How Mindfulness Can Help Your Brain Manage Pain

Man holding lower back

Mindfulness meditation is a practice that has gained considerable popularity in the west. Popularized in large part by the work of Dr. Jon Kabat-Zinn, mindfulness encourages present-moment, nonjudgmental awareness through simple meditative practices such as attending to one’s own breath. Over time, the practice of mindful awareness can become more easily generalized to an infinite number of external and internal events, helping practitioners to cultivate a state of equanimity, or calmness and poise, even in the face of distressing events, unpleasant physical sensations, or strong emotions. Mindfulness also can be very effective in dealing with chronic pain.

The Costs and Challenges of Chronic Pain

Pain is known to be a sensory, affective, and cognitive experience. That is, the experience of pain consists of 1) how our bodies feel and how our nervous system interprets these sensations, 2) the emotions we have in response the pain, and 3) the way we think about the pain, including our judgments about the experience. The latter two aspects of this trio also affect how well we cope with pain and how likely we are to be able to live a life that has meaning for us—despite having pain.

A recent, large-scale study found that roughly 100 million Americans suffer from chronic pain. Pain is responsible for enormous economic costs, including an estimated $300 billion in health care expenditures and up to $650 billion in economic costs each year due to lost days at work and decreased productivity. While staggering, these numbers say nothing about the personal costs of pain, including changes in social functioning and the ability to perform many daily tasks, relationship stresses, anxiety that pain will worsen, and hopelessness that things will improve.

Although medications and, at times, surgical and other interventions can be important tools for pain management, too often they fail to completely relieve pain. Furthermore, drugs and procedures do not directly impact how people cope with symptoms that may not be curable.

How Does Mindfulness Help with Pain and Coping?

  • Pain is a brain-centered experience in that our brains control how we experience any sensory input from our nervous system. In other words, without a brain, we could not “interpret” pain as such.
  • There is considerable overlap between the structures in the brain that process pain and those that process the emotional experience of pain, its degree of severity, and the meaning we give to pain and how well we cope with it. So our emotions and thoughts about pain can either improve or worsen the experience of it (which is good news and bad).
  • Mindfulness is a simple practice that has been shown to change the activity in areas of the brain that process pain severity and unpleasantness, improving both.

What’s the Evidence?

A recent study examined whether time-limited mindfulness training (four days of training, 20 minutes per day) would decrease pain severity and the unpleasantness associated with it. Researchers found that even after only a very brief instruction in mindfulness, meditating in the presence of experimentally induced pain significantly reduced pain intensity by 40%, and unpleasantness by 57%, as compared to simply resting during pain. Changes reported by participants were supported by what the team found when using brain imaging. The benefits described above were the result of increased activation in brain areas associated with the ability to reframe how pain is evaluated, and reduced activation in other areas that process the pain signal received from the body.

Another study found that experienced meditators had lower sensitivity to experimentally induced pain as well as greater thickness in the cortical areas associated with the processing of emotions in general and with the emotional experience of pain, specifically, as compared to nonmeditators. The team’s results suggest that the thicker cortical areas observed in long-term meditators may be due to the practice itself.

To summarize, the above studies suggest that mindfulness meditation, a low- to no-cost intervention that is free of side effects and easy to learn, can be effective in decreasing pain severity and unpleasantness, as well as enhancing one’s ability to cope despite the presence of pain. Preliminary studies using brain imaging techniques have shown observable differences in the brain function of new meditators, as well as in both the function and structure of the brains of experienced meditators, that objectively illustrate these improvements. Given the above, mindfulness is an important tool to consider adding to one’s toolbox to help manage the experience of chronic pain. Doing so can help sufferers resume activities that are important to them and feel better rather than waiting, endlessly, “until the pain is gone.”

References:

  1. Grant, J.A., Courtemanche, J., Duerden, E. G., Duncan, G. H. (2010). Cortical thickness and pain sensitivity in Zen meditators. Emotion, 10(1), 43-53.
  2. Study shows chronic pain costs U.S. up to $635 billion. (n.d.) Retrieved from http://www.ampainsoc.org/press/2012/cost-of-pain.html
  3. Zeidan, F., Martucci, K. T., Kraft, R. A., Gordon, N. S., McHaffie, J. G., Coghill, R. C. (2011). Brain mechanisms supporting the modulation of pain by mindfulness meditation. The Journal of Neuroscience, 31(14), 5540-5548.

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  • Deborh

    Deborh

    January 19th, 2013 at 11:02 AM

    Are you equating the experience of “experimentally-induced pain” with chronic pain that is not experimentally-induced?
    Part of what is so disturbing about chronic pain is that it has no clear beginning and may never end, but it may end- maybe. This is not true of experimentally-induced pain.
    I know nothing about the research. I question the validity of equating experimentally-induced pain to chronic pain and coming to conclusions about anything. I believe that it is a faulty premise.

  • Traci Stein

    Traci Stein

    January 21st, 2013 at 4:54 PM

    @Deborh – Thank you for reading and sharing your thoughts. I agree that the psychological and long-term physiological experiences related to experimentally induced pain are qualitatively different from chronic pain, particularly in terms of distress, anticipatory anxiety, and one’s functioning.

    There are other studies of mindfulness meditation, mindfulness based stress reduction (MBSR), and the concept of acceptance (an important outcome of both mindfulness meditation and MBSR) with people who have a chronic pain condition. What we know thus far from these studies is that many, although not all people experience reductions in distress, increased pain coping, and improved functioning from these practices. Many also experience a decrease in pain severity, and this is consistent with what many clinicians (myself included) observe on a regular basis.

    This post featured articles about experimentally induced pain because these articles shed light on both how specific brain areas respond to the experience of pain, as well as how mindfulness can change this experience for the better. Certainly, those who have derived benefits from mindfulness practice can attest to these benefits. But I think it’s particularly important to validate that both pain and mind-body practices exert objectively observable effects – both are “real.” Perhaps even more importantly, long term mindfulness practice can lead to structural and functional changes in the brain.

    One book you many enjoy is “Full Catastrophe Living,” by Dr. Jon Kabat-Zinn. It details MBSR for those who have medical and other conditions. Another, more recent book that you may enjoy is The Mindfulness Solution to Pain: Step-by-Step Techniques for Chronic Pain Management, by Jackie Gardner-Nix and Jon Kabat-Zinn. I hope this is helpful.

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