Reduce Migraine Symptoms with Yoga or Physical Therapy

Reduce Migraine Symptoms with Yoga or Physical Therapy

 

By John M. de Castro, Ph.D.

 

“Overall, yoga improved the cardiac autonomic balance. Disturbances in the autonomic nervous system and in the regulation of the circulatory system are associated with migraines. If balance is restored, the likelihood of a migraine is reduced.” – Debra Sullivan

 

Migraine headaches are a torment far beyond the suffering of a common headache. It is an intense throbbing pain usually unilateral, focused on only one side of the head and lasts from 4 hours to 3 days. They are actually a collection of neurological symptoms. Migraines often include: visual disturbances, nausea, vomiting, dizziness, extreme sensitivity to sound, light, touch and smell, and tingling or numbness in the extremities or face. Migraines are the 8th most disabling illness in the world. While most sufferers experience attacks once or twice a month, about 4% have chronic daily headaches. Migraines are very disruptive to the sufferer’s personal and work lives as most people are unable to work or function normally when experiencing a migraine.

 

There is no known cure for migraine headaches. Treatments are targeted at managing the symptoms. Prescription and over-the-counter pain relievers are frequently used. There are a number of drug and drug combinations that appear to reduce the frequency of migraine attacks. These vary in effectiveness but unfortunately can have troubling side effects and some are addictive. Behaviorally, relaxation, exercise, and sleep appear to help lower the frequency of migraines. Mindfulness practices have been shown to reduce stress and improve relaxation. So, they may be useful in preventing migraines. Indeed, it has been shown that mindfulness practice can reduce headache pain. Yoga is both a mindfulness practice and an exercise. It has also been shown to help reduce pain. Hence, it may be effective in treating migraines.

 

In today’s Research News article “Study of Additive Effect of Yoga and Physical Therapies to Standard Pharmacologic Treatment in Migraine.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7846311/ ) Mehta and colleagues recruited adult patients diagnosed with migraine headaches and randomly assigned them to either standard care or to receive standard care plus either yoga training or physical therapy. They were trained and then practiced at home daily for 3 months. Before training, at 1 and 2-months during training, and after training they were measured for headache pain and headache frequency and headache impact.

 

They found that all three groups had significant reductions in migraine frequency, severity (pain), and impact on life. Both yoga and physical therapy reduced frequency and impact on life to a significantly greater extent than standard care.

 

These findings suggest that either yoga or physical therapy when added to standard care for migraine headache produces significant additional improvements in the symptoms of migraine headaches. The fact that yoga and physical therapy did not differ in effectiveness suggests that the physical exercise provided by yoga is the reason for yoga’s effectiveness. These findings suggest that yoga practice or physical therapy should be added to the standard care for patients with Migraine headaches.

 

So, reduce migraine symptoms with yoga or physical therapy.

 

Yoga’s postures, deep breathing and meditation . . . could be very helpful in both treating migraine and fighting the disability associated with migraine.” – American Migraine Foundation

 

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

 

Mehta, J. N., Parikh, S., Desai, S. D., Solanki, R. C., & G. Pathak, A. (2021). Study of Additive Effect of Yoga and Physical Therapies to Standard Pharmacologic Treatment in Migraine. Journal of Neurosciences in Rural Practice, 12(1), 60–66. https://doi.org/10.1055/s-0040-1718842

 

Abstract

Objective  We aimed to evaluate and compare the effectiveness of physical and yoga therapies as an adjuvant therapy along with standard pharmacologic treatment in patients with migraine.

Materials and Methods  A total of 61 consenting patients diagnosed to have migraine were randomized into three groups to receive either standard treatment alone, physical therapy along with standard treatment, or yoga therapy along with standard treatment. The respective adjuvant intervention was taught to the respective group of patients and they were advised to perform it daily for 3 months with weekly telephonic reminders and review of their activity logs. Outcome measures assessed were headache frequency, Short-Form McGill Pain Questionnaire (SF-MPQ), and Headache Impact Test-6 (HIT-6) at recruitment and once every month for 3 months.

Statistical Analysis  Statistical analysis of the study was done by using Stata 14.1 software. All the descriptive statistics, paired t -test was used to compare the difference between pre and postintervention values of headache frequency, SF-MPQ, and HIT-6 score within all the three groups. Analysis of variance test and post hoc test were used to compare the differences between all groups for outcome measures ( p < 0.05).

Results  Headache frequency and the visual analog scale before intervention compared during each month intervals for 3 months in all the three groups were significantly decreased in all the three groups ( p < 0.005). Yoga or physical therapy as an adjuvant to standard treatment leads to a higher reduction in headache frequency and severity. Sensory and affective pain ratings of SF-MPQ and HIT-6 also showed a significant improvement at 1 to 3 months of treatment compared with baseline in all the three groups.

Conclusion  Either physical or yoga therapy as an adjuvant to standard pharmacologic treatment may further improve the quality of life and reduce headache frequency in patients with migraine.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7846311/

 

Control Chronic Pain with Mindfulness

Control Chronic Pain with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness is not like traditional painkillers, which are intended to dull or eliminate pain. While many experts recommend mindfulness-based practices to manage pain, the goal of those 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

 

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. Mindfulness appears to work by changing how the patient relates to pain rather than actually reducing or eliminating the pain. Cognitive Behavioral Therapy (CBT) is directed to change thought patterns and has also been shown to be an effective therapy for chronic pain. What is not known is the most effective treatment for chronic pain. The evidence has been accumulating. So, it makes sense to step back and summarize what has been learned.

 

In today’s Research News article “Differential efficacy between cognitive-behavioral therapy and mindfulness-based therapies for chronic pain: Systematic review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7753033/ ) Pardos-Gascón and colleagues review and summarize the published randomized clinical trials of the effectiveness of mindfulness-based and cognitive-behavioral treatments for chronic pain. They identified 18 published randomized clinical trials.

 

They report that the published studies found that mindfulness-based treatments produced significant reductions in symptoms and impact of the pain on the patients’ lives for patients with fibromyalgia, low back pain, and headache. There were few studies that compared mindfulness-based treatment to Cognitive Behavioral Therapy (CBT) but the few that did, did not find significant differences in effectiveness. It is clear that more direct comparisons are needed. Regardless, mindfulness-based treatments are effective for chronic pain.

 

So, control chronic pain with mindfulness.

 

Daily mindfulness practice can be helpful for people living with chronic pain because sometimes there are negative or worrisome thoughts about the pain. These thoughts are normal, and can affect mood and increase pain. 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.” – Andrea Neckar

 

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

 

Pardos-Gascón, E. M., Narambuena, L., Leal-Costa, C., & van-der Hofstadt-Román, C. J. (2021). Differential efficacy between cognitive-behavioral therapy and mindfulness-based therapies for chronic pain: Systematic review. International journal of clinical and health psychology : IJCHP, 21(1), 100197. https://doi.org/10.1016/j.ijchp.2020.08.001

 

Abstract

Background/Objective: To assess the differential efficacy between mindfulness-based interventions and cognitive-behavioral Therapy (CBT) on chronic pain across medical conditions involving pain. Method: ProQuest, Science Direct, Google Scholar, Pubmed, and Embase databases were searched to identify randomized clinical trials. Measurements of mindfulness, pain, mood, and further miscellaneous measurements were included. Results: 18 studies met the inclusion criteria (fibromyalgia, n = 5; low back pain, n = 5; headache/migraine, n = 4; non-specific chronic pain, n = 4). In fibromyalgia, mindfulness based stress reduction (MBSR) was superior to the usual care and Fibroqol, in impact and symptoms. In low back pain, MBSR was superior to the usual care, but not to CBT, in physical functionality and pain intensity. There were no studies on differential efficacy between mindfulness and CBT for headache and non-specific chronic pain, but Mindfulness interventions were superior to the usual care in these syndromes. Conclusions: Mindfulness interventions are superior to usual cares in all diagnoses, but it is not possible to conclude their superiority over CBT. Comparisons between mindfulness interventions are scarce, with MBSR being the most studied. In central sensitization syndromes, variables associated with pain tend to improve with treatment. More research is needed to differentiate diagnosis and intervention.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7753033/

 

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

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 Headache Pain with Mindfulness

Improve Headache Pain with Mindfulness

 

By John M. de Castro, Ph.D.

 

Mindfulness is a simple, effective method for managing migraines and reducing potential triggers.” – American Migraine Foundation

 

Headaches are the most common disorders of the nervous system. It has been estimated that 47% of the adult population have a headache at least once during the last year. Primary headaches do not result from other medical conditions and include migraine, tension, and cluster headaches. There are a wide variety of drugs that are prescribed for primary headache pain with varying success. Headaches are treated with pain relievers, ergotamine, blood pressure drugs such as propranolol, verapamil, antidepressants, antiseizure drugs, and muscle relaxants. Drugs, however, can have some problematic side effects particularly when used regularly and are ineffective for many sufferers.

 

Most practitioners consider lifestyle changes that help control stress and promote regular exercise to be an important part of headache treatment and prevention. Avoiding situations that trigger headaches is also vital. A number of research studies have reported that mindfulness training is an effective treatment for headache pain. But there is a need for further study.

 

In today’s Research News article “Use of Mindfulness-based Cognitive Therapy to Change Pain-related Cognitive Processing in Patients with Primary Headache: A Randomized Trial with Attention Placebo Control Group.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6925538/), Namjoo and colleagues recruited adults with chronic primary headaches and randomly assigned them to receive 8 weekly 2-hour group sessions of either Mindfulness-Based Cognitive Therapy (MBCT) or an Attention Placebo Control condition. MBCT consists of mindfulness training and Cognitive Behavioral Therapy (CBT) and assigned homework. During therapy the patient is trained to investigate and alter aberrant thought patterns underlying their reactions to headache pain. The Attention Placebo Control condition consists of therapist attention and empathy and group discussion. The patients were measured before and after training and 3 months later for pain, pain interference in everyday life, pain severity, and pain related cognitive processes.

 

A strength of the study is the Attention Placebo Control condition which is an excellent control condition that would be helpful in assessing placebo, attentional, and Hawthorne confounding effects. Even with this strong control condition, they found that at the 3-month follow up in comparison to the Attention Placebo Control condition the Mindfulness-Based Cognitive Therapy (MBCT) group had significant reductions in pain intensity, pain interference, pain reappraisal, and pain focus, and significant increases in pain openness. The reductions in pain interference and pain focus, and the increases in pain openness continued to improve from the end of training to the 3-month follow up.

 

These results suggest that Mindfulness-Based Cognitive Therapy (MBCT) is a safe, effective, and lasting treatment for primary headache, reducing pain and its interference in the daily activities of the patients. In addition, the results suggest that MBCT produces changes in the cognitive responses to the headache pain. It reduces pain focus suggesting that the patients pay less attention to the headache pain allowing them to attend to other aspects of their lives. It also increases the openness to pain such that they allow the pain to occur without fighting against it which can increase the pain. So, the study suggests that MBCT reduce primary headache symptoms and does so by improving the ways in which the patients think about and react to the pain.

 

So, improve headache pain with mindfulness.

 

Mindfulness for Migraine is effective because it teaches the sympathetic nervous system to let go rather than running on fight-or-flight mode. This deep, internal relaxation of the nervous system fosters healing and helps protect the body from a Migraine attack.” – Susan Dawson Cook

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Namjoo, S., Borjali, A., Seirafi, M., & Assarzadegan, F. (2019). Use of Mindfulness-based Cognitive Therapy to Change Pain-related Cognitive Processing in Patients with Primary Headache: A Randomized Trial with Attention Placebo Control Group. Anesthesiology and pain medicine, 9(5), e91927. doi:10.5812/aapm.91927

 

Abstract

Background

Mindfulness-based interventions have shown to be efficient in managing chronic pain. Cognitive factors play a prominent role in chronic pain complications and negative cognitive contents about pain are often the first issues targeted in cognitive-based therapies, which are known as first-line treatment of chronic pain over the past decades. Little, however, is known about the manner of thinking about pain or pain-related cognitive processing.

Objectives

Therefore, the purpose of this study was to investigate the effect of mindfulness-based cognitive therapy (MBCT) on pain-related cognitive processing and control of chronic pain in patients with primary headache.

Methods

A clinical trial was conducted in 2017 – 2018 on 85 Persian language patients with one type of primary headache selected through purposive sampling in Emam Hossein Hospital in Tehran province. To measure the variables of the study, we used the Brief Pain Inventory (BPI) and Pain-related Cognitive Processing Questionnaire (PCPQ). All data were analyzed by independent t-test and chi-square and longitudinal data were analyzed using linear mixed model analysis.

Results

Statistically significant time × group interactions were found in pain intensity (P < 0.001), pain interference (P < 0.001), as well as in three cognitive processing subscales including pain focus, pain distancing, and pain openness (P < 0.001). However, the results of pain diversion were not meaningful.

Conclusions

MBCT is a potentially efficacious approach for individuals with headache pain. Regulation and correction of cognitive processing are considered as effective cognitive coping strategies in MBCT treatment.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6925538/

 

Improve Quality of Life with Migraine Headaches with Mindfulness

Improve Quality of Life with Migraine Headaches with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Be mindful of your breathing. If you notice that your respirations are fast and shallow, concentrate on taking slower, deeper and longer breaths. As your breathing slows, your body will begin to relax. Tensions and stress slowly will ebb from your body, allowing you to release the some of the pain and discomfort associated with your headaches.” – National Headache Institute

 

Migraine headaches are a torment far beyond the suffering of a common headache. It is an intense throbbing pain usually unilateral, focused on only one side of the head and lasts from 4 hours to 3 days. They are actually a collection of neurological symptoms. Migraines often include: visual disturbances, nausea, vomiting, dizziness, extreme sensitivity to sound, light, touch and smell, and tingling or numbness in the extremities or face. Migraines are the 8th most disabling illness in the world. While most sufferers experience attacks once or twice a month, about 4% have chronic daily headaches. Migraines are very disruptive to the sufferer’s personal and work lives as most people are unable to work or function normally when experiencing a migraine.

 

There is no known cure for migraine headaches. Treatments are targeted at managing the symptoms. Prescription and over-the-counter pain relievers are frequently used. There are a number of drug and drug combinations that appear to reduce the frequency of migraine attacks. These vary in effectiveness but unfortunately can have troubling side effects and some are addictive. Behaviorally, relaxation and sleep appear to help lower the frequency of migraines. Mindfulness practices have been shown to reduce stress and improve relaxation. So, they may be useful in preventing migraines. Indeed, it has been shown that mindfulness practice can reduce headache pain.

 

In today’s Research News article “Mindfulness for female outpatients with chronic primary headaches: an internet-based bibliotherapy.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6036307/ ), Tavallaei and colleagues recruited women suffering with migraine headaches and randomly assigned them to receive either an on-line mindfulness training based upon the Mindfulness-Based Stress Reduction (MBSR) program or medical treatment as usual. The mindfulness training program was presented over the internet in 8 weekly sessions and included meditation, body scan, and didactic presentation. The participants were measured before and after treatment for mindfulness, migraine disability, pain, and distress including depression, anxiety, and stress.

 

They found that in comparison to the baseline and the treatment-as-usual control group that the group who received mindfulness training had significantly lower levels of migraine disability, distress, and pain and significantly higher levels of mindfulness. They found that the reductions in pain were due to changes in the emotional reactions to pain and not the sensory experiences of pain. So, the pain was perceived normally but the women did not react to the sensations emotionally and this resulted in a lower impact of the headache pain.

 

The results suggest that mindfulness training increases the quality of life and reduces the psychological distress of women with migraine headaches. Similar findings have been reported in other prior research studies. The importance of the present study resides in the presentation of the program over the internet. Presentation over the internet is important as in-person programs are inconvenient and expensive. Presentation over the internet allows for widespread, convenient, and inexpensive distribution of the therapy to affected populations. This makes mindfulness training more readily available to migraine sufferers.

 

So, improve quality of life with migraine headaches with mindfulness.

 

“mindfulness has been examined as a treatment for chronic pain and pain-related conditions, finding positive results such as reduction in medication usage, improved physical functioning, and physical-health-related quality of life.” – Monika Tomova

 

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

 

Tavallaei, V., Rezapour-Mirsaleh, Y., Rezaiemaram, P., & Saadat, S. H. (2018). Mindfulness for female outpatients with chronic primary headaches: an internet-based bibliotherapy. European Journal of Translational Myology, 28(2), 7380. http://doi.org/10.4081/ejtm.2018.7380

 

Abstract

Our aim was to investigate effectiveness of mindfulness by bibliotherapy on disability, distress, perceived pain and mindfulness in women with tension headaches and migraines. Primary headaches have been of great interest to mental health researchers because of the high prevalence, as well as significant disability and distress in the affected people. Despite the promising results of in-person treatment and some limitations that such interventions may cause, patients may be encountered with problems when using health care services. The present study is a quasi-experimental randomized design with pre-test, post-test, and control group. The study population consisted of 1396 women with migraine headache referring to headache clinic of Baqiyatallah Hospital in Tehran. Of these, 30 patients (including tboh experimental and control group) were selected by objective sampling method and were randomly assigned to the two groups. The experimental group, in addition to medical treatment as usual, was treated for a period of 8 sessions by Mindfulness-based Stress Reduction Internet-based Bibliotherapy, but the control group used only the medical treatment. The sample had no attritions. Data were collected by the four scales of (DASS-21), Migraine Disability Assessment Test (MIDAS), McGill’s Short Form Questionnaire (MPQ-SF), and Mindfulness Inventory (MAAS). We used covariance analysis to analyze the findings in the measured scales. MBSR-IBB treatment had no significant effect on pain sensory dimension (P <0.44), despite improvement of mindfulness (P <0.0001). In contrast, the greatest effect was on the level of disability (P <0.0001). We observed also a significant improvement in distress (P <0.0001). In conclusion, in spite of the presence of headaches, the mindfulness improved the quality of life and reduced the level of mental distress. In addition, using the Internet-based bibliotherapy method, these services can be used with easier access, lower cost, and more flexibility.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6036307/

 

Improve Headache Pain with Mindfulness

Improve Headache Pain with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness-based stress reduction (MBSR) can be a safe and effective means of lessening the effect of migraine headache and can be carried out while patients continue to take migraine medication.” – Pauline Anderson

 

Headaches are the most common disorders of the nervous system. It has been estimated that 47% of the adult population have a headache at least once during the last year. There are a wide variety of drugs that are prescribed for chronic headache pain with varying success. Headaches are treated with pain relievers, ergotamine, blood pressure drugs such as propranolol, verapamil, antidepressants, antiseizure drugs, and muscle relaxants. Drugs, however, can have some problematic side effects particularly when used regularly and are ineffective for many sufferers. So, almost all practitioners consider lifestyle changes that help control stress and promote regular exercise to be an important part of headache treatment and prevention. Avoiding situations that trigger headaches is also vital.

 

Individual studies have reported that mindfulness training is an effective treatment for headache pain. There is a need, however, to summarize and analyze the existing literature. In today’s Research News article “Mindfulness Meditation for Primary Headache Pain: A Meta-Analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5887742/ ), Gu and colleagues review, summarize, and perform a meta-analysis of the effectiveness of meditation practice for headache pain. They identified 11 published studies with adult patients. They find that the studies report that mindfulness meditation produces not only a significant reduction in headache pain but also a significant reduction in the frequency of headaches. Subgroup analysis revealed that Mindfulness-Based Stress Reduction (MBSR) was effective in reducing pain and 8 weeks of mindfulness meditation was effective in producing pain reduction.

 

Hence, the published research literature supports the conclusion that mindfulness meditation is a safe and effective treatment for headaches, reducing their number and intensity. Some of the effects of mindfulness practices are to alter thought processes, changing what is thought about. In terms of pain, mindfulness training, by focusing attention on the present moment has been shown to reduce worry and catastrophizing. Pain is increased by worry about the pain and the expectation of greater pain in the future. So, reducing worry and catastrophizing can reduce headache pain. In addition, mindfulness improves self-efficacy, the belief that the individual can adapt to and handle headache pain. In addition, mindfulness training also has been shown to alter not only what is thought, but also how thoughts are processed. Central to this cognitive change is mindfulness and acceptance. By mindfully viewing pain as a present moment experience it can be experienced just as it is and by accepting it, the individual stops fighting against the pain which can amplify the pain.

 

So, improve headache pain with mindfulness.

 

“Mindfulness meditation is proving to be of significant help in not only reducing migraines or chronic pain, but improvements in mood, outlook on life and illness, increased coping skills, enhanced sense of well-being, changes in perception of pain, higher tolerance of pain, enhanced immune function, less fatigue and stress and better sleep. Beyond that, other benefits that are derived from mindfulness include improved cognitive functioning and memory, more inner peace, empathy and compassion, higher levels of self-awareness, joy, pleasure, creativity, insight and intuition, all of which result in a life that is deeper and more fulfilling on many levels.” – Cynthia Perkins

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Gu, Q., Hou, J.-C., & Fang, X.-M. (2018). Mindfulness Meditation for Primary Headache Pain: A Meta-Analysis. Chinese Medical Journal, 131(7), 829–838. http://doi.org/10.4103/0366-6999.228242

 

Abstract

Background:

Several studies have reported that mindfulness meditation has a potential effect in controlling headaches, such as migraine and tension-type headache; however, its role remains controversial. This review assessed the evidence regarding the effects of mindfulness meditation for primary headache pain.

Methods:

Only English databases (PubMed, Cochrane Central Register of Controlled Trials [the Cochrane Library], PsycINFO, Psychology and behavioral science collection, PsyArticles, Web of Science, and Scopus) were searched from their inception to November 2016 with the keywords (“meditation” or “mindfulness” or “vipassana” or “dzogchen” or “zen” or “integrative body-mind training” or “IBMT” or “mindfulness-based stress reduction” or “MBSR” or “mindfulness-based cognitive therapy” or “MBCT” and “Headache” or “Head pain” or “Cephalodynia” or “Cephalalgia” or “Hemicrania” or “Migraine”). Titles, abstracts, and full-text articles were screened against study inclusion criteria: controlled trials of structured meditation programs for adult patients with primary headache pain. The quality of studies included in the meta-analysis was assessed with the Yates Quality Rating Scale. The meta-analysis was conducted with Revman 5.3.

Results:

Ten randomized controlled trials and one controlled clinical trial with a combined study population of 315 patients were included in the study. When compared to control group data, mindfulness meditation induced significant improvement in pain intensity (standardized mean difference, −0.89; 95% confidence interval, −1.63 to −0.15; P = 0.02) and headache frequency (−0.67; −1.24 to −0.10; P = 0.02). In a subgroup analysis of different meditation forms, mindfulness-based stress reduction displayed a significant positive influence on pain intensity (P < 0.000). Moreover, 8-week intervention had a significant positive effect (P< 0.000).

Conclusions:

Mindfulness meditation may reduce pain intensity and is a promising treatment option for patients. Clinicians may consider mindfulness meditation as a viable complementary and alternative medical option for primary headache.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5887742/

Improve Migraine Headaches with Spiritual Meditation

Improve Migraine Headaches with Spiritual Meditation

 

By John M. de Castro, Ph.D.

 

Meditation is an ancient spiritual practice that people are still using today to get headache relief. This mind-body practice seems to work by relieving stress associated with headache pain.” – Chris Iliades

 

Migraine headaches are a torment far beyond the suffering of a common headache. It is an intense throbbing pain usually unilateral, focused on only one side of the head and lasts from 4 hours to 3 days. They are actually a collection of neurological symptoms. Migraines often include: visual disturbances, nausea, vomiting, dizziness, extreme sensitivity to sound, light, touch and smell, and tingling or numbness in the extremities or face. Migraines are the 8th most disabling illness in the world. In the U.S. they affect roughly 40 million men, women and children. While most sufferers experience attacks once or twice a month, 14 million people or about 4% have chronic daily headaches. Migraines are very disruptive to the sufferer’s personal and work lives as most people are unable to work or function normally when experiencing a migraine.

 

There is no known cure for migraine headaches. Treatments are targeted at managing the symptoms. Prescription and over-the-counter pain relievers are frequently used. There are a number of drug and drug combinations that appear to reduce the frequency of migraine attacks. These vary in effectiveness but unfortunately can have troubling side effects and some are addictive. Behaviorally, relaxation and sleep appear to help lower the frequency of migraines. Mindfulness practices have been shown to reduce stress and improve relaxation. So, they may be useful in preventing migraines. Indeed, it has been shown that mindfulness practice can reduce headache pain.

 

There are a wide variety of meditation techniques. It is not known which kinds work best for migraine headaches. In today’s Research News article “Effect of Different Meditation Types on Migraine Headache Medication Use.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4600642/ ), Wachholtz and colleagues examine the effectiveness of spiritual focused vs. secular meditation techniques on treating migraine headaches. They recruited adult migraine sufferers who had at least 2 migraine headaches per month and who were naive to meditation. They were randomly assigned to one of four groups who meditated for 20 minutes per day for 30 days; Spiritual Meditation, Internally Focused Secular Meditation, Externally Focused Secular Meditation, or Progressive Muscle Relaxation.

 

The meditation techniques differed in a phrase that the participants repeated to themselves and used as a focus for their meditation during the 20-minute daily period. For the Spiritual Meditation group the participants chose one of four phrases; “God is peace,” “God is joy,” God is good,” and “God is love.” For the Secular Internal Meditation group the participants chose either; “I am content,” “I am joyful,” “I am good,” “I am happy.” For the Secular External Meditation group the participants chose either; “Grass is green,” “Sand is soft,” “Cotton is fluffy,” “Cloth is smooth.” The Relaxation group practiced progressive muscle relaxation, systematically tensing and relaxing muscles. Participants were measured before and after the 30 days of meditation for headache frequency, intensity, and usage of migraine medications, and for spiritual and religious experiences and activities. They also maintained daily headache diaries.

 

They found that while all groups showed some improvement in migraine frequency, the Spiritual Meditation groups had significantly greater improvement than the other groups. In addition, while all groups showed significant reduction in the use of migraine medications, the Spiritual Meditation groups had significantly greater reductions. There was, however, no change in the severity of the migraines. Hence, although there were fewer headaches, when they did occur they were just as intense as usual. It should be noted, however, that there wasn’t a no-treatment control. So, it is unclear that improvements would not have occurred without treatment.

 

The results suggest that meditation and relaxation, but especially spiritually focused meditation, can improve migraine frequency and medication use. Mindfulness practices, in the previous research have been shown to be effective in treating pain from a variety of sources including headaches. It is not clear, however, why meditating with a spiritual focus is superior to secular focused meditation or relaxation. Perhaps focusing on a greater power relieves the stress of searching for the sources of the headaches within the self or the environment, and the stress reduction, in turn, reduces the likelihood of a migraine.

 

So, improve migraine headaches with spiritual meditation.

 

“This kind of moment-to-moment, positive mindfulness is crucial for chronic pain sufferers. Pain is only ever exacerbated by depression and despair. And depression and despair most definitely intensify pain. Thus, the dark circle of chronic illness. Mindfulness can stop this cycle in its tracks by allowing the patient to take back control and climb out of the gloom, a single moment at a time. “ – Ashley Jonkman

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Wachholtz, A. B., Malone, C. D., & Pargament, K. I. (2017). Effect of Different Meditation Types on Migraine Headache Medication Use. Behavioral Medicine (Washington, D.C.), 43(1), 1–8. http://doi.org/10.1080/08964289.2015.1024601

 

Abstract

Spiritual meditation has been found to reduce the frequency of migraines and physiological reactivity to stress. However, little is known about how introducing a spirituality component into a meditation intervention impacts analgesic medication usage. In this study, 92 meditation naïve participants were randomly assigned to four groups (Spiritual Meditation (N=25), Internally Focused Secular Meditation (N=23), Externally Focused Secular Meditation (N=22), Progressive Muscle Relaxation (N=22)) and practiced their technique for 20min/day over 30 days while completing daily diaries. Headache frequency, headache severity, and pain medication use were assessed. Migraine frequency decreased in the Spiritual Meditation group compared to other groups (p<.05). Headache severity ratings did not differ across groups (p=NS). After adjusting for headache frequency, migraine medication usage decreased in the Spiritual Meditation group compared to other groups (p<.05). Spiritual Meditation was found to not affect pain sensitivity, but it does improve pain tolerance with reduced headache related analgesic medication usage.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4600642/

Improve Migraine Headaches with Mindfulness

Improve Migraine Headaches with Mindfulness

 

By John M. de Castro, Ph.D.

 

“When we allow our minds, hearts, and bodies to be heard and felt through mindful attention, they will say back to us, “Thank you for listening,” not because we tried to fix anything but just because we paid attention with gentle, nonjudgmental awareness. This nurturing umbrella of awareness is the key. It is both a form of refuge and a means of really being able to take control of and managing our lives. It is a way we can cultivate and honor the wholeness of our being. It is how we heal.” – American Migraine Foundation

 

Migraine headaches are a torment far beyond the suffering of a common headache. It is an intense throbbing pain usually unilateral, focused on only one side of the head. They last from 4 hours to 3 days. They are actually a collection of neurological symptoms. Migraines often include: visual disturbances, nausea, vomiting, dizziness, extreme sensitivity to sound, light, touch and smell, and tingling or numbness in the extremities or face. Migraines are the 8th most disabling illness in the world. They disproportionately affect women with about 18% of American women and 6% of men suffering from migraine. In the U.S. they affect roughly 40 million men, women and children. While most sufferers experience attacks once or twice a month, 14 million people or about 4% have chronic daily headaches. Migraines are very disruptive to the sufferer’s personal and work lives as most people are unable to work or function normally when experiencing a migraine.

 

There is no known cure for migraine headaches. Treatments are targeted at managing the symptoms. Prescription and over-the-counter pain relievers are frequently used. There are a number of drug and drug combinations that appear to reduce the frequency of migraine attacks. These vary in effectiveness but unfortunately can have troubling side effects and some are addictive. Behaviorally, relaxation and sleep appear to help lower the frequency of migraines. Mindfulness practices have been shown to reduce stress and improve relaxation. So, they may be useful in preventing migraines. Indeed, it has been shown that mindfulness practice can reduce headache pain.

 

In today’s Research News article “Mindfulness and pharmacological prophylaxis after withdrawal from medication overuse in patients with Chronic Migraine: an effectiveness trial with a one-year follow-up.” See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5292107/

Grazzi and colleagues recruited patients who were diagnosed with chronic migraine headaches with accompanying overuse of medications. They were withdrawn from medications over a 45-day period. The patients then volunteered to participate in a research study and were assigned to receive and 8-week Mindfulness Based Stress Reduction (MBSR) program or prophylactic (preventive) migraine medication. They were measured before and after treatment and at 6-months and 12-months later for headache frequency, frequency of pain reliever use, headache impact, migraine disability, depression, and anxiety.

 

They found that both MBSR and prophylactic medication treatment produced clinically significant reductions in headache frequency, pain reliever use, headache impact, migraine disability, and depression. These benefits were maintained at 6-monmth and 1-year follow-ups. These are preliminary findings as there wasn’t a control group present. But, the findings are exciting and the effects large, suggesting that mindfulness training is as effective in treating migraine headaches as prophylactic medications. Since the MBSR training, unlike the drugs, has no known adverse effects, it would appear to be a preferred treatment for migraine headaches.

 

Some of the effects of mindfulness practices are to alter thought processes, changing what is thought about. In terms of pain, mindfulness training, by focusing attention on the present moment has been shown to reduce worry and catastrophizing. Pain is increased by worry about the pain and the expectation of greater pain in the future. So, reducing worry and catastrophizing can reduce headache pain. In addition, mindfulness improves self-efficacy, the belief that the individual can adapt to and handle headache pain. Mindfulness training also has been shown to alter not only what is thought, but also how thoughts are processed. Central to this cognitive change is mindfulness and acceptance. By mindfully viewing pain as a present moment experience it can be experienced just as it is and by accepting it, the individual stops fighting against the pain which can amplify the pain.

 

So, improve migraine headaches with mindfulness.

 

“Can you namaste your migraines away? A new, small study published in the journal Headache suggests that meditation may help relieve the intensity and duration of migraines.” – Mandy Oaklander

 

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

Grazzi, L., Sansone, E., Raggi, A., D’Amico, D., De Giorgio, A., Leonardi, M., … Andrasik, F. (2017). Mindfulness and pharmacological prophylaxis after withdrawal from medication overuse in patients with Chronic Migraine: an effectiveness trial with a one-year follow-up. The Journal of Headache and Pain, 18(1), 15. http://doi.org/10.1186/s10194-017-0728-z

 

Abstract

Background

Chronic Migraine (CM) is a disabling condition, worsened when associated with Medication Overuse (MO). Mindfulness is an emerging technique, effective in different pain conditions, but it has yet to be explored for CM-MO. We report the results of a study assessing a one-year course of patients’ status, with the hypothesis that the effectiveness of a mindfulness-based approach would be similar to that of conventional prophylactic treatments.

Methods

Patients with CM-MO (code 1.3 and 8.2 of the International Classification of Headache Disorders-3Beta) completed a withdrawal program in a day hospital setting. After withdrawal, patients were either treated with Prophylactic Medications (Med-Group), or participated in a Mindfulness-based Training (MT-Group). MT consisted of 6 weekly sessions of guided mindfulness, with patients invited to practice 7–10 min per day. Headache diaries, the headache impact test (HIT-6), the migraine disability assessment (MIDAS), state and trait anxiety (STAI Y1-Y2), and the Beck Depression Inventory (BDI) were administered before withdrawal and at each follow-up (3, 6, 12 after withdrawal) to patients from both groups. Outcome variables were analyzed in separate two-way mixed ANOVAs (Group: Mindfulness vs. Pharmacology x Time: Baseline, 3-, 6-, vs. 12-month follow-up).

Results

A total of 44 patients participated in the study, with the average age being 44.5, average headache frequency/month was 20.5, and average monthly medication intake was 18.4 pills. Data revealed a similar improvement over time in both groups for Headache Frequency (approximately 6–8 days reduction), use of Medication (approximately 7 intakes reduction), MIDAS, HIT-6 (but only for the MED-Group), and BDI; no changes on state and trait anxiety were found. Both groups revealed significant and equivalent improvement with respect to what has become a classical endpoint in this area of research, i.e. 50% or more reduction of headaches compared to baseline, and the majority of patients in each condition no longer satisfied current criteria for CM.

Conclusions

Taken as a whole, our results suggest that the longitudinal course of patients in the MT-Group, that were not prescribed medical prophylaxis, was substantially similar to that of patients who were administered medical prophylaxis.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5292107/

 

 

Help Headaches in Adolescents with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness meditation is proving to be of significant help in not only reducing migraines or chronic pain, but improvements in mood, outlook on life and illness, increased coping skills, enhanced sense of well-being, changes in perception of pain, higher tolerance of pain, enhanced immune function, less fatigue and stress and better sleep.” – Cynthia Perkins

 

Headaches are the most common disorders of the nervous system. It has been estimated that 47% of the adult population have a headache at least once during the last year. There are a wide variety of drugs that are prescribed for chronic headache pain with varying success. Headaches are treated with pain relievers, ergotamine, blood pressure drugs such as propranolol, verapamil, antidepressants, antiseizure drugs, and muscle relaxants. Drugs, however, can have some problematic side effects particularly when used regularly and are ineffective for many sufferers. So, almost all practitioners consider lifestyle changes that help control stress and promote regular exercise to be an important part of headache treatment and prevention. Avoiding situations that trigger headaches is also vital.

 

Mindfulness training has been shown to be an effective treatment for headache pain in adults. It is not known whether it is also effective for adolescents. Yet, 60% of children and adolescents report headaches, with 20% having frequent or severe headaches. In today’s Research News article “Mindfulness-Based Intervention for Adolescents with Recurrent Headaches: A Pilot Feasibility Study.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1415631915127397/?type=3&theater

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

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4700163/

Hesse and colleagues study the effectiveness of mindfulness training for recurrent headaches in adolescents. They recruited adolescent females with recurrent headaches. The teens received group mindfulness training once a week for 1 to 1.5 hours for 12 weeks. Before and after training the adolescents recorded their mindfulness practices and headaches, and completed scales measuring headache-related disability, anxiety, depression, and quality of life, while their parents also completed a report of the teens’ quality of life.

 

They found that mindfulness training did not produce any changes in the frequency or severity of headaches, headache-related disability, or anxiety, but a significant reduction in depression and an improvement in acceptance of headache pain. The parents reported that the adolescents had improved physical quality of life. Hence, mindfulness training improved the teen’s depression, quality of life, and acceptance of pain but not the headaches themselves. These are encouraging results that need to be followed up with a large randomized controlled clinical trial. But, they suggest that mindfulness training may be a useful treatment for headache pain in adolescents.

 

Mindfulness practices may be helpful with headache pain by focusing attention on the present moment. This has been shown to reduce worry and catastrophizing which, in turn, reduces depression. Pain is increased by worry about the pain and the expectation of greater pain in the future. So, reducing worry and catastrophizing can reduce headache pain. Mindfulness teaches the individual to view pain as a present moment experience that can be experienced just as it is and accept it. As a result, the individual accepts the pain and stops fighting against it, which can amplify the pain.

 

So, help headaches in adolescents with mindfulness.

 

“Years of research and clinical experience demonstrate that behavioral medicine methods can have a powerful effect on pain, especially when used in conjunction with medical treatment. Behavioral medicine examines and trains an individual to become aware of the power of the mind and emotions on physical health. One potent method for recovering health is meditation.” – Michigan Headache & Neurological Institute

 

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

Hesse, T., Holmes, L. G., Kennedy-Overfelt, V., Kerr, L. M., & Giles, L. L. (2015). Mindfulness-Based Intervention for Adolescents with Recurrent Headaches: A Pilot Feasibility Study. Evidence-Based Complementary and Alternative Medicine : eCAM, 2015, 508958. http://doi.org/10.1155/2015/508958

 

Abstract

Recurrent headaches cause significant burden for adolescents and their families. Mindfulness-based interventions (MBIs) have been shown to reduce stress and alter the experience of pain, reduce pain burden, and improve quality of life. Research indicates that MBIs can benefit adults with chronic pain conditions including headaches. A pilot nonrandomized clinical trial was conducted with 20 adolescent females with recurrent headaches. Median class attendance was 7 of 8 total sessions; average class attendance was 6.10 ± 2.6. Adherence to home practice was good, with participants reporting an average of 4.69 (SD = 1.84) of 6 practices per week. Five participants dropped out for reasons not inherent to the group (e.g., extracurricular scheduling); no adverse events were reported. Parents reported improved quality of life and physical functioning for their child. Adolescent participants reported improved depression symptoms and improved ability to accept their pain rather than trying to control it. MBIs appear safe and feasible for adolescents with recurrent headaches. Although participants did not report decreased frequency or severity of headache following treatment, the treatment had a beneficial effect for depression, quality of life, and acceptance of pain and represents a promising adjunct treatment for adolescents with recurrent headaches.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4700163/

 

Reduce Pain by Accepting it Mindfully

By John M. de Castro, Ph.D.

 

“They were able to have a sense of personal control over their migraines. It really makes us wonder if an intervention like meditation can change the way people interpret their pain.” – Rebecca Erwin Wells

 

Headaches are the most common disorders of the nervous system. It has been estimated that 47% of the adult population have a headache at least once during the last year. The most common type of headache is the tension headache with 80 to 90 percent of the population suffering from tension headaches at least some time in their lives. The second most common type of headache is the migraine headache. Around 16 to 17 percent of the population complains of migraines. It is the 8th most disabling illness in the world with more than 90% of sufferers unable to work or function normally during their migraine. American employers lose more than $13 billion each year as a result of 113 million lost work days due to migraine.

 

There are a wide variety of drugs that are prescribed for chronic headache pain with varying success. Most tension headaches can be helped by taking pain relievers such as aspirin, naproxen, acetaminophen, or ibuprofen. A number of medications can help treat and prevent migraines and tension headaches, including ergotamine, blood pressure drugs such as propranolol, verapamil, antidepressants, antiseizure drugs, and muscle relaxants. Drugs, however, can have some problematic side effects particularly when used regularly and are ineffective for many sufferers. So, almost all practitioners consider lifestyle changes that help control stress and promote regular exercise to be an important part of headache treatment and prevention. Avoiding situations that trigger headaches is also vital.

 

Mindfulness training has been shown to be an effective treatment for headache pain. Some of the effects of mindfulness practices are to alter thought processes, changing what is thought about. In terms of pain, mindfulness training, by focusing attention on the present moment has been shown to reduce worry and catastrophizing. Pain is increased by worry about the pain and the expectation of greater pain in the future. So, reducing worry and catastrophizing can reduce headache pain. In addition, mindfulness improves self-efficacy, the belief that the individual can adapt to and handle headache pain. In addition, mindfulness training also has been shown to alter not only what is thought, but also how thoughts are processed. Central to this cognitive change is mindfulness and acceptance. By mindfully viewing pain as a present moment experience it can be experienced just as it is and by accepting it, the individual stops fighting against the pain which can amplify the pain.

 

It is not known whether it is the changes in the what or how, or both, of thoughts that is responsible for mindfulness training’s efficacy in treating headache pain. In today’s Research News article “The mediating role of pain acceptance during mindfulness-based cognitive therapy for headache.” See:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1229081490449108/?type=3&theater

or see below

Day and Thorn investigate this question. They randomly assigned headache patients to receive either 8-weeks of Mindfulness Based Cognitive Therapy (MBCT) or treatment as usual as a wait-list control condition. Before and again after treatment measurements were obtained of pain, pain acceptance, pain catastrophizing, and pain self-efficacy.

 

They found, as has previously been shown, that the MBCT training significantly reduced the level of pain and pain catastrophizing, and increased the levels of pain self-efficacy and pain acceptance. Day and Thorn then went on to use a sophisticated statistical technique to assess whether the change in pain produced by mindfulness training was due to the changes in the what or how about thinking. They found that only the how aspect of thought, pain acceptance, significantly mediated the effect. Neither of the what aspects of thought, pain catastrophizing nor pain self-efficacy, were significantly related to the mindfulness training effects on pain.

 

These results are very interesting and potentially important. They suggest that mindfulness training reduces headache pain by altering how pain is thought about, increasing acceptance of the pain. Acceptance is defined as the “conscious willingness to stay in direct contact with experience.” This may operate by reducing the individual’s attempts to counteract the pain. Since, fighting against the pain can actually increase the level of pain, accepting the pain interferes with this amplifying process, thus lowering the pain level experienced. It is interesting that neither the pain catastrophizing nor pain self-efficacy were significant mediators as they have long been thought to be important mechanisms of mindfulness’ effectiveness for pain management. But, it is clear that how pain is thought about, in particular, the acceptance of pain, is the key.

 

So, reduce pain by accepting it mindfully.

 

“Awareness transforms emotional pain just as it transforms the pain that we attribute more to the domain of body sensations. When we are immersed in emotional pain, if we pay close attention, we will notice that there is always an overlay of thoughts and a plethora of different feelings about the pain we are in, so here too the entire constellation of what we think of as emotional pain can be welcomed in and held in awareness.”Jon Kabat-Zinn

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Study Summary

 

Day MA, Thorn BE. The mediating role of pain acceptance during mindfulness-based cognitive therapy for headache. Complement Ther Med. 2016 Apr;25:51-4. doi: 10.1016/j.ctim.2016.01.002. Epub 2016 Jan 13.

 

Highlights

  • Pain acceptance was a significant mediator of the MBCT-pain interference relation.
  • Specifically, activity engagement emerged as the critical component of acceptance.
  • Pain catastrophizing and self-efficacy did not meet criteria for mediation.
  • This is the first study to show acceptance is a key mediator of MBCT for headache.

Abstract

Objectives: This study aimed to determine if mindfulness-based cognitive therapy (MBCT) engenders improvement in headache outcomes via the mechanisms specified by theory: (1) change in psychological process, (i.e., pain acceptance); and concurrently (2) change in cognitive content, (i.e., pain catastrophizing; headache management self-efficacy).

Design: A secondary analysis of a randomized controlled trial comparing MBCT to a medical treatment as usual, delayed treatment (DT) control was conducted. Participants were individuals with headache pain who completed MBCT or DT (N = 24) at the Kilgo Headache Clinic or psychology clinic. Standardized measures of the primary outcome (pain interference) and proposed mediators were administered at pre- and post-treatment; change scores were calculated. Bootstrap mediation models were conducted.

Results: Pain acceptance emerged as a significant mediator of the group-interference relation (p < .05). Mediation models examining acceptance subscales showed nuances in this effect, with activity engagement emerging as a significant mediator (p < .05), but pain willingness not meeting criteria for mediation due to a non-significant pathway from the mediator to outcome. Criteria for mediation was also not met for the catastrophizing or self-efficacy models as neither of these variables significantly predicted pain interference.

Conclusions: Pain acceptance, and specifically engagement in valued activities despite pain, may be a key mechanism underlying improvement in pain outcome during a MBCT for headache pain intervention. The theorized mediating role of cognitive content factors was not supported in this preliminary study. A large, definitive trial is warranted to replicate and extend the findings in order to streamline and optimize MBCT for headache.