Table of Contents
II. How is Chronic Pain Treated?
III. Chronic Pain and the Brain
IV. What is Mindfulness Meditation?
V. Mindfulness Meditation and Chronic Pain
VI. Problems with Mindfulness Studies
Mindfulness meditation has been around for thousands of years, but it’s seen a surge of new interest in the last decade. Much of this enthusiasm for mindfulness is thanks to the popularity of yoga, which often includes meditative practice. But beyond helping to promote feelings of relaxation or spiritual contentment, new research is suggesting that mindfulness meditation, along side medications like Celebrex and Cymbalta, could be harnessed to help people with chronic pain.
What is Chronic Pain?
Acute pain is a type of pain that usually lasts less than 3-6 months. Acute pain may also be related to a non-invasive injury or soft tissue damage, such as a sprained ankle, for example. Acute pain gradually dissolves as tissues repair themselves and is distinct from chronic pain which is more severe.
Pain is labelled “chronic” when it lasts more than 3 months. Chronic pain can be associated with an injury, a long-term illness, or may have no apparent cause. In addition to the negative physical sensations, chronic pain is often accompanied by depression, anxiety, and insomnia.
How is Chronic Pain Treated?
There are a variety of treatment options based on the origin and location of chronic pain. Some of the most common include:
- Opioids: These are effective painkillers, but patients can develop a tolerance that makes them problematic for long-term use. As highly addictive drugs, prescription opioid use is a major contributor to the current overdose epidemic.
- NSAIDs: Prescription and over-the-counter NSAIDs help to relieve pain and inflammation, and are frequently used to help manage arthritis pain.
- Steroids: For chronic pain associated with inflammation, oral or injectable steroids may be prescribed.
- Antidepressants: Even in patients who aren’t experiencing depression, anti-depressant drugs can help to reduce chronic pain due to arthritis, nerve pain, migraines, or fibromyalgia.
- Radiofrequency ablation: This treatment uses a radiofrequency current to heat up and destroy the nerves that send pain signals, and can provide long-term relief for people suffering from spondylosis or nerve pain.
For many people, a combination of treatments is most effective to treat chronic pain. Along with the treatments listed above, some may opt to include the following:
- Physical therapy
- Exercise
- Acupuncture
- Psychological counseling
- Relaxation techniques (such as mindfulness meditation) [1]
Chronic Pain and the Brain
Chronic pain not only lasts longer than acute pain, but it also appears to be processed differently in the brain.
A 2013 report from Northwestern University made interesting discoveries during a study of people with acute and chronic pain. Subjects experiencing back pain for less than 3 months showed brain activity in the areas that are generally accepted to be involved in acute pain. But those with back pain for more than 10 years showed brain activity in parts of the brain that are believed to control emotion. Researchers followed up with the acute patients, and those who still had pain one year later showed a change in their scans, with brain activity now in the “emotional” centers.
The idea that chronic pain comes from a different part of the brain could explain why it’s so difficult to treat, and also why depression and anxiety often come along with long-term pain.
A 2015 report published in The Journal of Neuroscience on mindfulness meditation-based pain relief highlights exciting discoveries related to how much time is needed meditating to influence pain centers in the brain. The report explains how research has repeatedly shown that as little as three 20 minute daily sessions of mindfulness-based mental training can reduce pain ratings and improve health measures. [2]
Often people mention a barrier to meditating is not having enough time. Research now outlines how much time is needed in mindfulness meditation to reap the rewards. Perhaps this can be seen as a motivator, knowing that each time you sit down to meditate, you are affecting how the brain reacts to pain.
What is Mindfulness Meditation?
There are many types of meditation, some of which are rooted in a specific spiritual practice. Mindfulness is part of Buddhist teachings, but can be practiced without any religious affiliation.
Our current understanding of mindfulness meditation is modeled after the Mindfulness-Based Stress Reduction program created in 1979 by Jon Kabat-Zinn. [3]
This program was developed to help counter stress and chronic pain. Since then, the concept of mindfulness meditation has spread to the masses. Mindfulness meditation courses can be found in schools, prisons, at work, and is even being taught to professional athletes.
The main emphasis of mindfulness meditation is awareness of the present moment. Practice usually involves sitting in a comfortable, upright position with the eyes closed. Verbal cues from an instructor may include paying attention to physical sensations in the body and any thoughts or emotions that come up. Rather than attaching to thoughts, the meditator is guided back to the present moment by paying attention to the breath.
Mindfulness Meditation and Chronic Pain
Chronic pain appears to be processed differently by the brain. There’s a growing body of research that suggests mindfulness meditation might also involve changes in the brain. With medical imaging technology, researchers have been able to get new information as to how the brain responds to meditation and pain.
- People who are considered mindfulness experts or advanced meditators report feeling less pain even when they aren’t in a meditative state.
- Rather than “blocking” the areas of the brain associated with pain, the brain of a mindfulness expert seems to disconnect physical pain from the thought processes that can amplify it.
- In mindfulness meditators with a history of chronic pain, experiences of anxiety and depression significantly decreased. Pain acceptance increased, and subjects reported better mental quality of life. [4]
- MRI scans have revealed that 8 weeks of mindfulness practice appears to shrink the amygdala, the brain’s “fight or flight” center.
- In a 2015 study, mindfulness meditation was found to be more effective than placebos at reducing how participants rated the intensity and unpleasantness of painful stimuli. Brain scans revealed that mindfulness meditation deactivated the thalamus, which acts like the brain’s gateway for sensory information.
Problems with Mindfulness Studies
- A 2016 review of studies examining mindfulness meditation and chronic pain concluded that mindfulness appears to improve pain and depression. But more randomized controlled studies are needed to determine exactly how the practice can help people with chronic pain.
- The ways that being a mindfulness expert can change the brain may not be helpful when dealing with older people who are already in chronic pain.
- Studies that prove mindfulness meditation can reduce the intensity of acute pain may not necessarily translate to reduction in chronic pain.
- Funding for mindfulness meditation research is limited. Unlike studies involving drug trials, meditation isn’t a product that can be repeatedly sold to patients.
Start Meditating
Practicing mindfulness medication is relatively low risk. People with mental illness, PTSD, or a history of psychosis should proceed with caution and consult a psychiatric care provider. Here are some tips for getting started:
Find a teacher
It’s certainly possible to begin a mindfulness practice on your own, but attending a class or workshop with a teacher can help provide beginners with a solid introduction. It also gives the opportunity to ask questions about what you experience and talk to other people about the process.
Set time-based goals
Research has now identified the amount of time meditation needs to happen to be effective. But experts measured meditation from the lens of chronic pain. Don’t let this discourage you. Try setting a goal of five to ten minutes each day spent meditating. You may be surprised at the subtle changes you begin to feel when you are consistent with this practice.
Start slow
Begin with small, reasonable goals that make meditation easy to fit into your schedule. As you become more comfortable with the process, you’ll probably find yourself naturally meditating for longer.
Use an app
Using an app to meditate is becoming standard practice. Meditation apps offer a variety of verbally guided meditations that you can listen to anywhere. You can often choose a theme, such as compassion, happiness, or sleep, and select the amount of time you want to spend in meditation.
Mindfulness meditation may not replace the need for prescription drugs, but it can be a useful complementary treatment for those who struggle daily with pain. If this practice really does have the power to change the structure of our brains, it may be to everyone’s advantage to start practicing mindfulness before they develop a chronic medical condition.
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DISCLAIMER: The content in this article is intended for informational purposes only. This website does not provide medical advice. In all circumstances, you should always seek the advice of your physician and/or other qualified health professionals(s) for drug, medical condition, or treatment advice. The content provided on this website is not a substitute for professional medical advice, diagnosis or treatment.