Improve Physical and Psychological Discomfort from Musculoskeletal Disorders with Mindfulness
By John M. de Castro, Ph.D.
“Meditation’s goal is to relax the mind and body, acknowledge and release feelings about pain or other challenges, let go of tension, and tap into a positive outlook. Focusing on negativity exacerbates pain. Mindfulness practice allows you to step back from that negative thinking. It brings focus to the present moment and allows you to interrupt the vicious cycle of negativity and pain. “With our thoughts, we create a reality,” – Andrea Rudolph
Orthopedic Disorders consist of a wide range of problems that are concerned with muscles, ligaments and joints. Disorders are ailments, injuries or diseases that cause knee problems, whiplash, dislocated shoulder, torn cartilages, foot pain and fibromyalgia. The most common forms of orthopedic disorders are arthritis, and back and neck pain.
Arthritis is a chronic disease that most commonly affects the joints. Depending on the type of arthritis symptoms may include pain, stiffness, swelling, redness, and decreased range of motion. It affects an estimated 52.5 million adults in the United States. The pain, stiffness, and lack of mobility associate with arthritis produce fatigue and markedly reduce the quality of life of the sufferers. Arthritis can have very negative psychological effects diminishing the individual’s self-image and may lead to depression, isolation, and withdrawal from friends and social activities.
The most common forms of chronic pain are back and neck pain. Low Back Pain is the leading cause of disability worldwide and affects between 6% to 15% of the population. It is estimated, however, that 80% of the population will experience back pain sometime during their lives. Back and neck pain interferes with daily living and with work, decreasing productivity and creating absences. There are many different treatments for pain, but few are both safe and effective for chronic pain conditions. So, alternative treatments are needed. Mindfulness practices are effective in treating pain and have been shown to be safe and effective in the management of arthritis, low back pain and neck pain.
In today’s Research News article “First Use of a Brief 60-second Mindfulness Exercise in an Orthopedic Surgical Practice; Results from a Pilot Study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5736889/ ), Chad-Friedman and colleagues perform a pilot study of the effectiveness of a brief mindfulness instruction via a video for the symptoms of orthopedic disorders. They recruited adult follow-up patients with a variety of orthopedic problems. The participants then watched a 60 second mindfulness video where they were instructed to envision a stressful situation and place it in a bright star. Over the next 60 seconds they were to envision shrinking that star till it becomes small. They were measured before and after watching the video for pain, anxiety, distress, depression, anger, and satisfaction with the intervention. They found that after watching the video the patients reported large and significant improvements in pain and all psychological measures and high satisfaction ratings.
Obviously, with such a brief and uncontrolled pilot study there can be no clear conclusions. But, mindfulness interventions have been found in numerous controlled studies to decrease pain, anxiety, depression, and anger. So, the results suggest that the 60-second mindfulness practice has similar effects. It remains to be seen if such a brief practice can have lasting effects in comparison to a comparable non-mindfulness control condition and if daily brief practice can help maintain the benefits.
Orthopedic disorders are so common, costly, and debilitating that a simple, safe, and effective intervention is sorely needed. Physicians have little time. So, having mindfulness training via a video relieves them of the need to take the time to train the patients. In addition, making it very brief and simple may promote patient compliance with the practice. So, this pilot study suggests that this 60-second video intervention should be further studied for its effectiveness in relieving the suffering of patients with orthopedic disorders.
“Mindfulness training involves the cultivation of nonjudgemental attention to unwanted thoughts, feelings and bodily experiences via meditation and may help ameliorate both psychological and physical symptoms of chronic disease,” – Mary Kreitzer
CMCS – Center for Mindfulness and Contemplative Studies
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Emma Chad-Friedman, Mojtaba Talaei-Khoei, David Ring, Ana-Maria Vranceanu. First Use of a Brief 60-second Mindfulness Exercise in an Orthopedic Surgical Practice; Results from a Pilot Study. Arch Bone Jt Surg. 2017 Nov; 5(6): 400–405.
Mindfulness based interventions may be useful for patients with musculoskeletal conditions in orthopedic surgical practices as adjuncts to medical procedures or alternatives to pain medications. However, typical mindfulness programs are lengthy and impractical in busy surgical practices. We tested the feasibility, acceptability and preliminary effect of a brief, 60-second mindfulness video in reducing pain and negative emotions in patients presenting to an orthopedics surgical practice.
This was an open pilot study. Twenty participants completed the Numerical Rating Scale to assess pain intensity, the State Anxiety subscale of the State Trait Anxiety Scale to assess state anxiety, and emotional thermometers to assess distress, anxiety, anger and depression immediately prior to and following the mindfulness video exercise. At the end of the exercise patients also answered three questions assessing satisfaction with the mindfulness video.
Feasibility of the mindfulness video was high (100%). Usefulness, satisfaction and usability were also high. Participants showed improvements in state anxiety, pain intensity, distress, anxiety, depression and anger after watching the video. These changes were both statistically significant and clinically meaningful, when such information was available.
People with musculoskeletal pain seeking orthopedic care seem receptive and interested in brief mindfulness exercises that enhance comfort and calm.