We all experience pain, , either short-term or chronic. Mindfulness is an effective tool in managing it.
While we spend the vast majority of our time talking about the brain and mind, they’re housed in a body and that body frequently hurts. That in turn affects the mind, so today, we’ll look at how mindfulness meditation can be used in managing pain. Almost everyone experiences minor pain on a frequent basis and chronic pain affects 1.5 billion people worldwide.
The pervasiveness of chronic pain has dramatically increased over the past couple of decades, leading to the widespread use of opioids which in turn has led to a tragic opioid epidemic in the United States, which is unfortunately spreading to other countries around the world.
Chronic pain has also increased the use of steroids and other pharmaceutical products that have serious side-effects and that can lead to a wide array of mental, emotional and physical ailments. A lot of people are in pain and they understandably want relief, but these solutions may not be the ideal choice for achieving well-being. I recently came off of a 9-month stretch of daily corticosteroid use and they absolutely got my body moving again, but at the price of my overall health. Working with my doctor, I slowly weaned off of them a full year earlier than the original plan called for because the side effects were simply overwhelming.
I’m not recommending anyone stop taking their medication and for some, medication may be their only option to maintain a livable quality of life, but mindfulness meditation may help manage pain better and could be used in a complimentary fashion to support those on pain killers or those who choose not to medicate.
For thousands of years, Buddhist monks have postulated that mindfulness meditation can significantly alter the subjective experience of pain. The Arrow, or Sullatta Sutta, an ancient Buddhist text, states that meditation practitioners have the unique ability to fully experience the sensory aspect of pain, which is the first arrow, but to let go of the evaluation of pain (the second arrow). To be clear, mindfulness meditation does not eliminate pain, but instead, changes how we experience it and may significantly reduce the level of pain experienced.
Jon Kabat Zinn’s Mindfulness Based Stress Reduction program began in response to hospitalized patients in pain. MBSR is one of the most studied and validated approaches for the treatment of chronic lower back pain which is the most common clinical pain condition and the leading cause of disability in the United States. Studies showed that patients reported improvements in pain symptomology and quality of life after completing the MBSR program and those improvements were sustained after a 3-year follow-up.
Although the most common type of chronic pain is lower back pain, it is closely followed by migraines and headache pain, neck, and facial pain. Then there are the 58.5 million people who have arthritis, 4 million people who suffer with fibromyalgia, a half-a-million people diagnosed with polymyalgia rheumatica and the millions who have pain related to cancer or other diseases. Auto-immune diseases are on the rise, all with the common symptom of inflammation, which of course causes pain. Over 20% of the global population suffers from some form of chronic pain in addition to all of those who suffer pain following injury or surgery.
Many studies have been conducted on the effectiveness of MBSR and pain relief, demonstrating that relatively brief bouts of mindfulness meditation training can significantly reduce chronic low back pain. Mindfulness meditation engages multiple unique brain mechanisms that diminish the subjective experience of pain and researchers have found that even after brief training, significant reductions in pain intensity and unpleasantness ratings were achieved.
Mindfulness meditation can be used to create more awareness of the sensation of pain itself, without judgment or resistance, that second arrow. Don’t underestimate the power of our thoughts when it comes to pain. When we approach our pain with negativity, it only becomes worse, and potentially produces other challenges, including anxiety and depression. Studies show that when we become more aware of what we’re actually experiencing without the added layer of judgment, the overall perception of pain is actually reduced.
It may sound counter-intuitive to focus on pain to reduce the sensory experience of it, but it is a pathway to pain relief. Kabat-Zinn states in his book, The Mindful Solution to Pain, that “from the perspective of mindfulness, nothing needs fixing. Nothing needs to be forced to stop, or change, or go away. It is only awareness itself that can balance out all of our various inflammations of thought and the emotional agitations and distortions that accompany the frequent storms that blow through the mind, especially in the face of a chronic pain condition.”
The use of modern imaging techniques like the fMRI shows that the brains of meditators respond differently to pain than non-meditators. They found that during pain, the meditators had increased activity in areas of the brain associated with processing the actual sensory experience of pain. They also discovered decreased activity in regions involved in emotion, memory and appraisal. Again, that second arrow that normally increases our perception of pain.
How can you use mindfulness meditation in your own life to manage pain? There are conflicting reports from studies regarding the level of expertise in meditation and how it affects pain, but overall, consistent meditation is shown to be effective and the longer you’ve meditated (studies run from 8 weeks to multiple decades) the more stabilized changes in the subjective evaluation of pain seem to occur. That’s an easy start to establishing a long-term relationship with pain improvement, but of course, it’s not immediate relief, as we’re talking about changing the structure of the brain.
More immediate relief can begin by focusing on specific meditations or activities to become more aware of pain and thereby change your relationship with it. Stress has been shown to increase pain, so relaxation can reduce that aspect and alleviate our perception of the pain we’re experiencing. I suggest you keep a journal to track your experiences in using a simple mindfulness meditation daily, noting how you feel before and after the meditation. The affects are cumulative, so stick with it over several weeks and then compare your pain levels before you started and to how you feel several weeks in.
MBSR studies indicate statistically significant reductions in measures of present-moment pain, negative body image, inhibition of activity by pain, mood disturbance and psychological symptoms including depression and anxiety. Pain-related drug use was reduced as well. You can take an 8-week mindfulness-based stress reduction class online or in most cities, in person.
Another well-studied meditation that has been shown to be effective in pain reduction is the Body Scan Meditation. The body scan allows us to use our bodies to experience present-centered, non-judgmental awareness. We become aware of whatever sensations are arising in the body, particularly the painful ones, and then we learn to notice the difference between the direct experience of these sensations and the indirect perceptions that we add on to that experience.
This meditation allows us to neutrally identify what we’re feeling and where, as we focus on each detailed part of the body. Simultaneously, we’re training our minds to broaden our focus away from the intricate parts of our body to a broader and more spacious awareness of the body as a whole, with different co-existing parts and sensations. This greater understanding of what our body endures allows us the opportunity to see what it feels, accept it, and cultivate compassion for it, without immediately judging it or trying to escape it.
The body scan is not a short meditation. It’s best to lie down and get into a relaxed state. Then, you slowly scan every part of your body, from your toes to the top of your head, paying attention to every detail you feel in each part. Visit our YouTube channel at work2live and go to the playlist to find our guided mindfulness meditations, which includes a 24 minute body scan meditation to help you get started.
Our minds and bodies are connected and work in constant synchronicity, so whether your pain feels physical or mental, both affect each other. There are many techniques to use in conjunction with mindfulness meditation to reduce pain, including stretching. Full body stretches, gentle yoga or t’ai chi for ten to fifteen minutes a day is recommended. It’s also important to stay active to improve mood, strengthen muscles and keep us distracted from our pain, but be sure to check in with your health care provider before starting any regimen.
Be sure to pace yourself. Doing too much or too little can increase pain. I’ve been struggling with this one for over a year because it’s a delicate balance. In addition to a smart watch to track activity, I keep a journal and that has resulted in me knowing that I do best between 7,000 and 9,000 steps a day. When I fall under that number, pain increases and sleep decreases. When I go over, I suffer the following day. I also know through experience that I need to move every hour. Sedentary has become a bad word in my house, but it’s very easy to sit for too long as we work on computers. My fitbit buzzes me hourly and I simply get up stretch or walk around the house for a few minutes. The key is to experiment with your activities but keep track so you know what to aim for each day for optimal results.
Speaking of sleep, it’s critical for your body’s repair, so take it seriously. Poor sleep can often worsen pain and add to low mood which also worsens pain. Take the time to plan your sleep. Relaxation techniques, meditation, low lighting and no screens leading up to your bedtime can help ensure a restful, restorative night.
Add in regular relaxation and short breathing exercises throughout your day. This is where phone apps can be invaluable, so use that smart phone to support your health by setting alarms to remind you to spend a couple of minutes every couple of hours to just breathe. There are thousands of apps with short breathing exercises or visualizations in addition to fitness and meditation apps to help you stay on track.
Remember that our mental state greatly impacts our pain level, so if you’re struggling with anxiety or depression, treatment of those conditions can reduce pain levels and improve quality of life. Mindfulness meditation can reduce anxiety and if you’re suffering from depression, seek professional support to ensure that you get the most out of life, including reducing chronic pain.
Pain may be an inevitable part of life, but we do have the ability to change our relationship with it, to reduce the physical sensations involved and to use our minds to reduce suffering and promote improved well-being. That’s something we all deserve.