Miraculous? Mindfulness in Pain Management

Could it be possible to effectively use mindfulness in pain management practice?

Mindfulness meditation may seem like the newest buzzword, but in fact Buddhists and Yogis have practiced mindfulness for many thousands of years, in order to bring awareness to the mind and the body in the present moment. Mindfulness is also practiced with an attitude of acceptance, and of loving kindness. We at OhMy.Health want to help you to be kind to your joints, and so we thought we would introduce you to the idea of mindfulness in pain management techniques…

What is mindfulness? 

The ancient symbol for Mindfulness depicts “presence of heart”. Mindfulness is a practice rooted in Buddhist meditation, whereby you learn to be in the present moment, and to experience the sensations of your body, your feelings, your emotions and your surroundings through a compassionate and non-judgemental lens. Mindfulness meditation encourages an attitude of kind, non-judgement of your thoughts and encourages acceptance of your experiences as they are in the present moment… 

Where does mindfulness meditation come from?

Mindfulness meditation has become mainstream in America and the rest of the world, in part through the work and research of Jon Kabat-Zinn who created the Mindfulness-Based Stress Reduction (MBSR) program at the University of Massachusetts Medical School in 1979. 

First mindfulness in pain management studies

In 1985, Jon Kabat-Zinn carried out a study on 90 chronic pain patients, who were trained in Mindfulness-Based Stress Reduction (MBSR). The results were remarkable, as they indicated significant decreases in measures of present-moment pain, negative body image, inhibition of activity by pain, mood disturbance, and psychological symptoms – including anxiety and depression. Amazingly, the use of pain-medications was reduced in these patients. Since then, many similar studies have consistently found the same results with mindfulness in pain management.

What is the difference between acute pain and chronic pain?

You can think of acute pain as being your body’s very intelligent warning system that something is wrong and requires your urgent attention! For example whipping your hand away from a hot stove plate, or alerting you to the fact you just stood on a shard of glass and you shouldn’t take another step, and that you need to remove that glass! These are just two typical situations in which your body protects itself from injury and harm. 

Acute pain is also the pain you feel in the first few weeks following an injury such as a ligament tear, a whiplash injury, a big bruise, or a broken bone. Acute pain is the pain, which you experience when there is physical damage to the tissues and your peripheral nerves get triggered with a pain impulse. This neuronal impulse manifested in pain is reminding you to be careful and to look after that area of your body, in order to prevent further tissue damage. Acute pain naturally subsides as tissue healing takes place, until one day the pain is a distant memory. 

The gap between modern medicine and mindfulness in pain management for chronic conditions

However, sometimes complete healing is not possible, such as in the case of arthritis, nerve damage, or structural damage to the body. Sometimes the tissues have healed, but the body has not yet realized that there is no longer any need to protect that area, and it keeps sending the urgent pain signals – shouting constantly that there is a problem. Chronic pain is unfortunately impossible to ignore, even if the acute incident has passed, and there is nothing to be done about the pain. According to research, chronic pain actually eventually also causes a reduction in pain threshold, which means that all sorts of sensations – which your body would not have taken as pain signals before – begin to activate your body’s pain alarm. 

Pain medication is useful and very helpful, but unfortunately it has its limits, and the drugs do not always relieve all of the pain. Painkillers, non-steroidal anti-inflammatories and opioids all also have some unfortunate and unwanted side effects. Modern medicine has its limits in terms of dealing pain, and these limits can be all too quickly realized. 

Chronic pain affects more people in the USA than diabetes, heart disease and cancer combined. This equates to more than 100 million adults suffering from chronic pain. More than half of them say that they feel they have no control over the pain. Chronic pain has a negative impact on a person’s ability to concentrate, their quality of sleep, their daily activities and energy levels, and on their overall quality of life. Sadly, 80% of chronic pain sufferers report feeling depressed because of the pain. The effects of chronic pain, the abuse of prescription pain meds, other forms of self-medicating, and depression combine to create a vicious downward spiral … so is there any way out? 

Mindfulness teaches you how to cope and live with chronic pain 

Chronic pain is real and it is also very complicated. The pain is no longer only being perceived simply from the nerve endings around the injury or affected part of your body. Your thoughts, emotions, anxiety and worries about the pain become entangled within the physical sensations to create an ongoing storm constantly flooding your brain with pain information, and creating immense suffering. It is the suffering when combined with the chronic pain, which is so very exhausting…

Shinzen Young came up with the equation 

Mindfulness in pain management, when practiced regularly, is a powerful way of helping to cope with the pain and stopping the downward negative cycle of chronic pain and depression. Part of the reason it is so very helpful is that it helps to guide your mind to shift the focus from what is outside of your control, to what is within your control. The only element, which is within your control, is how you choose to respond to the pain – whether you respond with resistance and worrying, or with acceptance. 

Evolutionarily we are hard wired to worry, and so it is normal to feel anxious about the pain and it is completely normal not to want the pain! Through the practice of mindfulness meditation, the elements of resistance and worrying may be made less, and through acceptance of the pain there may be somewhat less suffering. 

What do you do during mindfulness for pain management?

Here is a very summarized idea of the process of a Body Scan meditation. This is a very useful technique for mindfulness in pain management . A full version is also available as a downloadable Body Scan PDF 

• You can do it for anything from 5 – 20 minutes, whatever suits you
• It is important that you lie or sit in a comfortable position with your eyes closed
• Before you begin, imagine where you can feel at peace. It may be any of the following which resonate with you: a safe calm place or space; being in the presence of a loved being  (it may be a person, an animal, a spiritual being, or any other); an inner place; or a special moment or a memory – this is your safe space to which you can return at any time…
• You bring your awareness to your breathing first…
• Then you gradually bring your awareness to each part of your body, starting at the top of your head and slowly working down through every body part … focusing on the sensations of your body, with an attitude of acceptance.
• You can also notice any thoughts or emotions which drift into your mind… and then try bring your awareness back to the sensations in your body 
• You would then gently bring your kind attention to your area of pain to see if you can just be with your pain, notice your pain and the sensations with an attitude of curiosity, perhaps kindness and acceptance, but only for as long as you can bear it, before moving your focus to your safe or comfortable space or place… you can repeat this process as many times as you like… for as long as you like… with an attitude of curiosity and non-judgment of your pain
• It is then helpful to try to “zoom out” of the painful area, and to try to feel your entire body and the sensations of your body… bring your awareness back to your breathing… then slowly open your eyes and stretch and move…

How does mindfulness meditation help your pain? 

So with this attitude of curios, non-judgemental kind and loving attention, mindfulness allows you to gently explore 

• the physical sensations of your pain 
• the emotions which you feel about your pain
• the beliefs and meanings associated, for you, with your pain 

Mindfulness thereby helps you to disentangle the complicated knot of your pain. In so doing, and through regular mindfulness meditation, you will gradually get to know your pain, and recognise the separate elements of the storm of chronic pain – the rain, the wind, and the thunder and lightning. Through mindfulness you can eliminate some of the scarier elements of the storm and better cope with say just the rain… 

So although mindfulness in pain management will not magically stop the pain completely, it helps to alleviate the pain to some extent, and hopefully alleviates the suffering somewhat, by helping you to accept rather than constantly resist the pain. Some people experience up to 50% reduction in pain following 8 weeks of mindfulness meditation practice, and many chronic pain sufferers experience at least a 30% reduction in pain. With no side effects, and the added benefit of better mood and less anxiety, we know that mindfulness in pain management is the best practice you can do. 

So be kind to yourself, and be kind to your joints!

Some useful tools for mindfulness meditation 

OhMy.Health have written a more detailed Body Scan mindfulness meditation, which you can opt in for it here, if you would like to read it and print it out.

Mindfulness guru, Jon Kabat-Zin also has a wonderful Body Scape meditation which is available for free online and which we think you will find extremely useful. 

You could also find a mindfulness meditation teacher in your community, who has experience dealing with people with chronic pain, and thereby benefit from all that mindfulness in pain management has to offer. 

We would love to hear from you how mindfulness meditation has helped you deal with chronic pain, so write to us on [email protected] to tell us your story!