ACT to Improve Psychological Flexibility and Chronic Pain

September 30, 2016 psyjdc Leave a comment

By John M. de Castro, Ph.D.

“Hence, the ultimate goal of ACT is not to reduce symptoms or pain (although other simultaneous therapies may well be aimed at achieving this). Instead, its goal is to improve functioning by increasing psychological flexibility and the ability to act according to personal values, even in the presence of negative experiences, like pain.” – Painfocus

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. Fortunately, there are alternative treatments. Mindfulness and yoga practices have been shown to improve pain. A therapeutic technique that includes mindfulness training called Acceptance and Commitment Therapy (ACT) has been shown to be effective in treating a number of physical and psychological disorders and has been shown to successfully improve acceptance of chronic pain, pain intensity, satisfaction with life, and physical functioning in patients with chronic pain.

Acceptance and Commitment Therapy (ACT) is a mindfulness based psychotherapy technique that focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. Additionally, it teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes. At its core, ACT is targeted at increasing psychological flexibility, which is an ability to modify behavior based upon conscious and open contact with thoughts, feelings, and sensory experiences, and in a manner that reflects the individual’s values and goals.

In today’s Research News article “A Comprehensive Examination of Changes in Psychological Flexibility Following Acceptance and Commitment Therapy for Chronic Pain.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1336953456328577/?type=3&theater

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

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4917588/

Scott and colleagues examine the relationship of changes in psychological flexibility to improvements in chronic pain produced by Acceptance and Commitment Therapy (ACT). They recruited patients who suffered from chronic pain of various types, with lower back pain the most common (43%). They were treated 4 days per week for four weeks with a group based ACT therapy. Before and after treatment they were measured for pain intensity, pain acceptance, daily functioning, depression, cognitive fusion, decentering, and goal directed activity.

They found that ACT was quite effective in improving chronic pain symptoms. It produced a large significant improvement in depression, moderate improvements in pain intensity, physical and social functioning, and chronic pain acceptance, and small improvements in goal directed activity and decentering. They further found that the processes of psychological flexibility, including chronic pain acceptance, cognitive fusion, and goal directed activity significantly predicted the magnitude of the improvements in the chronic pain symptoms. Hence, it appears that ACT increases psychological flexibility and as a result improves chronic pain.

It is important to identify how a particular therapy has its effects upon the disorder. This allows for improvements in the techniques and maximization of its effects. The fact that psychological flexibility was the key change produced by ACT suggests that future efforts should be to modify ACT to maximize its impact on psychological flexibility.

So, ACT to improve psychological flexibility and chronic pain.

“Mindfulness teaches people with chronic pain to be curious about the intensity of their pain, instead of letting their minds jump into thoughts like “This is awful.” It also teaches individuals to let go of goals and expectations. When you expect something will ease your pain, and it doesn’t or not as much as you’d like, your mind goes into alarm- or solution-mode. You start thinking thoughts like “nothing ever works.” “What we want to do as best as we can is to engage with the pain just as it is.” It’s not about achieving a certain goal – like minimizing pain – but learning to relate to your pain differently.” – Elisha Goldstein

CMCS – Center for Mindfulness and Contemplative Studies

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

Study Summary

Scott, W., Hann, K. E. J., & McCracken, L. M. (2016). A Comprehensive Examination of Changes in Psychological Flexibility Following Acceptance and Commitment Therapy for Chronic Pain. Journal of Contemporary Psychotherapy, 46, 139–148. http://doi.org/10.1007/s10879-016-9328-5

Abstract

Acceptance and commitment therapy (ACT) for chronic pain aims to improve patient functioning by fostering greater psychological flexibility. While promising, ACT treatment process research in the context of chronic pain so far has only focused on a few of the processes of psychological flexibility. Therefore, this study aimed to more comprehensively examine changes in processes of psychological flexibility following an ACT-based treatment for chronic pain, and to examine change in these processes in relation to improvements in patient functioning. Individuals with chronic pain attending an interdisciplinary ACT-based rehabilitation program completed measures of pain, functioning, depression, pain acceptance, cognitive fusion, decentering, and committed action at pre- and post-treatment and during a nine-month follow-up. Significant improvements were observed from pre- to post-treatment and pre-treatment to follow-up on each of the treatment outcome and process variables. Regression analyses indicated that change in psychological flexibility processes cumulatively explained 6–27 % of the variance in changes in functioning and depression over both assessment periods, even after controlling for changes in pain intensity. Further research is needed to maximize the effectiveness of ACT for chronic pain, and to determine whether larger improvements in the processes of psychological flexibility under study will produce better patient outcomes, as predicted by the psychological flexibility model.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4917588/

Improve Bladder Problems with Mindfulness

September 6, 2016September 6, 2016 psyjdc Leave a comment

By John M. de Castro, Ph.D.

“Good news: You may be able to ease your bladder discomfort and Overactive Bladder Symptoms by tapping into mind-body techniques such as meditation. Slowing your breathing calms your autonomic nervous system, which slows your heart rate and can decrease spasms of the bladder.” – Karen Sebastian

Interstitial cystitis/bladder pain syndrome (IC/PBS) involves recurring discomfort or pain in the bladder and the surrounding pelvic region, including mild discomfort, pressure, tenderness, or intense pain in the bladder and pelvic area and/or an urgent and frequent need to urinate. There are an estimated 3.3 million adult U.S. women, or 2.7 percent, and 1.6 million adult U.S. men, or 1.3 percent who suffer from IC/PBS. The causes of IC/PBS are unknown and the current treatments employed are aimed at relieving symptoms. These include drugs, diet, exercise, bladder training, physical therapy, bladder washing and distension, and even surgery. These treatments have varying effectiveness and may become ineffective over time. So, there is a need to develop other treatments for IC/PBS.

Mindfulness training, including Mindfulness-Based Stress Reduction (MBSR) have been repeatedly shown to be safe and effective treatments for a variety of painful conditions. In today’s Research News article “Mindfulness-based stress reduction as a novel treatment for interstitial cystitis/bladder pain syndrome: a randomized controlled trial” (See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1315503701806886/?type=3&theater

or see summary below), Kanter and colleagues randomly assigned female patients with interstitial cystitis/bladder pain syndrome (IC/PBS) to either receive treatment as usual or an 8-week Mindfulness-Based Stress Reduction (MBSR) program. MBSR is taught in 2-hour weekly sessions with home practice encouraged. It is a combination of training in body scan, meditation, and yoga. Prior to and after the 8-week treatment period the patients were assessed with measures of Global Response Assessment, symptom assessment, pain, pain coping ability, quality of life, sexual function.

They found that MBSR in comparison to treatment as usual produced significant improvements of 28% with IC/PBS symptoms, including a 22% improvement in total symptoms and a 38% improvement in symptom problems and of 25% with pain coping ability. Hence, MBSR was found to be effective in reducing the symptoms of interstitial cystitis/bladder pain syndrome (IC/PBS) and to improve the patient’s ability to cope with the pain. This may well have occurred because of mindfulness training’s proven ability to reduce the psychological and physiological responses to stress. This would in turn, reduce stress induced symptom exacerbation. MBSR training did not reduce pain per se. Instead, because of the development of focus on the present moment, it improves the ability of patients to cope with the pain, making it less disruptive in their lives. Mindfulness has been shown to reduce catastrophizing, worry and rumination. So, it decreases the patient’s responses that amplify the pain. All in all, MBSR training would appear to be a viable treatment for interstitial cystitis/bladder pain syndrome (IC/PBS).

Because the Mindfulness-Based Stress Reduction (MBSR) program is a complex treatment that includes body scan, meditation, and yoga, it is impossible to assess which components or combination of components were responsible for its’ effectiveness. Future research, perhaps a component analysis design, is needed to determine what parts of the MBSR program are responsible for the effects.

So, improve bladder problems with mindfulness.

“Being mindful is about being in the present, and the conscious choice to experience your life in the present moment. Being mindful may be able to help you associate overactive bladder as just another function of the body.” – Urology Experts

CMCS – Center for Mindfulness and Contemplative Studies

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

Study Summary

Kanter G, Komesu YM, Qaedan F, Jeppson PC, Dunivan GC, Cichowski SB, Rogers RG Mindfulness-based stress reduction as a novel treatment for interstitial cystitis/bladder pain syndrome: a randomized controlled trial. Int Urogynecol J (2016). doi:10.1007/s00192-016-3022-8

Abstract

INTRODUCTION AND HYPOTHESIS: Mindfulness-based stress reduction (MBSR) is a standardized meditation program that may be an effective therapy for interstitial cystitis/bladder pain syndrome (IC/BPS), a condition exacerbated by stress. The aims of this study were to explore whether MBSR improved IC/BPS symptoms and the feasibility/acceptability of MSBR among women with IC/BPS.

METHODS: This randomized controlled trial included women with IC/BPS undergoing first- or second-line therapies. Women were randomized to continuation of usual care (UC) or an 8-week MBSR class + usual care (MBSR). Participants completed baseline and 8-week post-treatment questionnaires, including the O’Leary-Sant Symptom Problem Index (OSPI), the visual analog pain scale (VAS), the Short Form Health Survey (SF-12), the Female Sexual Function Index (FSFI), and the Pain Self-Efficacy Questionnaire (PSEQ). The Global Response Assessment (GRA) was completed post-treatment. Analyses were performed using Student’s t test, Chi-squared, and MANOVA where appropriate.

RESULTS: Eleven women were randomized to UC and 9 to MBSR, without differences in group characteristics. More MBSR participants’ symptoms were improved on the GRA (7 out of 8 [87.5 %] vs 4 out of 11 [36.4 %], p = 0.03). The MBSR group showed greater improvement in the OSPI total (p = 0.0498) and problem scores (p = 0.036); the OSPI symptom score change did not differ. PSEQ scores improved in MBSR compared with UC (p = 0.035). VAS, SF-12, and FSFI change did not differ between groups. Eighty-six percent of MBSR participants felt more empowered to control symptoms, and all participants planned to continue MBSR.

CONCLUSIONS: This trial provides initial evidence that MBSR is a promising adjunctive therapy for IC/BPS. Its benefit may arise from patients’ empowerment and ability to cope with symptoms.

Improve Body Awareness and Reduce Depression Due to Pain with Mindfulness

August 29, 2016 psyjdc Leave a comment

By John M. de Castro, Ph.D.

“People at risk for depression are dealing with a lot of negative thoughts, feelings and beliefs about themselves and this can easily slide into a depressive relapse. MBCT helps them to recognize that’s happening, engage with it in a different way and respond to it with equanimity and compassion.” – Willem Kuyken

We all have to deal with pain. It’s inevitable, but hopefully mild and short lived. But, for a wide swath of humanity pain is a constant in their lives. At least 100 million adult Americans have chronic pain conditions. Chronic pain accompanies a number of conditions. The most common form of chronic pain is low back pain affecting between 6% to 15% of the population. Osteoarthritis is a chronic degenerative joint disease that is the most common form of arthritis. It produces pain, swelling, and stiffness of the joints. In the U.S., osteoarthritis affects 14% of adults over 25 years of age and 34% of those over 65. Fibromyalgia is a mysterious disorder whose causes are unknown. It is characterized by widespread pain, abnormal pain processing, sleep disturbance, and fatigue that lead to psychological distress. It is very common affecting over 5 million people in the U.S., about 2% of the population.

Pain involves both physical and psychological issues. Indeed, people with chronic pain are much more likely to become depressed and people with depression are much more likely to develop chronic pain. Mindfulness practices have been shown to be safe and beneficial in pain management and to reduce depression. But, how mindfulness training may reduce the depression accompanying chronic pain is not known. Mindfulness is known to improve the awareness of the sensations from the body. It is possible then that the reduction of depression about pain is produced by making the patient more aware of their bodies and thus better able to respond to any aversive states in the body.

In today’s Research News article “Effects of Mindfulness-Based Cognitive Therapy on Body Awareness in Patients with Chronic Pain and Comorbid Depression.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1308036735886916/?type=3&theater

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

http://journal.frontiersin.org/article/10.3389/fpsyg.2016.00967/full

de Jong and colleagues recruited chronic pain patients with depression and randomly assigned them to receive either an 8-week Mindfulness-Based Cognitive Therapy (MBCT) plus the normal treatment provided to these patients or to receive only treatment as usual. They were measured for body awareness, pain catastrophizing, and depression before, during, and after the 8 weeks of treatment.

They found that the MBCT group had reduced depression and increased body awareness, especially in self-distracting and self-regulation. “Not-Distracting refers to not ignoring or distracting oneself from uncomfortable body sensations such as pain. Self-Regulation refers to the ability to control psychological distress by consciously attending to body sensations.” Hence MBCT significantly improved the chronic pain patient’s ability to control their pain by paying attention to it. Using a sophisticated statistical technique of mediation analysis, they were able to determine that the effects of mindfulness on depression were completely mediated by its effect on body awareness.

These results are interesting and important. It is well established that mindfulness training and MBCT in particular are very effective in reducing depression. The present findings, though, demonstrate that its ability to reduce the depression produced by chronic pain is due to improved body awareness. This may seem counterintuitive that increasing the awareness of body pain would improve the depression produced by the pain. But, denying pain by ignoring it or by distracting oneself from it doesn’t work and actually increases its pain’s impact by increasing worry and rumination. Directly addressing the pain and seeing it as it is, makes it easier to cope with it.

So, improve body awareness and reduce depression due to pain with mindfulness.

“MBCT helps participants learn how to recognize their sense of being and see themselves as separate from their thoughts and moods. This disconnect can allow people to become liberated from thought patterns in which the same negative messages may be replayed over and over. . . . In general, MBCT attempts to give participants the necessary tools to combat depressive symptoms as they arise. People who learn these skills may then be able to revert to these methods in times of distress or when faced with potentially overwhelming situations.” – Goodtherapy.org

CMCS – Center for Mindfulness and Contemplative Studies

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

Study Summary

de Jong M, Lazar SW, Hug K, Mehling WE, Hölzel BK, Sack AT, Peeters F, Ashih H, Mischoulon D and Gard T (2016) Effects of Mindfulness-Based Cognitive Therapy on Body Awareness in Patients with Chronic Pain and Comorbid Depression. Front. Psychol. 7:967. doi: 10.3389/fpsyg.2016.00967

Abstract

Body awareness has been proposed as one of the major mechanisms of mindfulness interventions, and it has been shown that chronic pain and depression are associated with decreased levels of body awareness. We investigated the effect of Mindfulness-Based Cognitive Therapy (MBCT) on body awareness in patients with chronic pain and comorbid active depression compared to treatment as usual (TAU; N = 31). Body awareness was measured by a subset of the Multidimensional Assessment of Interoceptive Awareness (MAIA) scales deemed most relevant for the population. These included: Noticing, Not-Distracting, Attention Regulation, Emotional Awareness, and Self-Regulation. In addition, pain catastrophizing was measured by the Pain Catastrophizing Scale (PCS). These scales had adequate to high internal consistency in the current sample. Depression severity was measured by the Quick Inventory of Depressive Symptomatology-Clinician rated (QIDS-C16). Increases in the MBCT group were significantly greater than in the TAU group on the “Self-Regulation” and “Not Distracting” scales. Furthermore, the positive effect of MBCT on depression severity was mediated by “Not Distracting.” These findings provide preliminary evidence that a mindfulness-based intervention may increase facets of body awareness as assessed with the MAIA in a population of pain patients with depression. Furthermore, they are consistent with a long hypothesized mechanism for mindfulness and emphasize the clinical relevance of body awareness.

http://journal.frontiersin.org/article/10.3389/fpsyg.2016.00967/full

Alter the Brain for Better Pain Management with Meditation

August 19, 2016September 5, 2020 psyjdc Leave a comment

By John M. de Castro, Ph.D.

“For some people with chronic pain, mindful meditation is an appealing pain management option because it has an unusual benefit; it is something that you personally control. Unlike pain medications or medical procedures, meditation is not done to you, it is something you can do for yourself.” – Stephanie Burke

Pain can be difficult to deal with, particularly if it’s persistent. But, even short-term pain, acute pain, is unpleasant. Pain, however, 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. Nevertheless, it would be useful to find ways to lower the intensity of perceived pain and improve recovery from painful stimuli.

Pain signals are processed in the brain and the state of the brain can alter the perception of pain. Indeed, pain is affected by the mind. The perception of pain can be amplified by the emotional reactions to it and also by attempts to fight or counteract it. On the other hand, pain perception can also be reduced by mental states. Indeed, contemplative practices have been shown to reduce both chronic and acute pain. These changes are reflected in the underlying processing of the pain signals in the nervous system. This suggests that mindfulness training produces long-lasting alterations of the neural circuits underlying pain processing.

In today’s Research News article “Altered Neural Activity Associated with Mindfulness during Nociception: A Systematic Review of Functional MRI.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1299302553427001/?type=3&theater

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

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4931491/

Bilevicius and colleagues review the published research literature on the neural circuits involved in mindfulness’ alterations of perceived pain. In these studies, it was routinely reported that mindfulness produced a reduction in the anticipation of pain and pain unpleasantness. There were mixed findings in regard to whether the intensity of pain was reduced or not. Regardless, mindfulness appears to reduce unpleasantness without blocking the actual perception of pain.

They then looked at the reported effects of mindfulness training on brain activity as measured with functional Magnetic Resonance Imagery (fMRI). The published studies reported consistently that mindfulness training increased the activity of two key areas in pain processing, the Insula and the Anterior Cingulate Cortex in response to pain signals. On the other hand, mindfulness training produced decreased activity in response to pain in the Lateral Prefrontal Cortex. The ACC and the Insula are involved in processing stimuli originating in the present moment and their increased activity suggests that the mindfulness training altered the neural circuits involved in present moment awareness of pain signals. The Lateral Prefrontal Cortex, on the other hand, is associated with the awareness, cognitive processing, of pain. This suggests that mindfulness training produces a reduction in the thinking about pain.

These results suggest that mindfulness training produces lasting changes to the nervous system, sometimes called neuroplasticity. These changes altered the usual processing of pain signals. Although, the pain signals occurring in the present moment are heightened, they have less of an impact upon awareness and cognitive appreciation of pain. Mindfulness training, then appears to produce long-lasting changes in the brain that allow pain signals to be processed but reduce the psychological responses to pain, making it less unpleasant. The individual then can respond adaptively to the pain but not suffer as much.

So, alter the brain for better pain management with meditation.

“Imaging studies show that mindfulness soothes the brain patterns underlying pain and, over time, these changes take root and alter the structure of the brain itself, so that patients no longer feel pain with the same intensity. Many say that they barely notice it at all.” – Danny Penman

CMCS – Center for Mindfulness and Contemplative Studies

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

Study Summary

Bilevicius, E., Kolesar, T. A., & Kornelsen, J. (2016). Altered Neural Activity Associated with Mindfulness during Nociception: A Systematic Review of Functional MRI. Brain Sciences, 6(2), 14. http://doi.org/10.3390/brainsci6020014

Abstract

Objective: To assess the neural activity associated with mindfulness-based alterations of pain perception. Methods: The Cochrane Central, EMBASE, Ovid Medline, PsycINFO, Scopus, and Web of Science databases were searched on 2 February 2016. Titles, abstracts, and full-text articles were independently screened by two reviewers. Data were independently extracted from records that included topics of functional neuroimaging, pain, and mindfulness interventions. Results: The literature search produced 946 total records, of which five met the inclusion criteria. Records reported pain in terms of anticipation (n = 2), unpleasantness (n = 5), and intensity (n = 5), and how mindfulness conditions altered the neural activity during noxious stimulation accordingly. Conclusions: Although the studies were inconsistent in relating pain components to neural activity, in general, mindfulness was able to reduce pain anticipation and unpleasantness ratings, as well as alter the corresponding neural activity. The major neural underpinnings of mindfulness-based pain reduction consisted of altered activity in the anterior cingulate cortex, insula, and dorsolateral prefrontal cortex.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4931491/

Reduce Chronic Pain with Mindfulness

August 16, 2016 psyjdc Leave a comment

By John M. de Castro, Ph.D.

“If you move into pure awareness in the midst of pain, even for the tiniest moment, your relationship with your pain is going to shift right in that very moment. It is impossible for it not to change because the gesture of holding it, even if not sustained for long, even for a second or two, already reveals its larger dimensionality.” – Jon Kabat-Zinn

We all have to deal with pain. It’s inevitable, but hopefully mild and short lived. For many, however, pain is a constant in their lives. Chronic pain affects a wide swath of humanity. At least 100 million adult Americans have common chronic pain conditions. It affects more Americans than diabetes, heart disease and cancer combined. Chronic pain accompanies a number of conditions. The most common form is low back pain affecting between 6% to 15% of the population. Osteoarthritis is a chronic degenerative joint disease that is the most common form of arthritis. It produces pain, swelling, and stiffness of the joints. In the U.S., osteoarthritis affects 14% of adults over 25 years of age and 34% of those over 65. Fibromyalgia is a mysterious disorder whose causes are unknown. It is characterized by widespread pain, abnormal pain processing, sleep disturbance, and fatigue that lead to psychological distress. It is very common affecting over 5 million people in the U.S., about 2% of the population.

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. Fortunately, there are alternative treatments. Mindfulness and Yoga have been shown to specifically improve back pain and mind-body practices in general have been shown to reduce the gene expressions that underlie the inflammatory response which contribute to arthritis. So, it would seem reasonable to look further into the effectiveness of alternative and complementary practices in treating chronic pain.

In today’s Research News article “Does mindfulness improve outcomes in patients with chronic pain? Systematic review and meta-analysis.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1296780620345861/?type=3&theater

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1296780620345861/?type=3&theateror see summary below or view the full text of the study at:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4439829/

Bawa and colleagues review the published research literature on the use of mindfulness training to treat chronic pain. Most of the studies reviewed used either Mindfulness-based Stress Reduction (MBSR) or Mindfulness-based Cognitive Therapy (MBCT) programs. They found that the published literature reported that mindfulness practices in general produced a small but significant reduction in pain, depression, and anxiety and an increase in sleep quality. They also found moderate significant improvements in physical functioning, physical and psychological quality of life. Large significant effects of mindfulness training were reported for pain acceptance and perceived pain. Hence, the published literature reports many beneficial effects of mindfulness training for chronic pain. The largest effects were for the psychological aspects of pain, but, also for the physical aspects of pain, albeit smaller effects.

There are a number of effects of mindfulness training that might underlie these improvements in chronic pain. 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 reduce stress responses and anxiety, and to improve emotion regulation producing more adaptive and less maladaptive responses to emotions. So, it would seem reasonable that mindfulness practices would be helpful in pain management. In addition, pain is accompanied by, and frequently caused by, inflammation and mindfulness training has been shown to reduce the inflammatory response. This may account for the mindfulness’ effects on the physical aspects of chronic pain.

These are exciting findings that non-drug treatments can be effective for chronic pain. They are effective and importantly, safe. So, reduce chronic pain with mindfulness.

“a regular meditation practice is the best ongoing foundation for working with pain. Mindfulness practice is a wonderful opportunity to do just that. It helps to shift the locus of control from the outside (“this is happening to me and there is nothing I can do about it”) to the inside (“this is happening to me but I can choose how I relate to it”).” – Christiane Wolf

CMCS – Center for Mindfulness and Contemplative Studies

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

Study Summary

Bawa, F. L. M., Mercer, S. W., Atherton, R. J., Clague, F., Keen, A., Scott, N. W., & Bond, C. M. (2015). Does mindfulness improve outcomes in patients with chronic pain? Systematic review and meta-analysis. The British Journal of General Practice, 65(635), e387–e400. http://doi.org/10.3399/bjgp15X685297

Abstract

Background: Chronic pain and its associated distress and disability are common reasons for seeking medical help. Patients with chronic pain use primary healthcare services five times more than the rest of the population. Mindfulness has become an increasingly popular self-management technique.

Aim: To assess the effectiveness of mindfulness-based interventions for patients with chronic pain.

Design and setting: Systematic review and meta-analysis including randomised controlled trials of mindfulness-based interventions for chronic pain. There was no restriction to study site or setting.

Method: The databases MEDLINE®, Embase, AMED, CINAHL, PsycINFO, and Index to Theses were searched. Titles, abstracts, and full texts were screened iteratively against inclusion criteria of: randomised controlled trials of mindfulness-based intervention; patients with non-malignant chronic pain; and economic, clinical, or humanistic outcome reported. Included studies were assessed with the Yates Quality Rating Scale. Meta-analysis was conducted.

Results: Eleven studies were included. Chronic pain conditions included: fibromyalgia, rheumatoid arthritis, chronic musculoskeletal pain, failed back surgery syndrome, and mixed aetiology. Papers were of mixed methodological quality. Main outcomes reported were pain intensity, depression, physical functioning, quality of life, pain acceptance, and mindfulness. Economic outcomes were rarely reported. Meta-analysis effect sizes for clinical outcomes ranged from 0.12 (95% confidence interval [CI] = −0.05 to 0.30) (depression) to 1.32 (95% CI = −1.19 to 3.82) (sleep quality), and for humanistic outcomes 0.03 (95% CI = −0.66 to 0.72) (mindfulness) to 1.58 (95% CI = −0.57 to 3.74) (pain acceptance). Studies with active, compared with inactive, control groups showed smaller effects.

Conclusion: There is limited evidence for effectiveness of mindfulness-based interventions for patients with chronic pain. Better-quality studies are required.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4439829/

Improve Physical Rehabilitation with Mindfulness

August 1, 2016 psyjdc Leave a comment

By John M. de Castro, Ph.D.

“When it comes to chronic pain, the key is learning to live with it rather than vainly trying to avoid or eradicate it. Mindfulness practice is a wonderful opportunity to do just that. It helps to shift the locus of control from the outside (“this is happening to me and there is nothing I can do about it”) to the inside (“this is happening to me but I can choose how I relate to it”).” – Christiane Wolf

Mindfulness practices have been shown to be effective in promoting physical and psychological health. As a result of mindfulness’ ability to reduce the physiological and psychological responses to stress these practices have been found to be helpful in treating a number of medical disorders. In addition, because of mindfulness’ ability to improve emotion regulation and reduce worry and rumination these practices have been found to be helpful in treating a number of psychological disorders. There is such a wide variety of benefits that the application of mindfulness training is being explored for an ever expanding list of conditions.

In today’s Research News article “Mindfulness Interventions in Physical Rehabilitation: A Scoping Review.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1284023361621587/?type=3&theater

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

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4834757/

Hardison and colleagues examine the effectiveness of mindfulness training in assisting rehabilitation from a variety of physical disorders. To do this, they reviewed the published research literature on the effects of mindfulness training on recovery from any illness, injury, or disability of the neurological, musculoskeletal, or other body system that could be treated within a medical or rehabilitation setting. A number of different mindfulness practices were employed in the studies including Mindfulness-Based Stress Reduction (MBSR), Acceptance and Commitment Therapy, and General Mindfulness.

They found that, in general the literature reported that mindfulness training was effective in treating musculoskeletal and pain disorders such as chronic musculoskeletal pain, work-related musculoskeletal injury, and knee surgery. These studies reported mixed results regarding mindfulness training effects on reducing the pain accompanying these disorders, but they routinely found that mindfulness produced significant improvements in acceptance of pain and functioning with pain, and reduced distress. They also found that, in general the published research found that mindfulness training was effective in treating recovery from traumatic brain injury (TBI). Mindfulness training improved the patients’ cognitive functioning, physical health, self-efficacy, quality of life, vitality, emotionality and mental health and reduced the distress produced by the TBI symptoms.

These results are potentially very important and suggest that mindfulness training is effective in improving the process of rehabilitation from a number of musculoskeletal and pain disorders and traumatic brain injury. This adds to the already extensive list of applications of mindfulness training to assist in prevention and recovery from medical disorders. It is not known exactly what effects of mindfulness training might be responsible for these benefits. But, it is reasonable to speculate that improvements in stress responses, emotion regulation, and worry and rumination are involved.

So, the published research literature suggests that mindfulness training should be included in the interventions recommended for rehabilitation from physical disorders.

“From the broadest vantage point, mindful clinical practice holds possibilities when used in conjunction with other strategies. It helps patients to take a step back, assess their experiences and move toward compassionate self-care. We owe it to our patients to help them discover their own pockets of rest, relief and comfort.” – Reji Mathew

CMCS – Center for Mindfulness and Contemplative Studies

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

Study Summary

Hardison, M. E., & Roll, S. C. (2016). Mindfulness Interventions in Physical Rehabilitation: A Scoping Review. The American Journal of Occupational Therapy, 70(3), 7003290030p1–7003290030p9. http://doi.org/10.5014/ajot.2016.018069

Abstract

A scoping review was conducted to describe how mindfulness is used in physical rehabilitation, identify implications for occupational therapy practice, and guide future research on clinical mindfulness interventions. A systematic search of four literature databases produced 1,524 original abstracts, of which 16 articles were included. Although only 3 Level I or II studies were identified, the literature included suggests that mindfulness interventions are helpful for patients with musculoskeletal and chronic pain disorders and demonstrate trends toward outcome improvements for patients with neurocognitive and neuromotor disorders. Only 2 studies included an occupational therapist as the primary mindfulness provider, but all mindfulness interventions in the selected studies fit within the occupational therapy scope of practice according to the American Occupational Therapy Association’s Occupational Therapy Practice Framework: Domain and Process. Higher-level research is needed to evaluate the effects of mindfulness interventions in physical rehabilitation and to determine best practices for the use of mindfulness by occupational therapy practitioners.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4834757/

Improve Arthritis Depression, Pain, and Disability with Mindfulness

July 23, 2016 psyjdc Leave a comment

By John M. de Castro, Ph.D.

“People in pain often react automatically to [what’s going on]. “You think I feel pain, and then the body tightens and you have a flurry of other thoughts like Pain is ruining my life. Mindfulness allows you to notice this distress as it happens and to intentionally step back, shifting awareness to the body and adjusting it in a way that can bring ease.” – Steven Rosenzweig

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. It is associated with aging as arthritis occurs in only 7% of adults ages 18–44, while 30% adults ages 45–64 are affected, and 50% of adults ages 65 or older. Due to complications associated with arthritis, the lifespan for people with RA may be shortened by 10 years.

The pain, stiffness, and lack of mobility associate with arthritis produce fatigue and markedly reduce the quality of life of the sufferers. It 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. It even affects the individual’s physical appearance. As the quality of life deteriorates the individual can feel a loss of control and become anxious about the future. Stress can build and influence the individual’s attitude toward life and can lead to frustration, anger, and hopelessness. The physical disability produced by arthritis, reduces the individual’s ability to function at work and may require modifications of work activities. This can lead to financial difficulties. The normal chores at home may take much longer to accomplish and the individual may need the help of a relative or caregiver. Hence, it can produce stress on the entire family system.

There are no cures for arthritis. Treatments are primarily symptomatic, including weight loss, exercise, braces, pain relievers, anti-inflammatory drugs, and corticosteroids. Recently, mindfulness practices have been found to be effective in coping with the symptoms of arthritis. In today’s Research News article “Chronic pain experience on depression and physical disability: The importance of acceptance and mindfulness-based processes in a sample with rheumatoid arthritis.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1277531588937431/?type=3&theater

or below, Costa and colleagues studied the relationship between mindfulness, acceptance, disability, and depression in adult rheumatoid arthritis sufferers. They measure them for mindfulness, pain, pain acceptance, health impact of arthritis, depression, anxiety, and stress.

They found, not surprisingly, that the greater the level of pain the greater the levels of disability and depression. Higher levels of both mindfulness, especially the non-reacting facet of mindfulness, and acceptance were found to be associated with lower levels of pain, disability and depression. Performing a mediational analysis, Costa and colleagues found that the effects of pain on depression were reduced by both acceptance and non-reacting while pain’s effects on disability was reduced by only acceptance.

The results show that being non-reactinge and accepting of experience were associated with lower levels of arthritis symptoms, with acceptance associated with lower levels of both depression and physical disability and mindful non-reacting to experience associated with lower levels of depression. Depression is amplified by rumination about past pain and worry about future pain. Mindfulness focuses the individual on the present moment and thereby reduces worry and rumination. This, to some extent explains, mindfulness’ association with lower depression. Accepting the situation is also important for pain management, as fighting against pain amplifies the pain. As a result, acceptance can reduce attempts to control the pain and thereby reduce the experience of pain and the resultant symptoms of depression and physical disability.

So, improve arthritis depression, pain, and disability with mindfulness and acceptance.

“mindfulness training, which teaches people to push away troublesome thoughts, helped improve well-being in people with rheumatoid arthritis and similar diseases. Patients . . . who received the training didn’t have less pain compared to those who didn’t, but they coped better, were less tired and showed less stress. “Yes, they still have pain, but they are able to manage their pain in more constructive ways,” – Randy Dotinga

CMCS – Center for Mindfulness and Contemplative Studies

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

Study Summary

Joana Costa, José Pinto-Gouveia, and João Marôco. Chronic pain experience on depression and physical disability: The importance of acceptance and mindfulness-based processes in a sample with rheumatoid arthritis. J Health Psychol, 1359105316649785, first published on June 15, 2016

Abstract

The mediating effect of acceptance and mindfulness in the relationship between pain, depression, and physical disability was examined in 55 rheumatoid arthritis patients. Results showed that the relationship between pain and depression was mediated by both nonreact and acceptance. By contrast, the relationship between pain and physical disability was mediated by acceptance but not by nonreact. This study provides evidences that the influence of these processes is different on depression and on physical disability. These findings support models that take both general measures of mindfulness and content-specific measures of acceptance into account when conceptualizing rheumatoid arthritis. Theoretical and clinical implications are discussed.

ACT for Chronic Pain

July 19, 2016 psyjdc 2 Comments

By John M. de Castro, Ph.D.

“meditation practice is the best ongoing foundation for working with pain: Mindfulness practice is a wonderful opportunity to do just that. It helps to shift the locus of control from the outside (“this is happening to me and there is nothing I can do about it”) to the inside (“this is happening to me but I can choose how I relate to it”).” – Christiane Wolf

Acceptance and Commitment Therapy (ACT) has been shown to be effective in treating a number of physical and psychological disorders. Acceptance and Commitment Therapy (ACT) is a mindfulness based psychotherapy technique that focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. Additionally, it teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes.

In today’s Research News article “Acceptance as a Mediator for Change in Acceptance and Commitment Therapy for Persons with Chronic Pain?” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1274906459199944/?type=3&theater

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

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4748004/

Cederberg and colleagues investigate the effectiveness of Acceptance and Commitment Therapy (ACT) in the treatment of chronic pain and to identify potential intermediaries; factors that are altered by ACT that are responsible for improved pain tolerance. They randomly assigned chronic pain patients to either receive ACT or relaxation therapy targeted to pain. The patients were measured before after treatment and again 6 and 12 months later for acceptance of chronic pain, pain intensity, satisfaction with life, physical functioning, anxiety, and depression.

They found that the patients receiving ACT had significant improvements in of acceptance of chronic pain, pain intensity, satisfaction with life, and physical functioning, while the relaxation group did not. Both groups showed reductions in anxiety, and depression. These effects were for the most part still present 12 months after the completion of treatment. They performed a sophisticated statistical analysis to identify whether the effects of ACT on acceptance, anxiety, or depression were responsible for the effects on physical functioning and satisfaction with life. They found that acceptance of pain was responsible for ACT’s effects on physical functioning, but not satisfaction with life.

These results are exciting and important demonstrating a mindfulness based treatment, Acceptance and Commitment Therapy (ACT), is effective in improving the ability of chronic pain patients to function and their satisfaction with life, and reducing their pain, anxiety, and depression. They further demonstrate that acceptance of pain is the important variable underlying the improvement in physical functioning. This underlines the importance of acceptance which is a predominant component of ACT. These results strongly suggest that ACT is an excellent, long-lasting, and safe treatment for people suffering with chronic pain.

So, ACT for chronic pain

“This perspective provides a new way to relate to distressing thoughts and emotions so they can be accepted as natural rather than avoided. In a similar way, patients are encouraged to re-engage in previously avoided valued activities¹⁰. Importantly, a therapeutic focus on strategies that reduce avoidance through increased acceptance have proved useful for people with chronic pain.” – Michael Hogan

CMCS – Center for Mindfulness and Contemplative Studies

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

Study Summary

Cederberg, J. T., Cernvall, M., Dahl, J., von Essen, L., & Ljungman, G. (2016). Acceptance as a Mediator for Change in Acceptance and Commitment Therapy for Persons with Chronic Pain? International Journal of Behavioral Medicine, 23, 21–29. http://doi.org/10.1007/s12529-015-9494-y

Abstract

Background: Cognitive behavior therapy (CBT) is considered effective for chronic pain, but little is known about active treatment components. Although acceptance correlates with better health outcomes in chronic pain patients, no study has examined its mediating effect in an experimental design.

Purpose: The aim of the present study is to investigate acceptance as a mediator in acceptance and commitment therapy (ACT), a third wave CBT intervention, for chronic pain.

Method: A bootstrapped cross product of coefficients approach was used on data from a previously published RCT evaluating ACT for chronic pain. To address the specificity of acceptance as a mediator, anxiety and depression were also tested as mediators. Outcome variables were satisfaction with life and physical functioning. Two change scores, pre-assessment to 6-month follow-up (n = 53) and pre-assessment to 12-month follow-up (n = 32), were used.

Results: Acceptance was found to mediate the effect of treatment on change in physical functioning from pre-assessment to follow-up at 6 months. Further, a trend was shown from pre-assessment to follow-up at 12 months. No indirect effect of treatment via acceptance was found for change in satisfaction with life.

Conclusion: This study adds to a small but growing body of research using mediation analysis to investigate mediating factors in the treatment of chronic pain. In summary, the results suggest that acceptance may have a mediating effect on change in physical functioning in ACT for persons with chronic pain. However, given the small sample size of the study, these findings need to be replicated.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4748004/

Improve Low Back Pain with Yoga

July 5, 2016 psyjdc Leave a comment

By John M. de Castro, Ph.D.

“Achy back? Give yoga a go. Multiple studies have shown the power of the ancient practice, which emphasizes stretching, strength, and flexibility, to relieve back soreness. In fact, several studies have found that yoga can even trump usual care for back pain when it comes to improving back function.” – Annie Hauser

Acute pain in all forms is a signal that there is something wrong that needs immediate attention. Chronic pain, on the other hand signals the presence of physical issues that are more difficult to address. Chronic pain is particularly difficult as it is not only a torment but is highly disruptive to the sufferer’s life, decreasing the ability to engage in everyday activities and lowering the quality of life. One source of chronic pain, low back pain, is ubiquitous. It is estimated that 80% of the population will experience back pain sometime during their lives. It is the leading cause of disability worldwide and affects between 6% to 15% of the 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. The 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. Obviously, there is a need for effective treatments for low back pain that are low cost and don’t have troublesome side effects.

Mindfulness training has shown promise in the treatment of a variety of pain conditions, including low back pain. Yoga practice is both a physical and a mindfulness training that under supervised conditions is effective for a variety of physical and psychological conditions, especially musculoskeletal problems including low back pain. There have been a variety of studies of the application of yoga for low back pain but they are highly variable in technique, postures employed, included components of practice, patient groups, and follow-up. So, there is a need for a rigorous review and summarization of these studies to ascertain the overall effectiveness of yoga practice for low back pain.

In today’s Research News article “Yoga as a treatment for chronic low back pain: A systematic review of the literature.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1265126300177960/?type=3&theater

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

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4878447/

Chang and colleagues review and summarize the published research on the application of yoga practice for low back pain. They found that the literature provides documented, scientific, controlled evidence that supports the conclusion that yoga practice when properly administered reduces pain and disability in patients with chronic low back pain. In addition, since postures once learned can be practiced at home, yoga provides a more cost effective long-term for back pain than physical therapy, spinal manipulation, physical therapy, and acupuncture.

These results are very promising and suggest that yoga practice is an excellent treatment for low back pain. Yoga, however, is not without risks. Back pain can be exacerbated and even disc herniation is possible. So, it is important that, at least in its initial stages, yoga practice be administered and supervised by a knowledgeable certified professional. It is important to also recognize that yoga practice has many psychological, physical, and spiritual benefits beyond relief of low back pain. So, yoga should not be evaluated with only one physical issue in mind, but should be looked upon as not only relieving symptoms but also having holistic benefits, improving the practitioner’s health and well-being.

So, improve low back pain with yoga.

“An estimated 84 percent of people may experience low back pain. If you’ve ever felt it yourself, you know that the most basic, daily movements can be challenging. Suddenly sitting, standing, and bending seem like advanced yoga postures. Back pain is actually one of the most common reasons that people visit the doctor. Fortunately, new studies are supporting yoga’s efficacy and many individuals are turning to the practice for help.” – Jennifer Carter Avgerinos

CMCS – Center for Mindfulness and Contemplative Studies

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

Study Summary

Chang, D. G., Holt, J. A., Sklar, M., & Groessl, E. J. (2016). Yoga as a treatment for chronic low back pain: A systematic review of the literature. Journal of Orthopedics & Rheumatology, 3(1), 1–8.

Abstract

Objectives: Chronic low back pain (CLBP) affects millions of people worldwide, and appears to be increasing in prevalence. It is associated not only with pain, but also with increased disability, psychological symptoms, and reduced quality of life. There are various treatment options for CLBP, but no single therapy stands out as being the most effective. In the past 10 years, yoga interventions have been studied as a CLBP treatment approach. The objective of this paper is to review the current literature supporting the efficacy of yoga for CLBP.

Methods: A literature search through the beginning of 2015 was conducted in Pub Med for randomized control trials addressing treatment of CLBP with yoga.

Results: In this review we evaluate the use of yoga as a treatment for CLBP. Specifically we evaluate how yoga impacts physical functioning and disability, pain, and associated psychological symptoms. We also evaluate possible mediators of the effect of yoga and the safety of yoga.

Discussion: With few exceptions, previous studies and the recent randomized control trials (RCTs) indicate that yoga can reduce pain and disability, can be practiced safely, and is well received by participants. Some studies also indicate that yoga may improve psychological symptoms, but these effects are currently not as well established.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4878447/

Relieve Chronic Pain with Tai Chi

June 2, 2016 psyjdc Leave a comment

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

Chronic pain accompanies a number of conditions. The most common form of chronic pain is low back pain affecting between 6% to 15% of the population. Osteoarthritis is a chronic degenerative joint disease that is the most common form of arthritis. It produces pain, swelling, and stiffness of the joints. In the U.S., osteoarthritis affects 14% of adults over 25 years of age and 34% of those over 65. Fibromyalgia is a mysterious disorder whose causes are unknown. It is characterized by widespread pain, abnormal pain processing, sleep disturbance, and fatigue that lead to psychological distress. It is very common affecting over 5 million people in the U.S., about 2% of the population.

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 reduce stress responses and anxiety, and to improve emotion regulation producing more adaptive and less maladaptive responses to emotions. So, it would seem reasonable to project that mindfulness practices would be helpful in pain management. Indeed, these practices have been shown to be safe and beneficial in pain management. Both Yoga and mindfulness has been shown to specifically improve back pain. Gentle movements of the joints with exercise appears to be helpful in the treatment of osteoarthritis. This suggests that alternative and complementary practices that involve gentle movements may be useful for treatment. Indeed, yoga practice has been shown to be effective in treating arthritis and mind-body practices in general have been shown to reduce the gene expressions that underlie the inflammatory response which contribute to arthritis. So, it would seem reasonable to look further into the effectiveness of alternative and complementary practices in treating osteoarthritis.

In today’s Research News article “Tai Chi for Chronic Pain Conditions: A Systematic Review and Meta-analysis of Randomized Controlled Trials.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1242319075792016/?type=3&theater

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

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4850460/

Kong and colleagues review the published research literature on the application of the ancient Chinese practice of Tai Chi, a mindful movement practice, on chronic pain. They found that the practice of Tai Chi reduced chronic pain significantly better than control conditions. These included osteoarthritis pain, low back pain, rheumatoid arthritis, and pain from herpes zoster. The results for fibromyalgia pain were not significant. Hence, they found that tai chi practice was a safe and effective treatment for most forms of chronic pain.

These are excellent results. They’re particularly encouraging as tai chi is a safe and very gentle practice that is applicable for all age groups including the elderly. It can also be practiced anywhere and after some initial instruction, without formal classes. In China it is frequently practiced either alone or in groups in public parks. But, it can also be practiced at home. So, it’s very inexpensive. Its safety, effectiveness, affordability, and convenience make tai chi practice an outstanding choice for the treatment of chronic pain.

So, relieve chronic pain with tai chi.

“Tai Chi is a form of exercise that has recently been gaining popularity as a way to relieve and/or manage back pain and neck pain. It is often easy to associate Tai Chi with groups of people in parks or gyms moving slowly and deliberately in synchronization. These people are using the same Tai Chi principles and movements created in ancient China and still practiced all around the world as a healing exercise.” – Robert Humphreys

CMCS – Center for Mindfulness and Contemplative Studies

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

Study Summary

Kong, L. J., Lauche, R., Klose, P., Bu, J. H., Yang, X. C., Guo, C. Q., … Cheng, Y. W. (2016). Tai Chi for Chronic Pain Conditions: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Scientific Reports, 6, 25325. http://doi.org/10.1038/srep25325

Abstract

Several studies reported that Tai Chi showed potential effects for chronic pain, but its role remains controversial. This review assessed the evidence regarding the effects of Tai Chi for chronic pain conditions. 18 randomized controlled trials were included in our review. The aggregated results have indicated that Tai Chi showed positive evidence on immediate relief of chronic pain from osteoarthritis (standardized mean difference [SMD], −0.54; 95% confidence intervals [CI], −0.77 to −0.30; P < 0.05). The valid duration of Tai Chi practice for osteoarthritis may be more than 5 weeks. And there were some beneficial evidences regarding the effects of Tai Chi on immediate relief of chronic pain from low back pain (SMD, −0.81; 95% CI, −1.11 to −0.52; P < 0.05) and osteoporosis (SMD, −0.83; 95% CI, −1.37 to −0.28; P = 0.003). Therefore, clinicians may consider Tai Chi as a viable complementary and alternative medicine for chronic pain conditions.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4850460/