioid system of the brain is a well-established pain processing system. Its function is blocked by Naloxone. So, the reduction in pain produced by meditation was not affected by disrupting the opioid system. So, meditation analgesia must not be due to changes in this opioid system. It must be processed by a different system in the brain. The increase in meditation analgesia after Naloxone was a surprise, for which there is no viable explanation at this time. Hence, meditation reduces pain sensitivity and does so independent of the brain system that responds to opiates.

 

So, meditation reduces pain sensitivity independent of brain opioid systems.

 

Mindfulness meditation is believed to be a viable alternative to drugs when it comes to pain management. Although research is still in the beginning phases, pilot studies focusing on the benefits of mindfulness have shown promising outcomes for patients suffering from chronic ailments such as fibromyalgia, back pain, migraines, etc.” – Mindworks

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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Study Summary

 

May, L. M., Kosek, P., Zeidan, F., & Berkman, E. T. (2018). Enhancement of Meditation Analgesia by Opioid Antagonist in Experienced Meditators. Psychosomatic medicine, 80(9), 807-813.

 

ABSTRACT

Objective

Studies have consistently shown that long-term meditation practice is associated with reduced pain, but the neural mechanisms by which long-term meditation practice reduces pain remain unclear. This study tested endogenous opioid involvement in meditation analgesia associated with long-term meditation practice.

Methods

Electrical pain was induced with randomized, double-blind, cross-over administration of the opioid antagonist naloxone (0.15-mg/kg bolus dose, then 0.2-mg/kg per hour infusion dose) with 32 healthy, experienced meditation practitioners and a standardized open monitoring meditation.

Results

Under saline, pain ratings were significantly lower during meditation (pain intensity: 6.41 ± 1.32; pain unpleasantness: 3.98 ± 2.17) than at baseline (pain intensity: 6.86 ±1.04, t(31) = 2.476, p = .019, Cohen’s d= 0.46; pain unpleasantness: 4.96 ±1.75, t(31) = 3.746, p = .001, Cohen’s d = 0.68), confirming the presence of meditation analgesia. Comparing saline and naloxone revealed significantly lower pain intensity (t(31) = 3.12, p = .004, d = 0.56), and pain unpleasantness (t(31) = 3.47, p = .002, d = 0.62), during meditation under naloxone (pain intensity: 5.53 ± 1.54; pain unpleasantness: 2.95 ± 1.88) than under saline (pain intensity: 6.41 ± 1.32; pain unpleasantness: 3.98 ± 2.17). Naloxone not only failed to eliminate meditation analgesia but also made meditation analgesia stronger.

Conclusions

Long-term meditation practice does not rely on endogenous opioids to reduce pain. Naloxone’s blockade of opioid receptors enhanced meditation analgesia; pain ratings during meditation were significantly lower under naloxone than under saline. Possible biological mechanisms by which naloxone-induced opioid receptor blockade enhances meditation analgesia are discussed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6162167/

 

Reduce Painful Diabetic Neuropathy with Mindfulness

Reduce Painful Diabetic Neuropathy with Mindfulness

 

By John M. de Castro, Ph.D.

 

Meditation techniques can help people struggling with neuropathy symptoms live through their pain. It can help to lower stress, improve your coping skills, and decrease your pain intensity. Taking a mind-body approach is a noninvasive technique that provides you with more control over your condition.” – Healthline

 

Managing Diabetes can be difficult on the health and quality of life of the patient. In addition, Diabetes can lead to a very painful condition known as diabetic neuropathy. The high blood glucose levels associated with diabetes can damage nerves and result in a burning pain and numbness, particularly from the legs and feet. It affects the majority of long-term diabetes patients. This is not only painful but is also disruptive to the normal life functions of these patients. There are no cures, but diabetic neuropathy can be prevented by blood glucose control in the diabetic patient with a rigorous program of measured diet and exercise. Treatment for diabetic neuropathy usually involves pain management with drugs.

 

Mindfulness practices have been shown to help with pain management and with quality of life in diabetes patients. It is possible, then, that mindfulness practices may be effective in reducing pain and improving quality of life in patients with diabetic neuropathy. In today’s Research News article “Randomized Trial of the Effect of Mindfulness-Based Stress Reduction on Pain-Related Disability, Pain Intensity, Health-Related Quality of Life, and A1C in Patients With Painful Diabetic Peripheral Neuropathy.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5734176/ ), Nathan and colleagues examined the effectiveness of mindfulness training on reducing pain and improving the quality of life in patients with Painful diabetic peripheral neuropathy (PDPN).

 

They recruited adults with Type II Diabetes and with Painful diabetic peripheral neuropathy (PDPN). The participants were maintained on their usual pharmacological treatments and randomly assigned to a wait-list or to receive an additional 8-week program, once weekly 2.5 hour sessions and home practice, of Mindfulness-Based Stress Reduction (MBSR). The mindfulness program consists of group discussion and training in sitting, walking, and body scan meditations, and yoga practice. They were measured before and after training and 3 months later for pain related disability, pain severity, pain catastrophizing, health related and diabetic neuropathy related quality of life, depression, diabetes self-care, blood sugar reactions, and A1C levels, a measure of long-term blood glucose control.

 

They found that in comparison to baseline and the wait-list control, the participants who received Mindfulness-Based Stress Reduction (MBSR) training had significantly improved scores on all measures including lower pain related disability, pain severity, pain catastrophizing, depression health related and diabetic neuropathy related quality of life, diabetes self-care, blood sugar reactions, and A1C levels. These improvements were maintained at the 3-month follow-up. In addition, there was a high retention rate with 94% of the treated patients completing the 8-week training and the 3-month follow-up.

 

These results are striking and important. Diabetic Neuropathy is a torment for Type II Diabetes patients and mindfulness training was found to markedly improve this condition. It increased quality of life and health and decreased pain and pain associated psychological and physical difficulties. This relief of suffering in important and remarkable and should lead to a recommendation for mindfulness training to be included in the usual care of patients with Painful diabetic peripheral neuropathy (PDPN).

 

So, reduce painful diabetic neuropathy with mindfulness.

 

“When people with diabetes are more mindful – being calmly aware of what is going on around them, inside their bodies and in their minds – they can potentially make healthier lifestyle choices, such as diet, medication and exercise, that help lower their blood glucose. Additionally, stress reduction decreases the amount of stress hormones, such as cortisol, in the blood. When elevated for too long, cortisol can cause anxiety, depression, digestive problems, heart disease, sleep problems, weight gain and memory and concentration problems.” – Diabetes Canada

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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Study Summary

 

Nathan, H. J., Poulin, P., Wozny, D., Taljaard, M., Smyth, C., Gilron, I., Sorisky, A., Lochnan, H., … Shergill, Y. (2017). Randomized Trial of the Effect of Mindfulness-Based Stress Reduction on Pain-Related Disability, Pain Intensity, Health-Related Quality of Life, and A1C in Patients With Painful Diabetic Peripheral Neuropathy. Clinical diabetes : a publication of the American Diabetes Association, 35(5), 294-304.

 

Abstract

IN BRIEF Painful diabetic peripheral neuropathy (PDPN) has a large negative impact on patients’ physical and mental functioning, and pharmacological therapies rarely provide more than partial relief. Mindfulness-based stress reduction (MBSR) is a group psychosocial intervention that was developed for patients with chronic illness who were not responding to existing medical treatments. This study tested the effects of community-based MBSR courses for patients with PDPN. Among patients whose PDPN pharmacotherapy had been optimized in a chronic pain clinic, those randomly assigned to treatment with MBSR experienced improved function, better health-related quality of life, and reduced pain intensity, pain catastrophizing, and depression compared to those receiving usual care.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5734176/