Managing Chronic Pain Using Meditation

by Dr. Michelle Lo, ND and Melissa J. Cornish, HHC
 

Millions of people suffer from some sort of daily pain. Whether the cause is injury, disease, or genetic defect, chronic pain affects quality of life. When pain limits the way you do something, or whether you do something, there is also a psychological effect. Disappointment and frustration can lead to feelings of depression. The stress of the pain itself can be physically taxing, leaving one exhausted and desperate for relief. This kind of mental stress can interfere with the progress of slow-healing injuries, and can actually make all forms of pain worse.

It is estimated that over one-third of the world suffers from chronic or persistent pain.^[1] In many countries, pain management is a multibillion-dollar industry. Modern advances in molecular studies have expanded our knowledge in the mechanism of pain and our response to it, thereby leading to better ways of managing pain. By understanding why you have pain, the type of pain it is, and the long-term outlook for possible recovery, effective pain management may include various forms of nonpharmaceutical treatment options such as physical therapy and mindfulness meditation. Pain is classified by the location and the way that it functions. Nociceptive pain is normal pain associated with trauma to tissue, and is further classified into somatic and visceral pain: Somatic pain is located in skin, muscles, tendons, joints, and bones; visceral pain is located in hollow organs and smooth muscle tissue. Both of these types of nociceptive pain are generated by pain receptors in the area of the damage.^[2][3] Neuropathic pain is either generated by or sustained by the nervous system. Neuropathic pain is much more complex than nociceptive pain. According to an article published by doctors Alexander G. Reeves and Rand S. Swenson at the Dartmouth Medical School in New Hampshire: “Neuropathic pain is much more likely to develop associated with conditions that damage the nervous system, including various direct nerve injuries and diseases such as diabetes, alcohol abuse, zoster, HIV, Lyme disease or conditions involving the central nervous system such as multiple sclerosis.”^[3]

Why Mindfulness Meditation Works

Whatever is the cause for pain, the level of suffering that people experience from it can vary greatly—in other words, everyone’s perception of pain is different. The psychological aspect of how physical pain affects an individual is processed by the frontal lobes of the brain and is, therefore, highly individualized. A person’s psychological state as well as past painful experiences can have an effect on how a person processes the pain. The significance of the pain to the individual also plays a factor. For example, if a person who is mildly depressed sustains an injury that keeps them from performing their best at work, they may experience a greater degree of suffering if they feel that they cannot properly do their job, let down their team, or are an embarrassment to their boss or coworkers. If the suffering caused by the pain is great enough, it may cause that person to give up trying to find ways to perform their job which don’t make the injury or pain worse. The increased focus on their pain and disability, whether temporary or permanent, can lengthen recovery time, make pain medications less effective, weaken the immune system, and worsen their depression. If you have ever experienced pain from an injury that restricted your movements, such as an injury to your back, foot, or leg, but you were resolved to not let it keep you from your daily activities, you may have noticed that your positive attitude is much harder to maintain when you are tired or frustrated; the pain may even seem more intense.

There are a couple of theories as to why “suffering” or our perception of pain can change, while the injury itself remains relatively unchanged. The first theory is pretty basic, and revolves around the presence or lack of endorphins. In general, endorphin levels are higher when a person is in a good mood. Endorphins can be responsible for muffling the pain, both at the time of the injury and in the days and weeks following the injury.^[4] Another theory involves so-called spinal nerve gates that control how much of the pain signal is allowed to pass to the brain. Some factors influencing these nerve gates include other stimuli such as heat and cold, vibration (such as rubbing the area of injury), and expectations based on the individual’s knowledge or assessment of the injury.^[5] If you have ever gotten hurt doing something and didn’t realize it until you saw the injury, you have experienced this. Acute pain is defined as pain lasting from three to six months. Chronic pain is defined as pain that lasts for more than three to six months.^[2] Nociceptive types of pain can include mechanisms of inflammation and swelling, spasms, and contraction of muscles (cramps). Suffering is often reduced by the appropriate application of heat or ice, gently rubbing the injury, and certain anti-inflammatory medications (including many over-the-counter pain relievers) or prescription pain killers. Neuropathic pain, however, does not respond to opioid-based medications, because the pain is generated or maintained by the nervous system.^[3] Unfortunately, many doctors have little else to offer their patients with chronic pain. Dependence on prescription painkillers causes major problems across the community, as they have negative effects financially, physically, and socially.^[1] Even though millions of people are affected by either chronic or acute pain, research has been fairly slow on exactly how it works and why it is experienced differently by different people. One thing that has been clinically proven to lessen an individual’s suffering is mindful meditation.

Putting it into Practice

During mindful meditation, the individual seeks to understand how chronic pain affects them physically, emotionally, and socially. This is done through compassionate observation of the sensations you feel in your body, seeking to view them in the purest form possible, without emotional attachment (as if observing them in someone else), and without judgement. You may find it useful to be able to describe the sensations that you feel—such as dull, aching, radiating, pressure, etc. From there, attention is shifted to the emotions that surround the condition that causes the chronic pain. Feelings of anger, guilt, frustration, etc. are to be viewed in a compassionate way that recognizes the feeling without judgement. View the emotions without justifying their existence. Try to identify how those emotions affect other parts of your body, and your body as a whole; again, without judgement. Observe how these emotions affect the level of pain you feel and your ability to think clearly and concentrate. Try to recall moments when you are not in pain or when you do not notice it (like when you first wake up, or being in a particular position). Try to return your mind to that particular instance as though you are reliving it. Finally, view how your feelings toward yourself affect how you interact with others around you. Do you have a negative self-image or a defensiveness about your disability? Recognizing that these behaviours are not directly connected to the pain itself and serve no purpose allows you to be able to let them go; treating yourself with the same compassion as you would a good friend. Studies show that even after several guided sessions of mindfulness meditation, chronic pain sufferers had less pain, not only immediately following each session, but also sustained pain relief over longer periods of time. Often times, pain medication could be reduced or eliminated.^[6] This is attributed to the psychological aspect involved in the perception of pain. Brain scans show increased activity in the areas of the brain that are associated with processing pain signals, and less activity in the areas involved in emotion.^[7] In a study published by the National Center for Biotechnology Information regarding patients with chronic pain who were trained in mindfulness meditation for the 10‑week study was this conclusion:

“Statistically significant reductions were observed in measures of present-moment pain, negative body image, inhibition of activity by pain, symptoms, mood disturbance, and psychological symptomatology, including anxiety and depression. Pain-related drug utilization decreased and activity levels and feelings of self-esteem increased. Improvement appeared to be independent of gender, source of referral, and type of pain.”^[8]

There are a variety of guided mindfulness meditations offered, many of them free, so finding the exact style that fits your personality should be easy. Most sessions last for 15–20 minutes, and are additionally found to reduce stress while inducing relaxation. If you would like to give mindfulness meditation a try for managing your chronic pain, talk to your doctor about including it in your pain-management regimen. They may even be able to recommend a person or program to help you get started. Once you find a style that works for you, you will be able to administer it on your own and as often as necessary.