Mindfullness Meditation & Chronic Pain, Integrating Mindfullness, Common Script By Margaret Heaton

Written by Margaret Heaton

In recent years, researchers, scientists, and theorists have been conducting clinical research on the effects of mindfulness and meditation practices and their findings are confirming the long-term benefits of regular mediation and mindfulness practice. These benefits include, but are not limited to: stress reduction, minimizing chronic pain, reducing anxiety, lowering the probability of symptoms of depression, enhancing brain performance, improving sleep, reducing risk of heart attack and stroke, and improving overall well-being (Bergland, C., 2015;helpguide.org).

There is also a greater focus on mindful meditation and its use in pain management, so much so that a quick Google search of the two terms generates 567,000 hits! Current research is quite overwhelming in demonstrating the benefits regular mindful meditation has on managing chronic pain, reducing experiences of pain by 30-50%.

What is Mindfulness?

According to Sylvia Boorstein, “mindfulness is the aware, balanced acceptance of the present experience. It isn’t more complicated than that. It is opening to or receiving the present moment, pleasant or unpleasant, just as it is, without either clinging to it or rejecting it.”

Mindfulness at its simplest definition is the act of being present in the moment without judgment (Ireland, T., 2014; Scientific American).

When we examine the definitions of mindful meditation, we see that it is the opposite of fighting, clinging, or avoiding the thoughts, feelings, and sensations present in the moment. Many of us, especially those struggling with chronic pain, spend large portions of our time consumed with either fighting, clinging, or avoiding our experiences in the present moment and end up missing out on life. Typically we are not even aware we are doing this.

Mindfulness is the opposite of mindlessness. How many of us are guilty of going through our days like a robot? Waking, taking medication, showering, then…(you fill in the blank), without even thinking. Sometimes we are so mindless we have to truly think to recall why we walked into a room or what we did the previous day. Mindfulness is living each day with purpose and intent and the practice of mindfulness would have us engage and be present in every moment of our day…and adapt/adjust as each moment changes.

Further, mindfulness would have us accept what is…what is present, pleasant or unpleasant, good or bad, and let it be.

“Mindfulness is not just paying attention to the positive experiences, but also to the neutral and negative ones” – Dr. Jackie Gardner-Nix

How Mindfulness Works to Reduce Pain

Mindfulness meditation has been shown in clinical trials to reduce chronic pain by 57% and by more than 90% in individuals who master the practice. How is this possible? Brain imaging studies show that mindfulness soothes the brain patterns underlying pain and, over time, these changes take root and alter the structure of the brain itself, so that patients no longer feel pain with the same intensity and many say that they barely notice it at all (Penman, D., 2014).

Chronic pain can trigger changes in brain structure, such as changes to the limbic system that controls our emotions and the pre-frontal cortex that is the thinking, decision-making, and problem solving area of our brain. Chronic pain changes the communication between these two areas of the brain, reducing the effectiveness of our pre-frontal cortex and increasing activity in parts of our limbic system. When these changes occur, individuals tend to struggle with concentration, decision-making, and problem solving, along with being more susceptible to emotional reactivity related to heightened stress (Penman, D., 2014).

Forming new memories can also be a struggle for people with chronic pain. Consequently, the changes in brain structure produce changes in brain functioning that are linked to depression, anxiety, and impaired cognitive functioning. The good news is that research shows these changes can be reversed when patients are treated for painful conditions (Poppy, B., 2016). If you are experiencing any of these symptoms, mindful meditation is a way to retrain your brain.

With advances in brain imaging technology we are able to literally see how regular (weekly) practice of meditation can profoundly change the way different regions of the brain communicate with each other and therefore how we think (Ireland, T., 2014; Scientific American). With regular mindfulness practice, the emotional response system of the brain (the limbic system, specifically the amygdala), which is directly impacted by stress shrinks, while the rational, decision making part of our brain, which is in control of concentration and awareness, grows (Ireland, T., 2014). Further the connections between these two areas of the brain also change. Thus mindful meditation practices seem to reverse the effects chronic pain has on the brain.

There are many ways to practice mindfulness, but the goal of any mindfulness technique is to achieve a state of alert, focused relaxation by deliberately paying attention to thoughts and sensations without judgment. This allows the mind to refocus on the present moment. All mindfulness techniques are a form of meditation.

Basic Mindfulness Meditation – Sit quietly and focus on your natural breathing or on a word or “mantra” (i.e. “quiet,” “relax”) that you repeat silently. Allow thoughts to come and go without judgment and return to your focus on breath or mantra.

Body Sensations – Notice subtle body sensations such as an itch or tingling without judgment and let them pass. Notice each part of your body in succession from head to toe.

Sensory – Notice sights, sounds, smells, tastes, and touches. Name them “sight,” “sound,” “smell,” “taste,” or “touch” without judgment and let them go.

Emotions – Allow emotions to be present without judgment. Practice a steady and relaxed naming of emotions: “joy,” “anger,” “frustration.” Accept the presence of the emotions without judgment and let them go.

Urge Surfing – Cope with cravings (for addictive substances or behaviors) or pain sensations and allow them to pass. Notice how your body feels as the craving/pain sensation enters. Replace the wish for the craving/pain to go away with the certain knowledge that it will subside (Benefits of Mindfulness).

There is no better time to start than now! The best thing about integrating mindful meditation to your pain treatment regimen is it is free! There are no gym memberships, copays, or other fees. You can simply review the techniques below, set a timer for 5-10 minutes, and begin your practice. You can also access a number of guided meditations on the internet; simply by searching for meditation for pain and sleep, or meditation for pain and stress. “Guided Meditation for Pain,” videos are especially helpful resources. There are also apps available on smart phones that allow access to meditation anywhere. There is no right or wrong way to meditate. You can start with 5-10 minutes a day and then integrate another 5-10- minute practice throughout your day. The key is to start right away and not put it off. Like all healthy lifestyle practices, regular and consistent mindfulness meditation practice is crucial in order to reap the associated benefits.

If you are interested in more formal meditation practices, I recommend reading The Mindfulness Solution to Pain by Dr. Jackie Gardner-Nix. You can also look into formal mindfulness training through a Mindfulness Based Stress Reduction (MBSR) course. Below are a few additional resources and recommendations.

Reading Resources:
• The Mindfulness Solution to Pain by Dr. Jackie Gardner-Nix
• 10% Happier by Dan Harris
• Mindfulness: A Practical Guide to Relieving Pain, Reducing Stress and Restoring Wellbeing by Danny
Penman and Vidyamala

Ted Talks:
• A Different Approach to Pain Management: Mindfulness Meditation by Fadal Zeidan
• How Mindfulness Meditation Redefines Pain, Happiness & Satisfaction by Dr. Kasim Al-Mashat

Apps/Websites:
• Headspace
• Calm

CDs/Audio File:
• Jon Kabat Zinn – Mindfulness Meditation for Pain Relief

Some common meditation practices for pain management begin with an awareness of your breathing , bringing all your attention to sensation of your breath entering and leaving your body. With this practice, you may concentrate on your attention on your nostrils, chest, or belly, wherever is easiest for you to notice your breath. Once you have your attention on your breath, work to quiet your mind and quiet your body. As your mind and body calm, begin to breathe into those areas of your body where you experience pain. While breathing into the pain, make sure you are not evaluating the pain, wishing it away, or letting anger or any other thoughts or feelings creep in. All you are doing is identifying your experiences with pain as sensations, sensations in your body. You can then move to body parts that are pain free (it may be an eyelash, fingernail, and tip of your nose) and breathe into those parts of your body.