CNMB Lab, Nashville, TN
dvago@bwh.harvard.edu

The use of Mindfulness training for acute and chronic pain

Brigham and Women's Hospital

There have been a number of studies investigating the effects of mindfulness and other forms of meditation training on the experience of pain, acutely or in chronic states. Below are just a few examples from 2009-2010

1. Brown, C. A. & Jones, A. K. P. (2010). Meditation experience predicts less negative appraisal of pain: Electrophysiological evidence for the involvement of anticipatory neural responses. Pain, 150(3), 428-438.
2. Cho, S., Heiby, E. M., McCracken, L. M., Lee, S. M., & Moon, D. E. (2010). Pain-Related anxiety as a mediator of the effects of mindfulness on physical and psychosocial functioning in chronic pain patients in Korea. The Journal of Pain, 11(8), 789-97.
3. Cusens, B., Duggan, G. B., Thorne, K., & Burch, V. (2010). Evaluation of the breathworks mindfulness-based pain management programme: Effects on well-being and multiple measures of mindfulness. Clinical Psychology & Psychotherapy, 17(1), 63-78.
4. Goyal, M., Haythornthwaite, J., Levine, D., Becker, D., Vaidya, D., Hill-Briggs, F., et al. (2010). Intensive meditation for refractory pain and symptoms. The Journal of Alternative and Complementary Medicine, 16(6), 627-31.
5. Grant, J. A., Courtemanche, J., Duerden, E. G., Duncan, G. H., & Rainville, P. (2010). Cortical thickness and pain sensitivity in Zen meditators. Emotion, 10(1), 43-54.
6. Perlman, D. M., Salomons, T. V., Davidson, R. J., & Lutz, A. (2010). Differential effects on pain intensity and unpleasantness of two meditation practices. Emotion, 10(1), 65-71.
7. Rosenzweig, S., Greeson, J. M., Reibel, D. K., Green, J. S., Jasser, S. A., & Beasley, D. (2010). Mindfulness-Based stress reduction for chronic pain conditions: Variation in treatment outcomes and role of home meditation practice. Journal of Psychosomatic Research, 68(1), 29-36.
8. Teixeira, E. (2010). The effect of mindfulness meditation on painful diabetic peripheral neuropathy in adults older than 50 years. Holistic Nursing Practice, 24(5), 277-83.
9. Zeidan, F., Johnson, S. K., Diamond, B. J., David, Z., & Goolkasian, P. (2010). Mindfulness meditation improves cognition: Evidence of brief mental training. Consciousness and Cognition, 19(2), 597-605.
10. Grant, J. A., & Rainville, P. (2009). Pain sensitivity and analgesic effects of mindful states in zen meditators: A crosssectional study. Psychosom Med, 71(1), 106.
11. McCracken, L. M., & Keogh, E. (2009). Acceptance, mindfulness, and values-based action may counteract fear and avoidance of emotions in chronic pain: An analysis of anxiety sensitivity. Journal of Pain, 10(4), 408-415.
12. Rosenzweig, S., Greeson, J. M., Reibel, D. K., Green, J. S., Jasser, S. A., & Beasley, D. (2009). Mindfulness-Based stress reduction for chronic pain conditions: Variation in treatment outcomes and role of home meditation practice. J Psychosom Res.
13. Zeidan, F., Gordon, N. S., Merchant, J., & Goolkasian, P. (2009). The effects of brief mindfulness meditation training on experimentally induced pain. Journal of Pain.

This also brings up the issue of PLACEBO. There are plenty of studies to demonstrate that negative expectation can enhance the negative experience. For example, a recent study published in Science Translational Medicine by Bingel and colleagues (“The Effect of Treatment Expectation on Drug Efficacy: Imaging the Analgesic Benefit of the Opioid Remifentanil” – [Link]) found that the effectiveness of pain killers on thermal pain decreased with expectation of receiving pain killers, while just the expectation alone of NOT receiving pain killers exacerbated the pain. In other words, the amount of potent opioid received was constant and the reported experience of pain changed in intensity depending upon expectancy.

I bring up Placebo not to make a point that  the effects of mindfulness or meditation training can be reduced to a placebo response, but more so to emphasize the powerful capability of the mind to profoundly change experience of the world depending upon OUR EXPECTATION!

As it turns out, the mechanisms of pain may be fairly clear (see Melzack’s original 1965 SCIENCE article HERE), but the biopsychsocial influences on the interpretation of pain signals is far from being completely understood.  Although over 50 billion dollars is spent on the global pain industry in prescription and over-the-counter pills…these remedies are typically little help, while some like morphine and other opiates can be highly addictive and subject to abuse.

4 Responses

  1. Cathy kerr says:

    Thanks Dave! This is helpful

  2. Excellent reference list. I’m subscribing to your blog!

  3. Varleo says:

    I have chronic pain in the back that bother me much why I take Hydrocodone and Oxycodone to relieve pain. Searching the web I found Findyourdrug which I think is a very interesting page that I have many options to buy.

Leave a Reply