Pain

Improve Rheumatoid Arthritis Symptoms with Yoga

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Improve Rheumatoid Arthritis Symptoms with Yoga

 

By John M. de Castro, Ph.D.

 

“Many people turn to yoga as a way to exercise gently, as well as to reduce tension and improve joint flexibility. Yoga also can help a person with arthritis build muscle strength and improve balance. In addition, yoga offers people with arthritis a form of exercise that is enjoyable enough to do regularly.” – Susan Bernstein

 

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 rheumatoid arthritis (RA), the lifespan for people with RA may be shortened by 10 years. This is due to a higher incidence of cardiovascular disease in rheumatoid arthritis (RA) patients, with the risk more than double that of non-RA individuals.

 

Obviously, there is a need to explore alternative treatments for rheumatoid arthritis. One possibility is contemplative practice. A variety of which including yoga practice have been shown to have major mental and physical benefits including a reduction in the inflammatory response and have been shown to improve arthritis. It is reasonable to take time to summarize what has been learned regarding the effectiveness of yoga practice for the treatment of rheumatoid arthritis.

 

In today’s Research News article “Yoga for Treating Rheumatoid Arthritis: A Systematic Review and Meta-Analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7732597/ ) Ye and colleagues review, summarize, and perform a meta-analysis of the published randomized controlled trials of the effectiveness of yoga practice for the treatment of rheumatoid arthritis. They identified 10 published trials that included a total of 840 participants.

 

They report that the published studies found that yoga in comparison to controls produced a significant reduction in pain that was equivalent to the effects of drugs. Yoga with additional medication was found to improve physical function and reduce disease activity (swollen joints) to a greater extent than medication alone. Finally, yoga in comparison to controls produced a significant increase in grip strength.

 

The findings of the published research suggest that yoga practice is beneficial for patients with rheumatoid arthritis. It appears to reduce pain and joint swelling and improve physical function and grip strength. No adverse events were reported. Hence, yoga is recommended to patients with rheumatoid arthritis.

 

So, improve rheumatoid arthritis symptoms with yoga.

 

“yoga classes will provide the opportunity to strengthen muscles, improve flexibility, increase your awareness of body posture, relax using breathing exercises. These benefits can lead to less arthritis pain, increased joint range-of-motion, and better joint function.” – Ron Miller

 

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

 

Ye, X., Chen, Z., Shen, Z., Chen, G., & Xu, X. (2020). Yoga for Treating Rheumatoid Arthritis: A Systematic Review and Meta-Analysis. Frontiers in medicine, 7, 586665. https://doi.org/10.3389/fmed.2020.586665

 

Abstract

Purpose: Rheumatoid arthritis (RA) is a pervasive inflammatory autoimmune disease that seriously impairs human health and requires more effective non-pharmacologic treatment approaches. This study aims to systematically review and evaluate the efficacy of yoga for patients with RA.

Methods: Medline (through PubMed), Cochrane Library, EMBASE (through SCOPUS), and Web of Science database were screened through for articles published until 20 July 2020. Randomized controlled trials (RCTs) of yoga in patients with RA were included. Outcomes measures were pain, physical function, disease activity, inflammatory cytokines, and grip strength. For each outcome, standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated.

Result: Ten trials including 840 patients with RA aged 30–70 years were identified, with 86% female participants. Meta-analysis revealed a statistically significant overall effect in favor of yoga for physical function (HAQ-DI) (5 RCTs; SMD = −0.32, 95% CI −0.58 to −0.05, I2 = 15%, P = 0.02), disease activity (DAS-28) (4 RCTs; SMD = −0.38, 95% CI −0.71 to −0.06, I2 = 41%, P = 0.02) and grip strength (2 RCTs; SMD = 1.30, 95% CI 0.47–2.13, I2 = 63%, P = 0.002). No effects were found for pain, tender joints, swollen joints count or inflammatory cytokines (i.e., CRP, ESR, IL-6, and TNF-α).

Summary: The findings of this meta-analysis indicate that yoga may be beneficial for improving physical function, disease activity, and grip strength in patients with RA. However, the balance of evidence showed that yoga had no significant effect in improving pain, tender joints, swollen joints count, and inflammatory cytokines in patients suffering from RA. Considering methodological limitations, small sample size, and low-quality, we draw a very cautious conclusion in the results of the estimate of the effect. High-quality and large-scale RCTs are urgently needed in the future, and the real result may be substantially different.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7732597/

 

Improve the Psychological Health of Cancer Patients with Mindfulness Taught over the Internet

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Improve the Psychological Health of Cancer Patients with Mindfulness Taught over the Internet

 

By John M. de Castro, Ph.D.

 

“some of the most difficult elements of the cancer experience are very well-suited to a mindfulness practice.” – Linda Carlson

 

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

 

Mindfulness training has been shown to help with cancer recovery and help to relieve chronic pain. It can also help treat the residual physical and psychological symptoms, including stress,  sleep disturbance, fear, and anxiety and depression. The vast majority of the mindfulness training techniques, however, require a trained therapist. This results in costs that many clients can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy schedules and at locations that may not be convenient.

 

As an alternative, mindfulness training over the internet have been developed. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. In addition, research has indicated that mindfulness training online can be effective for improving the health and well-being of the participants. The research has been accumulating. So, it makes sense to step back and summarize what has been learned about the effectiveness of mindfulness training over the internet in treating the psychological symptoms of cancer patients.

 

In today’s Research News article “Mindfulness-Based Programs for Patients With Cancer via eHealth and Mobile Health: Systematic Review and Synthesis of Quantitative Research.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7704284/ ) Matis and colleagues review, summarize, and perform a meta-analysis on the published research studies on the effectiveness of mindfulness training over the internet in treating the psychological symptoms of cancer patients. They identified 24 published research studies including at least 4 weeks of mindfulness training delivered over the internet.

 

They report that the published research studies found that mindfulness training delivered over the internet to cancer patients produced significant decreases in stress, anxiety, depression, pain, fatigue, and sleep problems, and significant increases in mindfulness, posttraumatic growth, and some parameters of general health. In the few studies where long-term follow-up measures were obtained the effects were maintained.

 

These are very promising results that suggest that mindfulness training over the internet is a safe and effective treatment for the psychological issues common in cancer survivors. Mindfulness training, in general, has been shown in a large number of previous studies o be effective in reducing stress, anxiety, depression, pain, fatigue, and sleep problems, and significant increases in mindfulness, posttraumatic growth, and some parameters of general health. So, the present study simply extends these findings to patients with cancer who receive mindfulness training over the internet.

 

These results are important as good mental health, particularly the ability to cope with stress, are predictors of good health outcomes. In addition, the fact that the interventions were provided over the internet allows for cost-effective and convenient delivery to patients. This makes participation and compliance more likely and effective. Hence, internet-based mindfulness training may help relieve the psychological suffering of patients diagnosed with cancer and should be included in their treatment plan.

 

So, improve the psychological health of cancer patients with mindfulness taught over the internet.

 

“Both MBCT and eMBCT significantly reduced fear of cancer recurrence and rumination and increased mental health–related quality of life, mindfulness skills, and positive mental health.” – Matthew Stenger

 

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

 

Matis, J., Svetlak, M., Slezackova, A., Svoboda, M., & Šumec, R. (2020). Mindfulness-Based Programs for Patients With Cancer via eHealth and Mobile Health: Systematic Review and Synthesis of Quantitative Research. Journal of medical Internet research, 22(11), e20709. https://doi.org/10.2196/20709

 

Abstract

Background

eHealth mindfulness-based programs (eMBPs) are on the rise in complex oncology and palliative care. However, we are still at the beginning of answering the questions of how effective eMBPs are and for whom, and what kinds of delivery modes are the most efficient.

Objective

This systematic review aims to examine the feasibility and efficacy of eMBPs in improving the mental health and well-being of patients with cancer, to describe intervention characteristics and delivery modes of these programs, and to summarize the results of the included studies in terms of moderators, mediators, and predictors of efficacy, adherence, and attrition.

Methods

In total, 4 databases (PubMed, PsycINFO, Scopus, and Web of Knowledge) were searched using relevant search terms (eg, mindfulness, program, eHealth, neoplasm) and their variations. No restrictions were imposed on language or publication type. The results of the efficacy of eMBPs were synthesized through the summarizing effect estimates method.

Results

A total of 29 published papers describing 24 original studies were included in this review. In general, the results indicate that eMBPs have the potential to reduce the levels of stress, anxiety, depression, fatigue, sleep problems, and pain, and improve the levels of mindfulness, posttraumatic growth, and some parameters of general health. The largest median of Cohen d effect sizes were observed in reducing anxiety and depression (within-subject: median −0.38, IQR −0.62 to −0.27; between-group: median −0.42, IQR −0.58 to −0.22) and facilitating posttraumatic growth (within-subject: median 0.42, IQR 0.35 to 0.48; between-group: median 0.32, IQR 0.22 to 0.39). The efficacy of eMBP may be comparable with that of parallel, face-to-face MBPs in some cases. All studies that evaluated the feasibility of eMBPs reported that they are feasible for patients with cancer. Potential moderators, mediators, and predictors of the efficacy, attrition, and adherence of eMBPs are discussed.

Conclusions

Although the effects of the reviewed studies were highly heterogeneous, the review provides evidence that eMBPs are an appropriate way for mindfulness practice to be delivered to patients with cancer. Thus far, existing eMBPs have mostly attempted to convert proven face-to-face mindfulness programs to the eHealth mode. They have not yet fully exploited the potential of eHealth technology.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7704284/

 

Poor Mental Health in Patients with Fibromyalgia is Associated with Brain Systems

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Poor Mental Health in Patients with Fibromyalgia is Associated with Brain Systems

 

By John M. de Castro, Ph.D.

 

“practicing mindfulness techniques may be a low-cost, side effect free option for people wishing to reduce the severity of their fibromyalgia.” – Kim Jones

 

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. Clearly, fibromyalgia greatly reduces the quality of life of its’ sufferers.

 

There are no completely effective treatments for fibromyalgia. Symptoms are generally treated with pain relievers, antidepressant drugs and exercise. But these only reduce the severity of the symptoms and do not treat the disease directly. Mindfulness practices have also been shown to be effective in reducing pain from fibromyalgia. Some of the effects of mindfulness practices are to alter thought processes, changing what is thought about. In terms of pain, mindfulness training, by focusing attention on the present moment has been shown to reduce worry and catastrophizing. Pain is increased by worry about the pain and the expectation of greater pain in the future. Brain systems are involved in pain processing. It is not known, however, what brain systems may be involved in the psychological effects of fibromyalgia.

 

In today’s Research News article “The Bed Nucleus of the Stria Terminalis as a Brain Correlate of Psychological Inflexibility in Fibromyalgia.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7074535/ ) Feliu-Soler and colleagues recruited adult women who were diagnosed with fibromyalgia and assigned them to either treatment as usual or to receive and 8-week program of Mindfulness-Based Stress Reduction (MBSR). They were measured before and after the program for psychological inflexibility in pain, functional impairment, anxiety, depression, perceived stress, pain catastrophizing, mindfulness, and self-compassion. They also underwent measurements of the gray matter volume in the brain with Magnetic Resonance Imaging (MRI).

 

They found that the higher the levels of psychological inflexibility in pain, the higher the gray matter volume of the bed nucleus of the stria terminalis (BNST). Further they found that the higher the gray matter volume of the BNST the higher the levels of functional impairment, anxiety, depression, perceived stress, and pain catastrophizing and the lower the levels of mindfulness and self-compassion. The Mindfulness-Based Stress Reduction (MBSR) program did not significantly alter the BNST volume or psychological inflexibility in pain.

 

These results are correlative and as such caution must be exercised in causal inferences. It was disappointing that mindfulness training did not produce a change in either psychological inflexibility or BNST volume. But the results are clear that the gray matter volume of the bed nucleus of the stria terminalis (BNST) is associated with poor mental health in patients with fibromyalgia. This brain structure is associated with physiological and psychological responses to stress. Since, the constant pain associated with fibromyalgia is very stressful it is not surprising that enlargement of the BNST would be associated with poor mental health in these patients.

 

So, poor mental health in patients with fibromyalgia is associated with brain systems.

 

“being overly observant of symptoms or trying to avoid pain can actually contribute towards the development of fibromyalgia and worsen the existing symptoms. Mindfulness practice can actually change the way you relate to your pain, . . the mindfulness group showed less avoidant and hypervigilance behaviour, supporting the idea that mindfulness encourages a non-judgemental and accepting relationship with pain, rather than trying to push it away.” – Vidyamala Burch

 

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

 

Feliu-Soler, A., Martínez-Zalacaín, I., Pérez-Aranda, A., Borràs, X., Andrés-Rodríguez, L., Sanabria-Mazo, J. P., Fayed, N., Stephan-Otto, C., Núñez, C., Soriano-Mas, C., & Luciano, J. V. (2020). The Bed Nucleus of the Stria Terminalis as a Brain Correlate of Psychological Inflexibility in Fibromyalgia. Journal of clinical medicine, 9(2), 374. https://doi.org/10.3390/jcm9020374

 

Abstract

This study explored the brain structural correlates of psychological flexibility (PF) as measured with the Psychological Inflexibility in Pain Scale (PIPS) in patients with fibromyalgia (FM). Structural magnetic resonance imaging data from 47 FM patients were used to identify Gray Matter Volume (GMV) alterations related to PIPS scores. Brain GMV clusters related to PIPS were then correlated with clinical and cognitive variables to further explore how emerged brain clusters were intertwined with FM symptomatology. Longitudinal changes in PIPS-related brain clusters values were assessed by studying pre–post data from 30 patients (15 allocated to a mindfulness-based stress reduction (MBSR) program and 15 to treatment-as-usual). Changes in PIPS-related brain clusters were also explored in participants showing greater/lower longitudinal changes in PIPS scores. PIPS scores were positively associated with GMV in a bilateral cluster in the ventral part of the bed nucleus of the stria terminalis (BNST). Significant associations between BNST cluster with functional impairment, depressive symptomatology, perceived stress and the nonjudging mindfulness facet were observed. Participants reporting greater pre–post increases in PIPS scores showed greater increases in BNST cluster values. These findings contribute to the understanding on the neurobiological bases of PF in FM and encourage further explorations of the role of the BNST in chronic pain.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7074535/

 

Improve Low Back Pain with Walking and Mind-Body Practices

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Improve Low Back Pain with Walking and Mind-Body Practices

 

By John M. de Castro, Ph.D.

 

“Mindfulness training teaches us to be aware of, and accept, moment-to-moment physical sensations of discomfort, while letting go of our usual negative reactions. So instead of spending hours each day thinking about how much we hate our back pain, worrying about our prognosis, and seeking relief, we learn how to be with the pain — paying attention to how it actually feels at each moment and relaxing our tendency to tense up against it, while observing our worried or distressed thoughts and feelings coming and going.” – Ronald Siegel

 

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

 

Obviously, there is a need for safe and effective treatments for low back pain that are low cost and don’t have troublesome side effects. Mindfulness practices are effective in treating pain and have been shown to be safe and effective in the management of low back pain. Yoga practice has been shown to have a myriad of health benefits. These include relief of chronic pain. Yoga practice has also been shown to be effective for the relief of chronic low-back pain.  Other mind-body  practices such as Tai Chi  improves spinal health and reduces pain. The evidence is accumulating, so, it would seem reasonable to summarize what has been learned regarding the ability of mind-body practices to treat chronic low back pain.

 

In today’s Research News article “Effectiveness of walking versus mind-body therapies in chronic low back pain: A systematic review and meta-analysis of recent randomized controlled trials.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7458239/ ) Nduwimana and colleagues reviewed, summarized, and performed a meta-analysis of the published randomized controlled trials comparing the effectiveness of m1nd-body practices and walking for the relief of chronic low back pain. They identified 31 published trials containing a total of 3193 participants.

 

They report that the published research found that both walking and m1nd-body practices were effective in significantly reducing low back pain. Of the m1nd-body practices, yoga was particularly effective not only reducing pain but also producing significant reductions in activity limitations resulting from low back pain. On the short-term (up to 3 months) yoga produced significant pain reductions while on the intermediate-term (3 to 6 months), walking produced significant pain reductions.

 

These results are important as low back pain is ubiquitous and produces not only discomfort but also limitations on the ability of patients to conduct their lives. So, its relief greatly reduces the suffering and improves the quality of life. The comparison of mind-body practices to walking is important as both are exercises and their relative effectiveness assessed. The results suggest that yoga practice has better short-term effectiveness while walking appears to be better for the intermediate term. This further suggests that future research should explore the effectiveness of the combination of mind-body practices and walking in the treatment of low back pain.

 

So, improve low back pain with walking and mind-body practices.

 

“Mindbody treatments (designed to change these attitudes, feeling, and beliefs about pain) can measurably reduce back pain over time.” – Curable

 

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

 

Nduwimana, I., Nindorera, F., Thonnard, J. L., & Kossi, O. (2020). Effectiveness of walking versus mind-body therapies in chronic low back pain: A systematic review and meta-analysis of recent randomized controlled trials. Medicine, 99(35), e21969. https://doi.org/10.1097/MD.0000000000021969

 

Abstract

Purpose:

Walking and mind-body therapies (MBTs) are commonly recommended to relieve pain and improve function in patients with chronic low back pain (CLBP). The purpose of this study was to compare the effectiveness of walking and MBTs in CLBP.

Methods:

We included randomized controlled trials (RCTs) comparing walking or MBTs to any other intervention or control in adults with CLBP. Studies were identified through PubMed, Cochrane Library, PsycINFO, Scopus, and ScienceDirect databases. The research was limited to studies published in English and French between January 2008 and December 2018. Two reviewers independently selected the studies, extracted data, and assessed studies quality using the Physiotherapy Evidence Database (PEDro) scale. Statistical analyses were performed under a random-effects model. We analyzed pain and activity limitation, with the calculation of standardized mean differences and 95% confidence intervals for the different treatment effects.

Results:

Thirty one randomized controlled trials involving 3193 participants were analyzed. Walking was as effective as control interventions in the short-term and slightly superior in the intermediate term with respect to pain (Standardized mean differences (SMD)  = –0.34; 95% CI, –0.65 to –0.03; P = .03) and activity limitation (SMD = –0.30; 95% CI, –0.50 to –0.10; P = .003). In contrast, yoga was more effective than control interventions in the short term in terms of pain (SMD = –1.47; 95% CI, –2.26 to –0.68; P = .0003) and activity limitation (SMD = –1.17; 95% CI, –1.80 to –0.55; P = .0002). Yoga was no longer superior to the control interventions for pain at the 6-month follow-up.

Conclusion:

MBTs, especially yoga, seem to be more effective in the short term, and walking seems to be more effective in the intermediate term, for the relief of pain and activity limitation in patients with CLBP. A combination of walking and MBTs fits the biopsychosocial model and might be valuable therapy for CLBP throughout follow-up due to combined effects.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7458239/

 

Relieve Pain with Brief Mindfulness-Based Interventions

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Relieve Pain with Brief Mindfulness-Based Interventions

 

By John M. de Castro, Ph.D.

 

“The mechanisms behind how mindfulness reduces pain . . . continue to include mindfulness meditation’s ability to provide pain relief by cultivating the ability to parse between the objective sensory dimension of pain, and the more subjective judgement that we attach to the pain that constructs the way we experience it.” – Jennifer Wolkin

 

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.

 

There is an accumulating volume of research findings that demonstrate that mindfulness practices, in general, are effective in treating pain. What is not known is the most effective approach to teaching mindfulness for the treatment of both acute and chronic pain. There are very brief mindfulness trainings that are practical methods, requiring minimal time and effort, for inducing mindfulness. The question is are they effective for reducing pain.

 

In today’s Research News article “Brief Mindfulness-Based Interventions for Acute and Chronic Pain: A Systematic Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6437625/ ) McClintock and colleagues review and summarize the published research literature on the effective of Brief Mindfulness-Based Interventions (BMBI), with total contact time of less than 1.5 hours, for the treatment of pain. They identified 20 published research studies.

 

They report that 11 of 19 quantitative studies reported that Brief Mindfulness-Based Interventions (BMBI) resulted in significant reductions in pain intensity or unpleasantness. But BMBIs less than 5 minutes or delivered by audio recording did not produce consistent results. On the other hand, when the BMBI was longer than 5 minutes and were delivered through direct participant-provider contact, there was a consistent significant reduction in pain intensity or unpleasantness This was true for both clinical and non-clinical participants.

 

It should be kept in mind that these findings relate to very brief mindfulness interventions. Longer interventions consistently produce reductions in pain regardless of whether the intervention is delivered in person or over the internet. But the present findings are interesting and potentially significant because of the brevity of the interventions. These Brief Mindfulness-Based Interventions (BMBI) can be provided quickly and conveniently without a long-term commitment by the patient or the provider. This makes them inexpensive and acceptable to a wide range of patients. This allows for widespread use of mindfulness to relieve the suffering of pain patients.

 

So, relieve pain with brief mindfulness-based interventions.

 

“the goal of those [mindfulness] practices is typically not to remove pain entirely, but to change your relationship with it so that you are able to experience relief and healing in the middle of uncomfortable physical sensations.” – Andrea Uptmor

 

 

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

 

Andrew S. McClintock, Shannon M. McCarrick, Eric L. Garland, Fadel Zeidan, Aleksandra E. Zgierska. Brief Mindfulness-Based Interventions for Acute and Chronic Pain: A Systematic Review. J Altern Complement Med. 2019 Mar 1; 25(3): 265–278. Published online 2019 Mar 9. doi: 10.1089/acm.2018.0351

 

Abstract

Objectives: Nonpharmacologic approaches have been characterized as the preferred means to treat chronic noncancer pain by the Centers for Disease Control and Prevention. There is evidence that mindfulness-based interventions (MBIs) are effective for pain management, yet the typical MBI may not be feasible across many clinical settings due to resource and time constraints. Brief MBIs (BMBIs) could prove to be more feasible and pragmatic for safe treatment of pain. The aim of the present article is to systematically review evidence of BMBI’s effects on acute and chronic pain outcomes in humans.

Methods: A literature search was conducted using PubMed, PsycINFO, and Google Scholar and by examining the references of retrieved articles. Articles written in English, published up to August 16, 2017, and reporting on the effects of a BMBI (i.e., total contact time <1.5 h, with mindfulness as the primary therapeutic technique) on a pain-related outcome (i.e., pain outcome, pain affect, pain-related function/quality of life, or medication-related outcome) were eligible for inclusion. Two authors independently extracted the data and assessed risk of bias.

Results: Twenty studies meeting eligibility criteria were identified. Studies used qualitative (n = 1), within-group (n = 3), or randomized controlled trial (n = 16) designs and were conducted with clinical (n = 6) or nonclinical (i.e., experimentally-induced pain; n = 14) samples. Of the 25 BMBIs tested across the 20 studies, 13 were delivered with audio/video recording only, and 12 were delivered by a provider (participant–provider contact ranged from 3 to 80 min). Existing evidence was limited and inconclusive overall. Nevertheless, BMBIs delivered in a particular format—by a provider and lasting more than 5 min—showed some promise in the management of acute pain.

Conclusions: More rigorous large scale studies conducted with pain populations are needed before unequivocally recommending BMBI as a first-line treatment for acute or chronic pain.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6437625/

 

Improve Low Back Pain and Its Effects with Yoga Practice

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Improve Low Back Pain and Its Effects with Yoga Practice

 

By John M. de Castro, Ph.D.

 

“If you’re dealing with back pain, yoga may be just what the doctor ordered. Yoga is a mind-body therapy that’s often recommended to treat not only back pain but the stress that accompanies it. The appropriate poses can relax and strengthen your body.” – Emily Cronkleton

 

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

 

Obviously, there is a need for safe and effective treatments for low back pain that are low cost and don’t have troublesome side effects. Mindfulness practices are effective in treating pain and have been shown to be safe and effective in the management of low back pain. Yoga practice combines mindfulness practice with exercise and has been shown to have a myriad of health benefits. 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. Indeed, yoga has been shown to relieve chronic pain. Yoga practice has also been shown to be effective for the relief of chronic low-back pain. The research has been accumulating and it is useful to summarize what has been learned.

 

In today’s Research News article “Yoga compared to non-exercise or physical therapy exercise on pain, disability, and quality of life for patients with chronic low back pain: A systematic review and meta-analysis of randomized controlled trials.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7462307/ ) Zhu and colleagues review, summarize, and perform a meta-analysis of the effectiveness of yoga practice in comparison to other exercises for low back pain. They identified 18 randomized controlled trials.

 

They report that the published research found that yoga practice, in comparison to baseline and no-exercise controls, produced significant reductions in pain and functional disability that was still present 6 months after the completion of training. At 12 months, there was still a significant difference in functional disability but not pain. In comparison to physical therapy, yoga produced significantly greater pain reduction but not functional disability immediately after treatment but this difference disappeared at 4 weeks after the completion of training. Yoga practice did not produce significant improvements in the patients’ quality of life.

 

These results suggest that yoga practice is effective in improving pain and functional disability in patients with low back pain. Yoga practice appears to be as effective but not superior to physical therapy. Hence, the published research to date suggests that low back pain can be successfully treated with either yoga practice or physical therapy.

 

So, improve low back pain and its effects with yoga practice.

 

“Achy back? Give yoga a go. Numerous studies have shown the power of the ancient practice, which emphasizes stretching, strength, and flexibility, to relieve back soreness and improve function.” – Annie Houser

 

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

 

Feilong Zhu, Ming Zhang, Dan Wang, Qianqin Hong, Cheng Zeng, Wei Che. Yoga compared to non-exercise or physical therapy exercise on pain, disability, and quality of life for patients with chronic low back pain: A systematic review and meta-analysis of randomized controlled trials. PLoS One. 2020; 15(9): e0238544. Published online 2020 Sep 1. doi: 10.1371/journal.pone.0238544

 

Abstract

Background

Chronic low back pain (CLBP) is a common and often disabling musculoskeletal condition. Yoga has been proven to be an effective therapy for chronic low back pain. However, there are still controversies about the effects of yoga at different follow-up periods and compared with other physical therapy exercises.

Objective

To critically compare the effects of yoga for patients with chronic low back pain on pain, disability, quality of life with non-exercise (e.g. usual care, education), physical therapy exercise.

Methods

This study was registered in PROSPERO, and the registration number was CRD42020159865. Randomized controlled trials (RCTs) of online databases included PubMed, Web of Science, Cochrane Central Register of Controlled Trials, Embase which evaluated effects of yoga for patients with chronic low back pain on pain, disability, and quality of life were searched from inception time to November 1, 2019. Studies were eligible if they assessed at least one important outcome, namely pain, back-specific disability, quality of life. The Cochrane risk of bias tool was used to assess the methodological quality of included randomized controlled trials. The continuous outcomes were analyzed by calculating the mean difference (MD) or standardized mean difference (SMD) with 95% confidence intervals (CI) according to whether combining outcomes measured on different scales or not.

Results

A total of 18 randomized controlled trials were included in this meta-analysis. Yoga could significantly reduce pain at 4 to 8 weeks (MD = -0.83, 95% CI = -1.19 to -0.48, p<0.00001, I2 = 0%), 3 months (MD = -0.43, 95% CI = -0.64 to -0.23, p<0.0001, I2 = 0%), 6 to 7 months (MD = -0.56, 95% CI = -1.02 to -0.11, p = 0.02, I2 = 50%), and was not significant in 12 months (MD = -0.52, 95% CI = -1.64 to 0.59, p = 0.36, I2 = 87%) compared with non-exercise. Yoga was better than non-exercise on disability at 4 to 8 weeks (SMD = -0.30, 95% CI = -0.51 to -0.10, p = 0.003, I2 = 0%), 3 months (SMD = -0.31, 95% CI = -0.45 to -0.18, p<0.00001, I2 = 30%), 6 months (SMD = -0.38, 95% CI = -0.53 to -0.23, p<0.00001, I2 = 0%), 12 months (SMD = -0.33, 95% CI = -0.54 to -0.12, p = 0.002, I2 = 9%). There was no significant difference on pain, disability compared with physical therapy exercise group. Furthermore, it suggested that there was a non-significant difference on physical and mental quality of life between yoga and any other interventions.

Conclusion

This meta-analysis provided evidence from very low to moderate investigating the effectiveness of yoga for chronic low back pain patients at different time points. Yoga might decrease pain from short term to intermediate term and improve functional disability status from short term to long term compared with non-exercise (e.g. usual care, education). Yoga had the same effect on pain and disability as any other exercise or physical therapy. Yoga might not improve the physical and mental quality of life based on the result of a merging.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7462307/

 

Improve Health and Treat Illness with Qigong

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Improve Health and Treat Illness with Qigong

 

By John M. de Castro, Ph.D.

 

“in order to do qigong … we have to be pretend to be empty, so the first thing to empty is the mind, so we try not to think of anything and only listen to our breathing, relax all the strength and relax the mind, so it’s some kind of meditation.” – Joe Lok

 

Tai Chi and Qigong are ancient mindfulness practices involving slow prescribed movements. They are gentle and completely safe, can be used with the elderly and sickly, are 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, they can also be practiced in social groups without professional supervision. This can make it fun, improving the likelihood of long-term engagement in the practice.

 

Tai Chi and Qigong are both mindfulness practices and exercises. They have been shown to be beneficial to the health and well-being of individuals of a variety of ages, but particularly the elderly. They also improve the symptoms of a variety of diseases. The studies of the benefits for health of Tai Chi and Qigong are accumulating and so it makes sense to take a moment to summarize what has been learned.

 

In today’s Research News article “Benefits of Qigong as an integrative and complementary practice for health: a systematic review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7365612/) Toneti and colleagues review and summarize the published research studies of the benefits for health of Qigong practice. They identified 28 published clinical trials.

 

They report that the published research studies found that Qigong practice significantly promotes health and is effective in the prevention and rehabilitation of diseases in adults and the elderly. The evidence supports the effectiveness of Qigong practice in treating the symptoms of cancer, fibromyalgia, Parkinson’s disease, cardiovascular disease, and COPD. It has also been shown to be effective in reducing chronic pain including low back pain, cervical pain, and osteoarthritis pain. In addition, it has been shown to be effective in reducing perceived stress, burnout, fatigue, social isolation, and depression.

 

Hence, the available published research suggests that Qigong practice is effective in promoting physical and psychological health in healthy people and people with diseases at a variety of ages including the elderly. These are impressive benefits for a gentle and safe practice that can be rolled out to a wide audience at low cost. This suggests that people should be encouraged to participate in Qigong practice to promote their health and well-being.

 

So, improve health and treat illness with Qigong.

 

“Qi gong and tai chi are relaxing ways to improve your flexibility and balance. Both are great ways to stay active and vital. The gentle, flowing movements are easy on the joints.” – Jodi Helmer

 

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

 

Toneti, B. F., Barbosa, R., Mano, L. Y., Sawada, L. O., Oliveira, I. G., & Sawada, N. O. (2020). Benefits of Qigong as an integrative and complementary practice for health: a systematic review. Revista latino-americana de enfermagem, 28, e3317. https://doi.org/10.1590/1518-8345.3718.3317

 

Abstract

Objective:

to analyze, in the literature, evidence about the benefits of the integrative and complementary practice of Qigong with regard to the health of adults and the elderly.

Method:

a systematic review by searching for studies in the PubMed, CINAHL, LILACS, EMBASE and Cochrane Library databases. Randomized and non-randomized clinical trials were included; in Portuguese, English and Spanish; from 2008 to 2018. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses strategy was adopted, as well as the recommendation of the Cochrane Collaboration for assessing the risk of bias in the clinical trials analyzed.

Results:

28 studies were selected that indicated the benefit of the practice to the target audience, which can be used for numerous health conditions, such as: cancer; fibromyalgia; Parkinson’s disease; Chronic Obstructive Pulmonary Disease; Burnout; stress; social isolation; chronic low back pain; cervical pain; buzz; osteoarthritis; fatigue; depression; and cardiovascular diseases. However, there was a great risk of bias in terms of the blinding of the research studies.

Conclusion:

the practice of Qigong produces positive results on health, mainly in the medium and long term. This study contributes to the advancement in the use of integrative and complementary practices in nursing, since it brings together the scientific production in the area from the best research results available.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7365612/

 

Meditation and Yogic Breathing Techniques Improve Respiration and Psychological Well-Being

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Meditation and Yogic Breathing Techniques Improve Respiration and Psychological Well-Being

 

By John M. de Castro, Ph.D.

 

“Yoga, meditation and other relaxation techniques all depend on focusing on the breath. There are many benefits of meditation and proper breathing is an important part of learning how to calm the mind and body.” – Home Care Assistance

 

Breathing is essential for life and generally occurs automatically. It’s easy to take for granted as it’s been there our entire lives. Nevertheless, we become more aware of it when it varies with circumstances, such as when we exercise and also in emotional states, especially fear and anxiety. But we rarely notice it during everyday ongoing life. Yet, its characteristics are associated with our state of well-being. Slow deep breathing is characteristic of a healthy relaxed state. Breathing exercises are common in yoga and meditation practices and have been found to have a number of beneficial effects.

 

Modern medicine has also developed respiratory therapies for the treatment of patients with cardiovascular and pulmonary diseases. Many of these techniques are similar to those practiced in meditation and yoga. In today’s Research News article “Analogy between classical Yoga/Zen breathing and modern clinical respiratory therapy.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7429199/) Tobe and Saito examine the similarities of meditation and yoga breathing exercises and respiratory therapies and their relative effects.

 

Respiratory therapy has been shown to be essential in the treatment of respiratory diseases. But, breathing techniques are not new. They’ve been practiced for over 3000 years. Yoga incorporates a number of different techniques. Even the Buddha emphasized breathing techniques during meditation and these were greatly elaborated on in Zen meditation. There are considerable similarities with respiratory therapy and meditation and yogic breathing techniques. They all emphasize deep inhalation, slow exhalation with some resistance, low respiratory frequency, and even counting of breaths.

 

Tobe and Saito note that research has shown that meditation and yogic breathing techniques, like respiratory therapy, have considerable positive effects on respiration including improved “vital capacity, timed vital capacity, maximum voluntary ventilation, breath-hold time, maximal inspiratory and expiratory pressures and oxygen saturation.” They also increase the psychological well-being of practitioners including reducing panic attacks, depression, and headaches, relieving pain, and improving sleep.

 

Tobe and Saito conclude that meditation and yogic breathing techniques are effective in modern clinical practice improving respiratory function and psychological well-being, and relieving chronic pain. Indeed, research on meditation and yogic breathing techniques suggest that they improve physiological and respiratory function and are effective for the treatment of a number of diseases and psychological problems.

 

So, meditation and yogic breathing techniques improve respiration and psychological well-being.

 

“By inducing stress resilience, breath work enables us to rapidly and compassionately relieve many forms of suffering.” – Richard Brown

 

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

 

Tobe, M., & Saito, S. (2020). Analogy between classical Yoga/Zen breathing and modern clinical respiratory therapy. Journal of anesthesia, 1–6. Advance online publication. https://doi.org/10.1007/s00540-020-02840-5

 

Abstract

Anesthesiologists and intensivists are modern-day professionals who provide appropriate respiratory care, vital for patient survival. Recently, anesthesiologists have increasingly focused their attention on the type of spontaneous breathing made by non-intubated patients with pulmonary disease cared for in an intensive care unit, and also patients with chronic pain receiving cognitive behavioral therapy. Prior to our modern understanding of respiratory physiology, Zen meditators recognized that breathing has a significant impact on a person’s mental state and general physical well-being. Examples of this knowledge regarding respiration include the beneficial effects of deep inhalation and slow exhalation on anxiety and general wellness. The classical literature has noted many suggestions for breathing and its psycho-physical effects. In the present review, we examine the effect of classical breathing methods and find an analogy between typical Yoga/Zen breathing and modern clinical respiratory therapy. Evidence is increasing about historical breathing and related meditation techniques that may be effective in modern clinical practice, especially in the field of anesthesiology, such as in improving respiratory function and reducing chronic pain. Clarification of the detailed mechanisms involved is anticipated.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7429199/

 

Improve Anxiety and Depression in Iranian Chronic Pain Patients with Mindfulness

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Improve Anxiety and Depression in Iranian Chronic Pain Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindful meditation can help ease psychological stresses like anxiety, depression, and pain.” – Julie Corliss

 

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.

 

There is an accumulating volume of research findings to demonstrate that mindfulness practices, in general, are effective in treating pain. Chronic pain patients tend to also suffer from anxiety and depression and mindfulness has been shown to improve anxiety and depression. A lot of research has been done on various psychological treatments for chronic pain and its associated anxiety and depression. So, it makes sense to step back and take a look at what has been learned.

 

In today’s Research News article “Psychological interventions for depression and anxiety: a systematic review and meta-analysis of Iranian chronic pain trials.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7420174/) Jandaghi and colleagues review, summarize and perform a meta-analysis on treatments for chronic pain and its associated anxiety and depression in Iranian patients. They identified 30 randomized controlled trials with a total of 1021 participants.

 

They report that the published randomized controlled trials found that psychological interventions in general improve anxiety and depression in patients with chronic pain and these effects persist for at least several months. On average mindfulness-based therapies produced superior results to Cognitive Behavioral and other therapeutic approaches; producing greater relief of anxiety and depression.

 

Thus, the accumulated findings suggest that psychological treatments and especially mindfulness-based therapies are safe and effective treatment for anxiety and depression in chronic pain patients. This is important not only for the psychological well-being of the patients but also for their pain as anxiety and depression can amplify the levels of experienced pain in the patients.

 

So, improve anxiety and depression in Iranian chronic pain patients with mindfulness.

 

“Mindfulness exercises help people to focus their mind and body in the moment without judgment. . . Being able to focus on relaxing the body, noticing the breath and body sensations as being there just as they are, can help manage pain, as well as reduce depression and anxiety symptoms.” – Mayo Clinic

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Jandaghi, G., Firoozi, M., & Zia-Tohidi, A. (2020). Psychological interventions for depression and anxiety: a systematic review and meta-analysis of Iranian chronic pain trials. Health promotion perspectives, 10(3), 180–191. https://doi.org/10.34172/hpp.2020.31

 

Abstract

Background: Chronic pain is commonly associated with anxiety and depression, making it more challenging to be managed. Psychological interventions are suggested for such complicated issues which are well evident in the United States and Europe. However, generalizing the evidence to Iranian population – as a Middle Eastern society – might be questionable. We aimed to synthesize our evidence on the effectiveness of these interventions among Iranian populations.

Methods: This was a systematic review and meta-analysis. Persian and English literature were searched through Iran-doc, Elm-net, and PubMed until March 2019 using the following terms (or its Persian synonyms): chronic pain; persistent pain; chronic fatigue; fibromyalgia; neuropath*; LBP; irritable bowel; CFS; psycho*; cogniti*; acceptance; meaning; mindfulness; relaxation; biopsychosocial; rehabilitation; educat*. Eligible trials were randomized trials that evaluated the effectiveness of psychological interventions on Iranian adults with chronic pain. No setting restriction was considered. Risk of bias for each trial was assessed, and the random-effect model was used to pool summary effect across trials.

Results: In all 30 eligible RCTs, the risk of bias for randomization was low except for one study. The pooled standardized mean difference (SMD) for depression and anxiety were 1.33 (95%CI: -1.42 to -0.68) and 1.25 (95% CI: -1.55 to -0.96), respectively.

Conclusion: This study suggests that psychological interventions are highly effective in reducing depression and anxiety in Iranian patients with chronic pain, compared to what observed in the U.S. and European studies. However, there are still some methodological issues to be addressed. Future research should focus on high-quality trials with considerations on the methodological issues reported in the present study.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7420174/

 

Improve Painful Diabetic Neuropathy with Mindfulness

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Improve Painful Diabetic Neuropathy with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness specifically can also potentially improve quality of life for patients with neuropathy. . . Research indicates that in addition to improving pain, mindfulness also addresses the psychological consequences of chronic pain, including depression symptoms.” – Foundation for Peripheral Neuropathy

 

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

 

Mindfulness practices have been shown to help with pain management and with quality of life in diabetes patients. and has been shown to improve the symptoms of diabetic neuropathy. A therapeutic technique that contains mindfulness training is Acceptance and Commitment Therapy (ACT). It is a mindfulness-based psychotherapy technique that is employs many of the techniques of Cognitive Behavioral Therapy (CBT) and focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes.

 

It is important, then, to study the effectiveness of Acceptance and Commitment Therapy (ACT) for reducing pain and improving quality of life in patients with diabetic neuropathy. In today’s Research News article “The Effectiveness of Acceptance and Commitment Therapy on Pain Acceptance and Pain Perception in Patients with Painful Diabetic Neuropathy: A Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7376796/) Taheri and colleagues recruited patients diagnosed with diabetic peripheral neuropathy, aged 35 to 65 years, and randomly assigned them to either receive 8 sessions of ACT or to a no-treatment control condition. They were measured before and after training and 3 months later for sensory pain, psychological pain, and chronic pain acceptance.

 

They found that in comparison to the baseline and the no-treatment control group the patients who received Acceptance and Commitment Therapy (ACT) had significant decreases in pain and significant increases in pain acceptance. These benefits of ACT were still significant at the 3-month follow up. So ACT were appears to produce significant and lasting improvements in diabetic peripheral neuropathy pain and its acceptance.

 

The trial did not have an active control group. So, the design is not the strongest and may be open to confounding. In addition, Acceptance and Commitment Therapy (ACT) is a complex therapy that includes mindfulness and Cognitive Behavioral Therapy (CBT), along with other therapeutic components. So, it cannot be determined which of these components or which combination of components were responsible for the effects. Previous research has shown that mindfulness training improves the symptoms of diabetic neuropathy. So, it is reasonable to conclude that the mindfulness component of ACT is effective. Hence, the study suggests that ACT is a safe, effective, and lasting treatment for diabetic peripheral neuropathy pain.

 

So, improve painful diabetic neuropathy with mindfulness.

 

“by activating and reinforcing some areas of the brain used in pain processing, meditation has the overall effect of helping to reduce pain intensity in patients. Other theories on how meditation affects pain, including that it decreases stress, which in turn decreases pain.” – Foundation for Peripheral Neuropathy

 

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

 

Taheri, A. A., Foroughi, A. A., Mohammadian, Y., Ahmadi, S. M., Heshmati, K., Hezarkhani, L. A., & Parvizifard, A. A. (2020). The Effectiveness of Acceptance and Commitment Therapy on Pain Acceptance and Pain Perception in Patients with Painful Diabetic Neuropathy: A Randomized Controlled Trial. Diabetes therapy : research, treatment and education of diabetes and related disorders, 11(8), 1695–1708. https://doi.org/10.1007/s13300-020-00851-9

 

Abstract

Introduction

Neuropathic pain is a complex phenomenon in patients with diabetes. These patients have many problems, such as psychological problems, high-level pain perception, and pain acceptance. This study aimed to evaluate the effectiveness of acceptance and commitment therapy on pain acceptance and pain perception in patients with painful diabetic neuropathy.

Methods

This study was performed according to the clinical trial method. The sample size was 50 participants. In this study, participants were divided into interventional and control groups. According to the diagnosis of neurologists, all participants received conventional medications to manage neuropathic pain. The intervention group received acceptance and commitment therapy for eight sessions. The results in the three phases of pre-test, post-test, and follow-up were evaluated. After completing the study, to comply with ethical standards, the control group received psycho-education. The tools used were the McGill Pain Questionnaire (MPQ) and the Chronic Pain Acceptance Questionnaire (CPAQ). Statistical analysis includes mean, standard deviation, and repeated-measures (ANOVA) conducted by SPSS software version 22.

Results

The results demonstrated that in the post-test and follow-up phases, acceptance and commitment therapy could improve pain acceptance and reduce pain perception in the intervention group compared to the control group (P < 0.01).

Conclusion

The results indicated that acceptance and commitment therapy could be used as a psychological intervention besides pharmacotherapy to improve pain acceptance and reduce pain perception in patients with painful diabetic neuropathy.

Key Summary Points

Why carry out this study?
Patients with painful diabetic neuropathy endure severe and excruciating pain that adversely affects their function. According to Melzack theory, one of the most important factors in pain perception is psychological factors.
Before this study, no clinical trial study had been performed to measure the effectiveness of psychological therapy in reducing the severity of pain perception in patients with painful diabetic neuropathy.
The main purpose of this study was to investigate the effectiveness of acceptance and commitment therapy (ACT) therapy on improving pain acceptance and subsequently reduction of pain perception.
What was learned from the study?
The results showed that compared to the control group, the interventional group had significant improvement in pain acceptance and also a major reduction in pain perception in the post-test phase. The same results were observed after a 3-month follow-up.

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7376796/