Meditation and Mindfulness for the Management of Chronic Pain

By Alison Heyerdahl

It is estimated that around one in three people suffers from chronic pain associated with decreased quality of life and increased psychological distress.  It has a knock-on effect, causing missed workdays or early retirement, enormous discomfort, and often sleep disruption. Many people are prescribed medications such as opiates to help quell the pain but report that they can't function while taking these medications.  Furthermore, despite conventional medical care interventions, nearly half of these patients report their pain as not under control.

In patients with chronic pain, it has been found that stress, fear, and depression amplifies the perception of pain.  Mind-body approaches to chronic pain such as progressive muscle relaxation, meditation, laughter, and mindfulness-based approaches have been found to markedly reduce the pain experience. 

What is Chronic Pain?

Chronic pain is different from pain you experience from an injury or tissue damage.  While it often begins with an injury, it is perpetuated by other factors long after a reasonable time has passed for the injury to heal. Many people with chronic pain also experience stress, fear, anxiety, and depression.  These emotions and mental states amplify pain perception and can even cause other conditions, including burnout and chronic fatigue. 

In many cases, the brain will register pain messages in the absence of demonstrable tissue damage, making it difficult for doctors to verify the pain.  However, evidence suggests that neural loops in the brain are sensitized and maintained by focusing on the pain, meaning that the person becomes preoccupied with it and becomes emotionally and physically reactive to it.   For example, a person with chronic headaches is likely to experience more pain when psychologically or emotionally stressed. 

Does meditation help with chronic pain?

Have you ever wondered how injured soldiers can continue to function with severe war wounds or an athlete can continue to play with debilitating injuries?  It's because mental processes and distractions alter these sensory phenomena, and it is why meditation for chronic pain management works. 

Researchers have studied the effects of meditation on people, including attention regulation, body awareness, affect (or emotions), stress, anxiety, depression, and addiction.  They have also studied the use of meditation as a treatment for chronic pain.  According to a study performed at Wake Forest University, scientists found an approximately 40% reduction in pain intensity ratings during meditation compared to the non-meditating control group. 

How does meditation help in pain relief?

According to the study mentioned above, it seems that meditation activates and reinforces areas of the brain used in pain processing, reducing the pain experience.  It also decreases stress and emotional intensity, which in turn decreases the experience of pain. Furthermore, the relaxation response elicited by meditation is associated with greater pain tolerance because it has the potential to:

·         Cause muscle relaxation

·         Reduce inflammation

·         Reduce hypervigilance and desensitize central pain pathways in the brain

·         Reduce inflammation

·         Enhance mood and reduce emotional reactivity to pain

Meditation also creates an attitude of acceptance toward chronic pain symptoms, thereby reducing the emotional reactivity to pain. 

Furthermore, in the long term, meditation can change the structure of the brain.  The resulting increase in cortical (or brain) thickness makes people less pain-sensitive.  Meditation also induces the body's own opioid (or pain-reducing) system – such as the endorphin-release you experience during heavy exercise.

According to Jon Kabat-Zinn, American professor emeritus of medicine and creator of the Center for Mindfulness in Medicine, pain reduction occurs by 'uncoupling' the physical sensation from the emotional experience, thereby reducing the pain. 

Interestingly, it also works for beginner meditators – one does not need to be a practiced Zen master to experience the benefits of meditation practice.

Conclusion

Chronic pain can be debilitating, often causing a myriad of other problems, such as depression, anxiety, and psychological distress. Usually, the side effects of pain worsen the pain experience, leading to a vicious cycle.  Evidence exists that meditation helps some people with pain, reducing pain sensitivity and increasing the brain's own pain-reducing opioids.

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