Improve Pain Tolerance After Athletic Injuries with Mindfulness

Improve Pain Tolerance After Athletic Injuries with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Meditation is not something that only benefits yogis. Meditation gives athletes the ability to stay calm in the eye of the storm, it improves your ability to ignore distractions, and it has a powerful impact on the state of your nervous systems. All of these elements are significant to recovery time.” – Jennifer Houghton

 

Athletic performance requires the harmony of mind and body. Excellence is in part physical and in part psychological. That is why an entire profession of Sports Psychology has developed. “In sport psychology, competitive athletes are taught psychological strategies to better cope with a number of demanding challenges related to psychological functioning.” They use a number of techniques to enhance performance including mindfulness training. It has been shown to improve attention and concentration and emotion regulation and reduces anxiety and worry and rumination, and the physiological and psychological responses to stress. As a result, mindfulness training has been employed by athletes and even by entire teams to enhance their performance.

 

Athletes, however, often get injured. It has been shown that mindfulness can help with pain management. But, it is not known if mindfulness training can help in dealing with and recovering from severe athletic injuries. In today’s Research News article “Effect of Mindfulness Based Stress Reduction (MBSR) in Increasing Pain Tolerance and Improving the Mental Health of Injured Athletes.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2018.00722/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_650705_69_Psycho_20180524_arts_A ), Mohammed and colleagues examined the ability of a Mindfulness Based Stress Reduction (MBSR) program to reduce the physical and psychological effects of severe athletic injuries.

 

They recruited university athletes who had severe injuries that kept them from participating in their sport for at least 3 months. All athletes received usual care consisting of the standard physiotherapy treatments throughout the study. They were randomly assigned to receive either an additional 8-week program of Mindfulness Based Stress Reduction (MBSR). They met once a week for 90 minutes and were asked to practice at home for 20 minutes per day. MBSR contains meditation, yoga and body scan practices. For this study the practices were adapted to the physical needs and capabilities of the injured athletes. All athletes were measured before and after training for pain tolerance with a cold pressor test, rated their own levels of pain, and completed measures of mindfulness, positive and negative emotions, anxiety, and depression.

 

They found that following training the athletes receiving MBSR training had a significantly greater level of pain tolerance, and mindfulness compared to baseline and the control group. Both groups had significant improvements in mood, especially significant reductions in anxiety and stress. This is a small study and it needs to be repeated with larger groups and an active control condition. But, the results indicate that Mindfulness Based Stress Reduction (MBSR) improves pain tolerance and mindfulness in injured athletes. It has been previously demonstrated that mindfulness training reduces pain perception in general. The present study suggests that it also does so for severely injured athletes. This may be important for the athlete’s recovery from their injuries.

 

It will be interesting to see if the heightened mindfulness produces improved athletic performance when the athletes recover and return to their respective sporting activities. It has been shown that mindfulness training improves athletic performance. But it is not known whether it is effective with athletes returning to competition after serious injury.

 

So, improve pain tolerance after athletic injuries with mindfulness.

 

Athletes that fall into reactive habits are being mindful when under stress.  They are at the mercy of these destructive habits.  Becoming mindful creates a pause between the stimulus that occurs and the athletes reaction to the event.” – Robert Andrews

 

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

 

Mohammed WA, Pappous A and Sharma D (2018) Effect of Mindfulness Based Stress Reduction (MBSR) in Increasing Pain Tolerance and Improving the Mental Health of Injured Athletes. Front. Psychol. 9:722. doi: 10.3389/fpsyg.2018.00722

 

Abstract

Literature indicates that injured athletes face both physical and psychological distress after they have been injured. In this study, a Mindfulness Based Stress Reduction (MBSR) was utilised as an intervention for use during the period of recovery with injured athletes and, to the best of our knowledge, this is the first study using MBSR as an intervention for this purpose.

Objective: The aim of this research was to investigate the role of MBSR practise in reducing the perception of pain and decreasing anxiety/stress, as well as increasing pain tolerance and mindfulness. An additional aim was to increase positive mood and decrease negative mood in injured athletes.

Methods: The participants comprised of twenty athletes (male = 14; female = 6; age range = 21–36 years) who had severe injuries, preventing their participation in sport for more than 3 months. Prior to their injury, the participants had trained regularly with their University teams and participated in official university championships. Both groups followed their normal physiotherapy treatment, but in addition, the intervention group practised mindfulness meditation for 8 weeks (one 90-min session/week). A Cold Pressor Test (CPT) was used to assess pain tolerance. In contrast, the perception of pain was measured using a Visual Analogue Scale. Other measurements used were the Mindful Attention Awareness Scale (MAAS), Depression Anxiety and Stress Scale (DASS), and Profile of Mood States (POMS).

Results: Our results demonstrated an increase in pain tolerance for the intervention group and an increase in mindful awareness for injured athletes. Moreover, our findings observed a promising change in positive mood for both groups. Regarding the Stress/Anxiety scores, our findings showed a notable decrease across sessions; however, no significant changes were observed in other main and interaction effects in both groups.

Conclusion: Injured athletes can benefit from using mindfulness as part of the sport rehabilitation process to increase their pain tolerance and awareness. Further research is required to assess whether increasing pain tolerance could help in the therapeutic process.

https://www.frontiersin.org/articles/10.3389/fpsyg.2018.00722/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_650705_69_Psycho_20180524_arts_A

Reduce the Symptoms of Fibromyalgia with Tai Chi

Reduce the Symptoms of Fibromyalgia with Tai Chi

 

By John M. de Castro, Ph.D.

 

“Tai chi mind-body treatment results in similar or greater improvement in symptoms than aerobic exercise, the current most commonly prescribed non-drug treatment. This mind-body approach may be considered a therapeutic option in the multi-disciplinary management of fibromyalgia.” – Wang et al.

 

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. Mindfulness practices that are also exercises may be particularly effective. Indeed, yoga practice has been shown to improve the symptoms of fibromyalgia. This suggests that Tai Chi, another mindful exercise might be similarly effective.

 

In today’s Research News article “Effect of tai chi versus aerobic exercise for fibromyalgia: comparative effectiveness randomized controlled trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5861462/ ), Wang and colleagues recruited patients with fibromyalgia and randomly assigned them to one of three groups; 60 minutes of Tai Chi once a week for 24 weeks, 60 minutes of Tai Chi twice a week for 12 weeks, or 60 minutes of light to moderate aerobic exercises twice a week for 24 weeks. Participants were encouraged to practice at home and continue the exercises after the end of formal sessions. Participants were measured before and at 12, 24, and 52 weeks into the intervention for overall severity of fibromyalgia, including intensity of pain, physical function, fatigue, morning tiredness, depression, anxiety, job difficulty, and overall wellbeing, anxiety, depression, self-efficacy, sleep quality, symptom severity, physical and mental health, coping strategies, social support, disability, and physical function, including muscle strength and power.

 

They found that at 24 and again at 52 weeks all groups showed significant improvement but the Tai Chi groups had significantly greater improvement than the aerobic exercise group in overall fibromyalgia severity, self-efficacy, anxiety, and coping strategies. Hence, participation in Tai Chi exercise produce significant improvement in the symptoms of fibromyalgia that were better than those produced by aerobic exercise.

 

These are remarkable findings that Tai Chi practice is better than aerobic exercise in treating the symptoms of fibromyalgia. Both helped, but Tai Chi helped more. Fibromyalgia patients suffer greatly and to bring relief with a simple, gentle, safe exercise is very important. Tai Chi is inexpensive to administer, can be performed in groups or alone, at home or in a facility or even public park, and can be quickly learned. In addition, it can be practiced in social groups without professional supervision. This can make it fun, improving the likelihood of long-term engagement in the practice. Hence, Tai Chi practice would appear to be a wonderful effective treatment for the relief of the suffering of fibromyalgia patients.

 

So, reduce the symptoms of fibromyalgia with Tai Chi.

 

“The authors attributed the success of the program to the postures and low impact movements of Tai Chi, and to the “controlled breathing and movements leading to restful state and mental tranquility.” Pain thresholds were likely raised in the process, which helped break the cycle of movement pain.“ – Joanna Fernandes

 

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

 

Wang, C., Schmid, C. H., Fielding, R. A., Harvey, W. F., Reid, K. F., Price, L. L., … McAlindon, T. (2018). Effect of tai chi versus aerobic exercise for fibromyalgia: comparative effectiveness randomized controlled trial. The BMJ, 360, k851. http://doi.org/10.1136/bmj.k851

 

Abstract

Objectives

To determine the effectiveness of tai chi interventions compared with aerobic exercise, a current core standard treatment in patients with fibromyalgia, and to test whether the effectiveness of tai chi depends on its dosage or duration.

Design

Prospective, randomized, 52 week, single blind comparative effectiveness trial.

Setting

Urban tertiary care academic hospital in the United States between March 2012 and September 2016.

Participants

226 adults with fibromyalgia (as defined by the American College of Rheumatology 1990 and 2010 criteria) were included in the intention to treat analyses: 151 were assigned to one of four tai chi groups and 75 to an aerobic exercise group.

Interventions

Participants were randomly assigned to either supervised aerobic exercise (24 weeks, twice weekly) or one of four classic Yang style supervised tai chi interventions (12 or 24 weeks, once or twice weekly). Participants were followed for 52 weeks. Adherence was rigorously encouraged in person and by telephone.

Main outcome measures

The primary outcome was change in the revised fibromyalgia impact questionnaire (FIQR) scores at 24 weeks compared with baseline. Secondary outcomes included changes of scores in patient’s global assessment, anxiety, depression, self efficacy, coping strategies, physical functional performance, functional limitation, sleep, and health related quality of life.

Results

FIQR scores improved in all five treatment groups, but the combined tai chi groups improved statistically significantly more than the aerobic exercise group in FIQR scores at 24 weeks (difference between groups=5.5 points, 95% confidence interval 0.6 to 10.4, P=0.03) and several secondary outcomes (patient’s global assessment=0.9 points, 0.3 to 1.4, P=0.005; anxiety=1.2 points, 0.3 to 2.1, P=0.006; self efficacy=1.0 points, 0.5 to 1.6, P=0.0004; and coping strategies, 2.6 points, 0.8 to 4.3, P=0.005). Tai chi treatment compared with aerobic exercise administered with the same intensity and duration (24 weeks, twice weekly) had greater benefit (between group difference in FIQR scores=16.2 points, 8.7 to 23.6, P<0.001). The groups who received tai chi for 24 weeks showed greater improvements than those who received it for 12 weeks (difference in FIQR scores=9.6 points, 2.6 to 16.6, P=0.007). There was no significant increase in benefit for groups who received tai chi twice weekly compared with once weekly. Participants attended the tai chi training sessions more often than participants attended aerobic exercise. The effects of tai chi were consistent across all instructors. No serious adverse events related to the interventions were reported.

Conclusion

Tai chi mind-body treatment results in similar or greater improvement in symptoms than aerobic exercise, the current most commonly prescribed non-drug treatment, for a variety of outcomes for patients with fibromyalgia. Longer duration of tai chi showed greater improvement. This mind-body approach may be considered a therapeutic option in the multidisciplinary management of fibromyalgia.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5861462/

 

Improve Psychological Well-Being with EcoMeditation

Improve Psychological Well-Being with EcoMeditation

 

By John M. de Castro, Ph.D.

 

“Eco Meditation ,. . .is a powerful meditation, a synergy of multiple techniques, doing certain physiological moves to help you get into a deep delta meditative state, the same as a meditative master, and in only 90 seconds. You can do this meditation any time of the day, and cumulative benefits accrue with long-term use.” – Inspire Nation

 

Meditation training has been shown to improve health and well-being. It has also been found to be effective for a large array of medical and psychiatric conditions, either stand-alone or in combination with more traditional therapies. As a result, meditation training has been called the third wave of therapies. One problem with understanding meditation effects is that meditation is not a specific practice but rather a category encompassing a wide array of practices. It is not known which work best for the health and well-being of the practitioners and for improving different conditions.

 

In today’s Research News article “The Interrelated Physiological and Psychological Effects of EcoMeditation.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5871048/ ), Groesbeck and colleagues study the effects of a relatively new, less commonly practiced, technique called Eco-Meditation. As described by the authors, EcoMeditation “focuses on physiological cues. . . it has participants mimic the physiological state of an experienced practitioner. Participants mechanically assume breathing patterns and body postures that are characteristic of long-time meditators. EcoMeditation combines elements of 4 evidence-based techniques: the Quick Coherence Technique, Clinical Emotional Freedom Techniques, mindfulness meditation, and neurofeedback.

 

In an uncontrolled pilot study, they recruited participants who were attending a weekend meditation workshop at a residential conference center where they practiced EcoMeditation. Before and after the workshop and 2 months later, the participants were measured for anxiety, depression, happiness, pain, Posttraumatic stress disorder (PTSD), resting blood pressure, heart rate, heart rate variability, heart coherence, and Salivary immunoglobulin A and cortisol levels as physiological markers of stress.

 

They found that in comparison to the levels prior to the workshop, afterward there were significant decreases in anxiety, depression, pain, resting heart rate, salivary cortisol levels, and a significantly increase in happiness. Unfortunately, none of these effects were still present 2 months later. Hence, after participating in the workshop but not 2 months later the participants reported improved psychological well-being and less stress.

 

This is an uncontrolled pilot study and no firm conclusions can be made. Without a control group there are many sources of confounding present and many alternative explanations for the results. But, the results were interesting and provide support for a more controlled study.

 

So, improve psychological well-being with EcoMeditation.

 

“In meditation, you’re seeking a state, like peace of mind, not an outcome. The rest of your life is about doing; meditation is about being.” – Anne Siret

 

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

 

Groesbeck, G., Bach, D., Stapleton, P., Blickheuser, K., Church, D., & Sims, R. (2018). The Interrelated Physiological and Psychological Effects of EcoMeditation. Journal of Evidence-Based Integrative Medicine, 23, 2515690X18759626. http://doi.org/10.1177/2515690X18759626

 

Abstract

This study investigated changes in psychological and physiological markers during a weekend meditation workshop (N = 34). Psychological symptoms of anxiety, depression, posttraumatic stress disorder (PTSD) and happiness were assessed. Physiological markers included cortisol, salivary immunoglobulin A (SigA), heart rate variability (HRV), blood pressure (BP), and resting heart rate (RHR). On posttest, significant reductions were found in cortisol (−29%, P < .0001), RHR (−5%, P = .0281), and pain (−43%, P = .0022). Happiness increased significantly (+11%, P = .0159) while the increase in SigA was nonsignificant (+27%, P = .6964). Anxiety, depression, and PTSD all declined (−26%, P = .0159; −32%, P = .0197; −18%, P = .1533), though changes in PTSD did not reach statistical significance. No changes were found in BP, HRV, and heart coherence. Participants were assessed for psychological symptoms at 3-month follow-up, but the results were nonsignificant due to inadequate sample size (n = 17). EcoMeditation shows promise as a stress-reduction method.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5871048/

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/

Mindful Patients with Multiple Sclerosis Have Less Interference in Living from Pain

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

 

Study Summary

 

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

 

Abstract

Background:

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.

Methods:

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.

Results:

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).

Conclusions:

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.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5825983/

 

Mindfulness is Associated with Reduced Pain by Improving the Capacity for Pleasure

Mindfulness is Associated with Reduced Pain by Improving the Capacity for Pleasure

 

By John M. de Castro, Ph.D.

 

“It felt good to realize [through mindfulness] that I can co-exist with my pain. Being mindful helped me realize that in my angry reaction to my back pain, I was neglecting my whole body. I saw my body only through my pain, which caused me to hate my body over time. I can now see myself outside of my body, and am working day by day with my meditation to become a happier person living with chronic pain.” – Natalia Morone

 

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. 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. But there is very little systematic study of how these practices effect chronic pain.

 

In today’s Research News article “Mindfulness Is Associated with Increased Hedonic Capacity Among Chronic Pain Patients Receiving Extended Opioid Pharmacotherapy.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5235319/ ), Thomas and Garland recruited chronic pain patients who were being treated with opioids. They were measured for mindfulness, hedonic (pleasure) capacity, pain severity, pain interference, and depression. The relationships among these variables was explored with regression analysis.

 

They found that for the higher the levels of mindfulness for these chronic pain patients the higher their ability to experience pleasure (hedonic capacity) and the less that pain interfered with their daily lives (pain interference). This was also true for the mindfulness facets of observing inner experience, non-judgment, and acting with awareness. A mediation analysis demonstrated that the association of mindfulness with less pain interference in daily living resulted from mindfulness’ association with higher levels of hedonic capacity that in turn was associated with lower pain interference. So, the higher levels of ability to experience pleasure associated with mindfulness was the mediator of mindfulness’ association with lower ability of pain to interfere with living.

 

It needs to be kept in mind that this study was correlational and causation cannot be determined. But, the results suggest that being mindful predicts a greater ability to experience pleasure and, in turn, less interference in daily life produced by pain. This makes sense as pleasure occurs in the present moment and the ability of mindfulness to focus attention on the present moment would heighten the appreciation of this pleasure. In turn, it makes sense that being able to experience the good things in life would interfere with the ability of pain to interfere with living. So, being mindful may heighten the appreciation of pleasure and lower the difficulties in daily living produced by chronic pain.

 

“The current state of chronic pain and opioid use in the United States may indeed be daunting and require a multifaceted approach; yet, there is promise for our Veterans and the more than 100 million Americans1 who suffer from chronic pain in the age-old and now richly evidence-based practice of mindfulness meditation.” – Dawn Bazarko

 

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

 

Thomas, E. A., & Garland, E. L. (2017). Mindfulness Is Associated with Increased Hedonic Capacity Among Chronic Pain Patients Receiving Extended Opioid Pharmacotherapy. The Clinical Journal of Pain, 33(2), 166–173. http://doi.org/10.1097/AJP.0000000000000379

 

Abstract

Objectives

Chronic pain and long-term opioid use may lead to a persistent deficit in hedonic capacity, characterized by increased sensitivity to aversive states and insensitivity to natural rewards. Dispositional mindfulness has been linked with improved emotion regulation and pain coping. The aim of the current study was to examine associations between dispositional mindfulness, hedonic capacity, and pain-related interference in an opioid-using chronic pain sample.

Methods

Data were obtained from a sample of 115 chronic pain patients on long-term opioid therapy (68% females, M age=48.3, SD=13.6) who completed the Five Facet Mindfulness Questionnaire (FFMQ), the Snaith Hamilton Anhedonia and Pleasure Scale (SHAPS), the Brief Pain Inventory (BPI), and a psychiatric assessment of major depression. Bivariate correlations, hierarchical multiple regression, and path analysis were used to determine if dispositional mindfulness scores (FFMQ) predicted variance in hedonic capacity (SHAPS), and if hedonic capacity mediated the association between mindfulness and pain interference.

Results

We observed a significant positive correlation between dispositional mindfulness and hedonic capacity scores, r=.33, p<.001. Hierarchical regression indicated that after controlling for pain interference and major depressive disorder diagnosis, dispositional mindfulness explained a significant portion of variance in hedonic capacity (Beta = .30, p< .01). The association between dispositional mindfulness and pain interference was mediated by hedonic capacity (b = −.011, SE=.005, 95% C.I. = −.004 to −.024, full model R2=.39).

Discussion

Findings indicate that dispositional mindfulness was associated with hedonic capacity among this chronic pain sample. In light of this association, it is plausible that interventions that increase mindfulness may reduce pain-related impairment among opioid-using patients by enhancing hedonic capacity.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5235319/

 

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/

Reduce Low Back Pain with Yoga

Reduce Low Back Pain with Yoga

 

By John M. de Castro, Ph.D.

 

“For most of our lives, we take our backs for granted. But at some point in just about everyone’s life, our backs revolt and remind us that they need love and attention too. Thankfully, for many of us, the pain is only temporary. But for others, it can be much more debilitating—and much more frustrating. In severe cases, medical attention may be necessary, but if your pain is less severe, yoga may be able to help by strengthening the back, stretching it and improving circulation to the spine and nerves.” – Liz Rosenblum

 

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.

 

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 pain. Yoga 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 therapy for chronic low back pain.

 

In today’s Research News article “Yoga treatment for chronic non-specific low back pain.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5294833/ ), Wieland and colleagues review and summarize the published research studies that examined the effectiveness of yoga practice for the treatment of chronic low back pain. They discovered only 12 published research studies on the subject. They reported that the studies found that yoga practice in comparison to no-exercise control conditions produced small but significant improvements in pain and back function that were maintained for 6 months. This demonstrates that yoga practice is effective for back pain but does not allow for a determination of whether exercise in general or yoga specifically was effective. So, they looked at studies of yoga practice in comparison to other forms of exercise and found that yoga practice produced small but significantly better improvements than other exercises in pain but equivalent improvements in back function. When yoga practice was combined with other exercises it did not produce significantly greater benefits than exercise alone.

 

The summary suggests that yoga practice and other exercises are safe and effective treatments for chronic low back pain that can produce lasting improvements in pain and back function. They found evidence that yoga practice may be slightly better than other exercises in reducing pain, but there is no additional benefit of combining yoga with other exercises. Hence, yoga practice is an acceptable, safe, and effective alternative to drug and surgical treatments that has small but significant benefits for the relief to the suffering of people with chronic low back pain.

 

So, reduce low back pain with Yoga.

 

“a structured yoga program may be an alternative to physical therapy for people with chronic low-back pain, depending on individual preferences, availability, and cost.” – NCCIH

 

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

 

Wieland, L. S., Skoetz, N., Pilkington, K., Vempati, R., D’Adamo, C. R., & Berman, B. M. (2017). Yoga treatment for chronic non-specific low back pain. The Cochrane Database of Systematic Reviews, 1, CD010671. http://doi.org/10.1002/14651858.CD010671.pub2

 

Abstract

Background

Non-specific low back pain is a common, potentially disabling condition usually treated with self-care and non-prescription medication. For chronic low back pain, current guidelines state that exercise therapy may be beneficial. Yoga is a mind-body exercise sometimes used for non-specific low back pain.

Objectives

To assess the effects of yoga for treating chronic non-specific low back pain, compared to no specific treatment, a minimal intervention (e.g. education), or another active treatment, with a focus on pain, function, and adverse events.

Search methods

We searched CENTRAL, MEDLINE, Embase, five other databases and four trials registers to 11 March 2016 without restriction of language or publication status. We screened reference lists and contacted experts in the field to identify additional studies.

Selection criteria

We included randomized controlled trials of yoga treatment in people with chronic non-specific low back pain. We included studies comparing yoga to any other intervention or to no intervention. We also included studies comparing yoga as an adjunct to other therapies, versus those other therapies alone.

Data collection and analysis

Two authors independently screened and selected studies, extracted outcome data, and assessed risk of bias. We contacted study authors to obtain missing or unclear information. We evaluated the overall certainty of evidence using the GRADE approach.

Main results

We included 12 trials (1080 participants) carried out in the USA (seven trials), India (three trials), and the UK (two trials). Studies were unfunded (one trial), funded by a yoga institution (one trial), funded by non-profit or government sources (seven trials), or did not report on funding (three trials). Most trials used Iyengar, Hatha, or Viniyoga forms of yoga. The trials compared yoga to no intervention or a non-exercise intervention such as education (seven trials), an exercise intervention (three trials), or both exercise and non-exercise interventions (two trials). All trials were at high risk of performance and detection bias because participants and providers were not blinded to treatment assignment, and outcomes were self-assessed. Therefore, we downgraded all outcomes to ‘moderate’ certainty evidence because of risk of bias, and when there was additional serious risk of bias, unexplained heterogeneity between studies, or the analyses were imprecise, we downgraded the certainty of the evidence further.

For yoga compared to non-exercise controls (9 trials; 810 participants), there was low-certainty evidence that yoga produced small to moderate improvements in back-related function at three to four months (standardized mean difference (SMD) −0.40, 95% confidence interval (CI) −0.66 to −0.14; corresponding to a change in the Roland-Morris Disability Questionnaire of mean difference (MD) −2.18, 95% −3.60 to −0.76), moderate-certainty evidence for small to moderate improvements at six months (SMD −0.44, 95% CI −0.66 to −0.22; corresponding to a change in the Roland-Morris Disability Questionnaire of MD −2.15, 95% −3.23 to −1.08), and low-certainty evidence for small improvements at 12 months (SMD −0.26, 95% CI −0.46 to −0.05; corresponding to a change in the Roland-Morris Disability Questionnaire of MD −1.36, 95% −2.41 to −0.26). On a 0–100 scale there was very low- to moderate-certainty evidence that yoga was slightly better for pain at three to four months (MD −4.55, 95% CI −7.04 to −2.06), six months (MD −7.81, 95% CI −13.37 to −2.25), and 12 months (MD −5.40, 95% CI −14.50 to −3.70), however we pre-defined clinically significant changes in pain as 15 points or greater and this threshold was not met. Based on information from six trials, there was moderate-certainty evidence that the risk of adverse events, primarily increased back pain, was higher in yoga than in non-exercise controls (risk difference (RD) 5%, 95% CI 2% to 8%).

For yoga compared to non-yoga exercise controls (4 trials; 394 participants), there was very-low-certainty evidence for little or no difference in back-related function at three months (SMD −0.22, 95% CI −0.65 to 0.20; corresponding to a change in the Roland-Morris Disability Questionnaire of MD −0.99, 95% −2.87 to 0.90) and six months (SMD −0.20, 95% CI −0.59 to 0.19; corresponding to a change in the Roland-Morris Disability Questionnaire of MD −0.90, 95% −2.61 to 0.81), and no information on back-related function after six months. There was very low-certainty evidence for lower pain on a 0–100 scale at seven months (MD −20.40, 95% CI −25.48 to −15.32), and no information on pain at three months or after seven months. Based on information from three trials, there was low-certainty evidence for no difference in the risk of adverse events between yoga and non-yoga exercise controls (RD 1%, 95% CI −4% to 6%).

For yoga added to exercise compared to exercise alone (1 trial; 24 participants), there was very-low-certainty evidence for little or no difference at 10 weeks in back-related function (SMD −0.60, 95% CI −1.42 to 0.22; corresponding to a change in the Oswestry Disability Index of MD −17.05, 95% −22.96 to 11.14) or pain on a 0–100 scale (MD −3.20, 95% CI −13.76 to 7.36). There was no information on outcomes at other time points. There was no information on adverse events.

Studies provided limited evidence on risk of clinical improvement, measures of quality of life, and depression. There was no evidence on work-related disability.

Authors’ conclusions

There is low- to moderate-certainty evidence that yoga compared to non-exercise controls results in small to moderate improvements in back-related function at three and six months. Yoga may also be slightly more effective for pain at three and six months, however the effect size did not meet predefined levels of minimum clinical importance. It is uncertain whether there is any difference between yoga and other exercise for back-related function or pain, or whether yoga added to exercise is more effective than exercise alone. Yoga is associated with more adverse events than non-exercise controls, but may have the same risk of adverse events as other back-focused exercise. Yoga is not associated with serious adverse events. There is a need for additional high-quality research to improve confidence in estimates of effect, to evaluate long-term outcomes, and to provide additional information on comparisons between yoga and other exercise for chronic non-specific low back pain.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5294833/

Improve Physical and Psychological Discomfort from Musculoskeletal Disorders with Mindfulness

Improve Physical and Psychological Discomfort from Musculoskeletal Disorders with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Meditation’s goal is to relax the mind and body, acknowledge and release feelings about pain or other challenges, let go of tension, and tap into a positive outlook. Focusing on negativity exacerbates pain. Mindfulness practice allows you to step back from that negative thinking. It brings focus to the present moment and allows you to interrupt the vicious cycle of negativity and pain. “With our thoughts, we create a reality,” – Andrea Rudolph

 

Orthopedic Disorders consist of a wide range of problems that are concerned with muscles, ligaments and joints. Disorders are ailments, injuries or diseases that cause knee problems, whiplash, dislocated shoulder, torn cartilages, foot pain and fibromyalgia. The most common forms of orthopedic disorders are arthritis, and back and neck pain.

 

Arthritis is a chronic disease that most commonly affects the joints. Depending on the type of arthritis symptoms may include pain, stiffness, swelling, redness, and decreased range of motion. It affects an estimated 52.5 million adults in the United States. The pain, stiffness, and lack of mobility associate with arthritis produce fatigue and markedly reduce the quality of life of the sufferers. Arthritis can have very negative psychological effects diminishing the individual’s self-image and may lead to depression, isolation, and withdrawal from friends and social activities.

 

The most common forms of chronic pain are back and neck 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. Back and neck pain interferes with daily living and with work, decreasing productivity and creating absences. There are many different treatments for pain, but few are both safe and effective for chronic pain conditions. So, alternative treatments are needed. Mindfulness practices are effective in treating pain and have been shown to be safe and effective in the management of arthritislow back pain and neck pain.

 

In today’s Research News article “First Use of a Brief 60-second Mindfulness Exercise in an Orthopedic Surgical Practice; Results from a Pilot Study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5736889/ ), Chad-Friedman and colleagues perform a pilot study of the effectiveness of a brief mindfulness instruction via a video for the symptoms of orthopedic disorders. They recruited adult follow-up patients with a variety of orthopedic problems.  The participants then watched a 60 second mindfulness video where they were instructed to envision a stressful situation and place it in a bright star. Over the next 60 seconds they were to envision shrinking that star till it becomes small. They were measured before and after watching the video for pain, anxiety, distress, depression, anger, and satisfaction with the intervention. They found that after watching the video the patients reported large and significant improvements in pain and all psychological measures and high satisfaction ratings.

 

Obviously, with such a brief and uncontrolled pilot study there can be no clear conclusions. But, mindfulness interventions have been found in numerous controlled studies to decrease pain, anxiety, depression, and anger. So, the results suggest that the 60-second mindfulness practice has similar effects. It remains to be seen if such a brief practice can have lasting effects in comparison to a comparable non-mindfulness control condition and if daily brief practice can help maintain the benefits.

 

Orthopedic disorders are so common, costly, and debilitating that a simple, safe, and effective intervention is sorely needed. Physicians have little time. So, having mindfulness training via a video relieves them of the need to take the time to train the patients. In addition, making it very brief and simple may promote patient compliance with the practice. So, this pilot study suggests that this 60-second video intervention should be further studied for its effectiveness in relieving the suffering of patients with orthopedic disorders.

 

“Mindfulness training involves the cultivation of nonjudgemental attention to unwanted thoughts, feelings and bodily experiences via meditation and may help ameliorate both psychological and physical symptoms of chronic disease,” – Mary Kreitzer

 

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

 

Emma Chad-Friedman, Mojtaba Talaei-Khoei, David Ring, Ana-Maria Vranceanu. First Use of a Brief 60-second Mindfulness Exercise in an Orthopedic Surgical Practice; Results from a Pilot Study. Arch Bone Jt Surg. 2017 Nov; 5(6): 400–405.

 

Abstract

Background:

Mindfulness based interventions may be useful for patients with musculoskeletal conditions in orthopedic surgical practices as adjuncts to medical procedures or alternatives to pain medications. However, typical mindfulness programs are lengthy and impractical in busy surgical practices. We tested the feasibility, acceptability and preliminary effect of a brief, 60-second mindfulness video in reducing pain and negative emotions in patients presenting to an orthopedics surgical practice.

Methods:

This was an open pilot study. Twenty participants completed the Numerical Rating Scale to assess pain intensity, the State Anxiety subscale of the State Trait Anxiety Scale to assess state anxiety, and emotional thermometers to assess distress, anxiety, anger and depression immediately prior to and following the mindfulness video exercise. At the end of the exercise patients also answered three questions assessing satisfaction with the mindfulness video.

Results:

Feasibility of the mindfulness video was high (100%). Usefulness, satisfaction and usability were also high. Participants showed improvements in state anxiety, pain intensity, distress, anxiety, depression and anger after watching the video. These changes were both statistically significant and clinically meaningful, when such information was available.

Conclusion:

People with musculoskeletal pain seeking orthopedic care seem receptive and interested in brief mindfulness exercises that enhance comfort and calm.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5736889/

Improve Pain Responding in Adolescents with Mindfulness

Improve Pain Responding in Adolescents with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness was a significant predictor of both real-world and experimental pain outcomes. Adolescents who were more mindful tended to experience less interference in their day-to-day life as a result of pain. Additionally, . . . more mindful adolescents reported less intense pain and a higher level of pain tolerance.” – Mark Petter

 

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. Sadly, about a quarter to a third of children experience chronic pain. It has to be kept in mind that pain is an important signal that there is something wrong or that damage is occurring. This signals that some form of action is needed to mitigate the damage. This is an important signal that is ignored at the individual’s peril. So, in dealing with pain, it’s important that pain signals not be blocked or prevented. They need to be perceived. But, methods are needed to mitigate the psychological distress produced by chronic pain.

 

The most common treatment for chronic pain is drugs. These include over-the-counter analgesics and opioids. But opioids are dangerous and prescription opioid overdoses kill more than 14,000 people annually. The use of drugs in adolescents is even more complicated and potentially directly harmful or could damage the developing brain. So, there is a great need to find safe and effective ways to lower the psychological distress and improve adolescents’ 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. These include meditationyogatai chi, qigong, biofeedback, progressive muscle relaxation, guided imagery, hypnosis, acupuncture, and deep breathing exercises. 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. But there is very little systematic study of the application of these practices for the treatment of chronic pain in adolescents.

 

In today’s Research News article “I Learned to Let Go of My Pain”. The Effects of Mindfulness Meditation on Adolescents with Chronic Pain: An Analysis of Participants’ Treatment Experience.” (See summary below or view the full text of the study at:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5742755/ ), Ruskin and colleagues recruited adolescents between the ages of 12 to 18 years who suffered from chronic pain. They provided the adolescents with an 8-week program or Mindfulness-Based Stress Reduction (MBSR) modified for adolescents, including meditation, yoga, and body scan, but with reduced expectation for home practice and shortened sessions. One week after the end of the program the youths were asked about their satisfaction with the program and participated in focus groups to provide feedback, evaluations, and suggestions regarding the program. The groups discussions were transcribed and a content analysis performed.

 

The participants rated their satisfaction program at 8.29 out of 10, suggesting a high degree of satisfaction. Ruskin and colleagues found that the “Qualitative analysis of focus group transcripts revealed six main themes: Mindfulness Skills, Supportive Environment, Group Exercises, Empowerment, Program Expectations, and Logistics.”

 

In terms of the mindfulness category the participants reported that the program improved their awareness of the present moment, their ability to let go of their pain, their ability to cope with the emotions produced by the pain, and increased their overall emotional well-being and happiness. In addition, they reported that the mindfulness skills transferred to other aspects of their life such as work, and became a part of how they normally viewed the world.

 

In terms of the supportive environment, the participants reported that the group developed a sense of openness and trust, provided emotional support and made them feel less alone. They also reported that being able to discuss their pain issues with others who were also suffering was very beneficial. In terms of the group exercises, the participants reported that the “weather report”, reporting on their current state with the group was very helpful, that focusing on the pain in meditation was helpful. In terms of empowerment, the participants felt that the program did not actually ease their pain but empowered them to take actions to cope with it and not let it interfere with their activities. In terms of the program expectations, they reported that they had great misconceptions of mindfulness at the beginning believing it to be uninteresting and dumb and some reported that they thought the program would actually lower their pain levels. Finally,

in terms of the logistics, the meeting room was too sterile and needed to be decorated in a more interesting fashion, there needed to be more meetings, and they liked working with other adolescents with chronic pain.

 

Hence, the participants viewed the program very positively as improving their ability to appreciate and stay in the present moment and better cope with the emotional and practical consequences of their pain. That the practice was conducted in a group of other adolescents with chronic pain was viewed as an important and helpful characteristic of the program. In other words, they were pleased and felt the program was helpful to them in dealing with their pain.

 

These results must be interpreted carefully. They should be viewed as constructive feedback on the program and nothing more. More empirical evidence is needed to reach firm conclusions regarding the programs efficacy. But, the results are suggestive that more systematic studies are warranted as mindfulness training may be very helpful to adolescents in coping with chronic pain.

 

 “Mindful meditation can have profound effects for those who suffer from chronic pain. This simple practice seems to be able to change a patient’s perception of pain, making it less intense. . . . consistent meditation helped patients locate and turn down the “volume knob” on sensations. Often pain sufferers are unable to focus on anything but their pain, which increases their perception of it.” – Pain Doctor

 

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

 

Danielle Ruskin, Lauren Harris, Jennifer Stinson, Sara Ahola Kohut, Kathryn Walker, Erinn McCarthy. I Learned to Let Go of My Pain”. The Effects of Mindfulness Meditation on Adolescents with Chronic Pain: An Analysis of Participants’ Treatment Experience. Children (Basel) 2017 Dec; 4(12): 110. Published online 2017 Dec 15. doi: 10.3390/children4120110

 

Abstract

Chronic pain can lead to significant negative outcomes across many areas of life. Recently, mindfulness-based interventions (MBIs) have been identified as potentially effective tools for improved pain management among adolescents living with pain. This study aimed to explore the experience of adolescents who participated in an eight-week mindfulness group adapted for adolescents with chronic pain (MBI-A), and obtain their feedback and suggestions on group structure and content. A mixed method design was used employing qualitative data from focus groups and data from a satisfaction questionnaire. Focus group data were transcribed and analyzed using inductive simple descriptive content analysis. Of the total participants (n = 21), 90% (n = 19) provided feedback by completing satisfaction questionnaires and seventeen (n = 17) of those also participated across two focus groups. Analysis of the focus group transcripts uncovered six themes: mindfulness skills, supportive environment, group exercises (likes and dislikes), empowerment, program expectations, and logistics. Participants reported positive experiences in the MBI-A program, including support received from peers and mindfulness skills, including present moment awareness, pain acceptance, and emotion regulation. Group members suggested increasing the number of sessions and being clearer at outset regarding a focus on reduction of emotional suffering rather than physical pain.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5742755/