Improve Headache Pain with Mindfulness
By John M. de Castro, Ph.D.
“Mindfulness is a simple, effective method for managing migraines and reducing potential triggers.” – American Migraine Foundation
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. Primary headaches do not result from other medical conditions and include migraine, tension, and cluster headaches. There are a wide variety of drugs that are prescribed for primary 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.
Most 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. A number of research studies have reported that mindfulness training is an effective treatment for headache pain. But there is a need for further study.
In today’s Research News article “Use of Mindfulness-based Cognitive Therapy to Change Pain-related Cognitive Processing in Patients with Primary Headache: A Randomized Trial with Attention Placebo Control Group.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6925538/), Namjoo and colleagues recruited adults with chronic primary headaches and randomly assigned them to receive 8 weekly 2-hour group sessions of either Mindfulness-Based Cognitive Therapy (MBCT) or an Attention Placebo Control condition. MBCT consists of mindfulness training and Cognitive Behavioral Therapy (CBT) and assigned homework. During therapy the patient is trained to investigate and alter aberrant thought patterns underlying their reactions to headache pain. The Attention Placebo Control condition consists of therapist attention and empathy and group discussion. The patients were measured before and after training and 3 months later for pain, pain interference in everyday life, pain severity, and pain related cognitive processes.
A strength of the study is the Attention Placebo Control condition which is an excellent control condition that would be helpful in assessing placebo, attentional, and Hawthorne confounding effects. Even with this strong control condition, they found that at the 3-month follow up in comparison to the Attention Placebo Control condition the Mindfulness-Based Cognitive Therapy (MBCT) group had significant reductions in pain intensity, pain interference, pain reappraisal, and pain focus, and significant increases in pain openness. The reductions in pain interference and pain focus, and the increases in pain openness continued to improve from the end of training to the 3-month follow up.
These results suggest that Mindfulness-Based Cognitive Therapy (MBCT) is a safe, effective, and lasting treatment for primary headache, reducing pain and its interference in the daily activities of the patients. In addition, the results suggest that MBCT produces changes in the cognitive responses to the headache pain. It reduces pain focus suggesting that the patients pay less attention to the headache pain allowing them to attend to other aspects of their lives. It also increases the openness to pain such that they allow the pain to occur without fighting against it which can increase the pain. So, the study suggests that MBCT reduce primary headache symptoms and does so by improving the ways in which the patients think about and react to the pain.
So, improve headache pain with mindfulness.
“Mindfulness for Migraine is effective because it teaches the sympathetic nervous system to let go rather than running on fight-or-flight mode. This deep, internal relaxation of the nervous system fosters healing and helps protect the body from a Migraine attack.” – Susan Dawson Cook
CMCS – Center for Mindfulness and Contemplative Studies
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Namjoo, S., Borjali, A., Seirafi, M., & Assarzadegan, F. (2019). Use of Mindfulness-based Cognitive Therapy to Change Pain-related Cognitive Processing in Patients with Primary Headache: A Randomized Trial with Attention Placebo Control Group. Anesthesiology and pain medicine, 9(5), e91927. doi:10.5812/aapm.91927
Mindfulness-based interventions have shown to be efficient in managing chronic pain. Cognitive factors play a prominent role in chronic pain complications and negative cognitive contents about pain are often the first issues targeted in cognitive-based therapies, which are known as first-line treatment of chronic pain over the past decades. Little, however, is known about the manner of thinking about pain or pain-related cognitive processing.
Therefore, the purpose of this study was to investigate the effect of mindfulness-based cognitive therapy (MBCT) on pain-related cognitive processing and control of chronic pain in patients with primary headache.
A clinical trial was conducted in 2017 – 2018 on 85 Persian language patients with one type of primary headache selected through purposive sampling in Emam Hossein Hospital in Tehran province. To measure the variables of the study, we used the Brief Pain Inventory (BPI) and Pain-related Cognitive Processing Questionnaire (PCPQ). All data were analyzed by independent t-test and chi-square and longitudinal data were analyzed using linear mixed model analysis.
Statistically significant time × group interactions were found in pain intensity (P < 0.001), pain interference (P < 0.001), as well as in three cognitive processing subscales including pain focus, pain distancing, and pain openness (P < 0.001). However, the results of pain diversion were not meaningful.
MBCT is a potentially efficacious approach for individuals with headache pain. Regulation and correction of cognitive processing are considered as effective cognitive coping strategies in MBCT treatment.