Mindfulness – A useful tool to manage pain

Posted by Helen Potter on 12 November 2017 | Filed under Brain training, Chronic Pain, In Touch Physiotherapy, Tips

From PainHEALTH Website

-modified by Helen Potter 2017

Mindfulness is about being here now, being ‘present’ or in the moment.

While the idea is simple, embodying mindfulness is not easy.

We can absorb ourselves in what we are doing – perhaps walking on the beach, playing with a child, looking up at a magnificent sunset, or enjoying the first mouthful of a delicious meal.

Moments of mindful awareness are present all the time, butare brief and fleeting.

our minds wander off into streams of consciousness – analysis, remembering, planning and a myriad of other distractions.

What does mindfulness meditation involve?

The practice of mindfulness meditation, is about stretching moments of present-focused awareness by training our minds to keep coming back to what is happening right now.

  • Some people describe it as shifting out of the ‘doing’ mode and into the ‘being’ mode, or switching out of autopilot.
  • Pick something to pay attention to – like the flow of your breathing, the shifting sensations in your body, or the many sounds around you.
  • Notice each time things distract you – gently coax your attention back.
  • Return to the now, over and over, until it becomes a habit, just as practising scales on a piano develops muscle memory.
  • Stop ‘missing precious moments’ and start engaging with what is happening as it unfolds.

What does mindfulness meditation have to do with pain?

  • Practising mindfulness meditation can be helpful for people with persistent pain. It has a moderate effect in reducing pain intensity1,2.
  • Compared to normal medical care for pain, meditation also seems to improve other important aspects of life.
  • Depression, coping ability, quality of life, acceptance, sleep quality and physical functioning may all improve2-5 
  • With acute or short-term pain, people report less distress and can tolerate more pain in the research laboratory after meditation training, compared to people who do not meditate6.
  • Current evidence suggests that mindfulness-based treatments are as good as well-established psychological treatments for persistent pain
  • We still need to do more high-quality studies to figure out which types of pain meditation helps most, what doses work best, and what makes meditation helpful.

How does mindfulness meditation help with pain?

It is still early days in terms of understanding why meditation can be so helpful in coping with pain. Possibly people have known of these benefits for hundreds of years.

1. Relaxation

  • Although meditation is not simply a relaxation technique, relaxation is a common helpful side effect.
  • Relaxation is  important for coping with pain because pain is not only stressful in itself
  • stress exacerbates and maintains pain.
  • It is helpful in calming down your nervous system, which often becomes ‘sensitised’ when pain persists for a long time.
  • Relaxation also boosts your body’s natural pain modifiers, such as endogenous endorphins, or “feel good” hormones.

2. Acceptance

  • We can feel like we’re locked in a fierce battle with our pain and just want to get rid of it.
  • While completely understandable, it can frustrate us, increase anxiety or depression when we can’t control the pain.
  • Mindfulness is about accepting what is here right now as best we can, including pain, so that we can soften and be more receptive to what happens next.
  • This is different from resigning yourself to a life of pain.
  • Mindfulness is all about curiosity and what some people call ‘beginner’s mind’.
  • Research shows that people who learn how to accept their pain respond better to various treatments and have better overall pain outcomes.

    3. Mental flexibility

    Negative thoughts drive negative feelings, which can sensitise our nervous systems and increase our pain.

  • Thinking negatively about pain,  ‘pain catastrophising’, is one of the strongest predictors that short-term acute pain will become longer-term persistent pain.
  • Mindfulness meditation can reduce the burden of these negative thoughts because it changes our relationship to thinking itself.
  • We start to see thoughts as just ‘mental events’ rather than facts, which lessens their impact.
  • We don’t as easily buy into the negative story around our pain.
  • This is especially important in overcoming the upsetting emotional impacts of pain and disability, such as depression and anxiety.

    4. Pain with less distress

    Exciting research using brain scanning technology (fMRI) is beginning to shed light on patterns of activity in the brain when a person is in pain and when they are meditating

  • It looks like people are still aware of the sensory aspects of pain during mindfulness meditation but they experience it as less unpleasant
  • It does not activate as many of the brain networks related to memory, emotion and self-referential thought.
  •  This relates to a decoupling of sensory-discriminative and cognitive-evaluative brain networks6,7.
  •  Meditation trains your brain to experience pain with less distress.

 HOW to meditate

Getting started

Do I need a special place to practice?
  • Mindfulness practice is generally an individual practice,
  • Ideally, you have a space in your home or garden where you can be undisturbed for the duration of your practice (10-45mins).
  • You don’t need any special equipment, just a comfortable chair, stool, meditation cushion or anywhere you can sit, stand or lie for the duration of the exercise.
  • To get yourself started or motivated it can be helpful to attend a meditation group or undertake a mindfulness meditation course.
  • These days you can even do these online and connect with the facilitator and other participants remotely, or even use smartphone apps
Do I need to tell my health care professional I am doing mindfulness meditation?
  • It’s always worth discussing trying any new intervention with your different health professionals,
  • use meditation as a complementary therapy rather than abandoning your usual care.
Can anyone do it?
  • You don’t have to be in pain to benefit from meditation, so why not get a friend or family member to do the mindfulness meditation with you?

 

How do I start?
  • try the body scan meditation and follow the instructions.
  • if you are finding motivation is a problem, consider looking for a mindfulness group or course to get you started
  • The mindfulness programs that have been researched for pain include:
  • Mindfulness-Based Stress Reduction (MBSR), Mindfulness-Based Cognitive Therapy (MBCT) and Breathworks.
  • Helen Potter FACp. see WWW.painhealth.UWA.edu.au

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