can meditation help ease chronic pain

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Can Meditation Help Ease Chronic

Pain?

By Macayla Donegan | HIPPO Reads – 7 hours ago

Eastern forms of mindfulness meditation have become increasingly

popular in the United States. These forms of meditation increase

awareness by encouraging the practitioner to pay attention to

sensations and to accept those sensations without judgment. These

practices are designed to relax your mind and body through breath

or a certain mantra: instead of moving away from uncomfortable

sensations, you accept that sensation and bring focus your back to

your breath or mantra. This ability to accept negative sensation can

be useful in many facets of life, especially for those living with

chronic pain, anxiety, or depression. People afflicted by these

disorders are often told at some point in their treatment plan that

they must learn to live with some degree of pain or anxiety, whether

it be physical or psychological. But does the degree to which you

accept negative sensation influence the degree to which you feel it?

Recent studies indicate that this is indeed the case, and that

neurological changes that occur during meditation may help explain

why.

Chronic pain affects 10-25% of adults in the United States. Two

thirds of those affected individuals report that pain has prevented

them from working and has severely impacted their quality of life,

and two thirds of the population living with chronic pain report that

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they have been experiencing chronic pain for more than five years.

Furthermore, three quarters of those suffering from chronic pain are

depressed, and a staggering 95% suffer from anxiety.

We currently have a range of methods to treat pain from opiates to

surgery. Sometimes, some of these treatments can be limited in their

effectiveness and do not fully treat patients.

Understanding the way we perceive pain may lead to more effective

treatments. As depicted in the image to the left, the mechanisms that

allow us to perceive pain are relatively complex. First, sensory inputs

come into an area of the brain called the somatosensory cortex,

which maps sensory information from the body and allows for

perception of things like touch, heat, and pain. Signals sent to the

somatosensory cortex are then sent to another area of the brain,

called the dorsolateral prefrontal cortex (DLPFC). It has been

theorized that the DLPFC monitors stimuli from the external world,

stores these experiences in our working memory, and governs what

we pay attention to in the presence of competing stimuli. In other

words, the DLPFC could “decide” how we process pain.

Recent studies have shown that patients with chronic back pain


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have lower cortical grey volumes in the DLPFC than subjects

without chronic pain. “Grey matter” refers to cell bodies that process

information while “white matter” refers to axon tracts, the cellular

cables that transmit information. Higher cortical grey volume means

that there are more healthy cells to perform neural computations.

When chronic back pain is treated effectively, cortical grey volume of

the DLPFC increases. This suggests that there is less activity in the

DLPFC when a patient is in pain, and the decrease in cortical grey

volume could alter how pain is perceived.

The DLPFC is also involved in regulating attention: 18.7 % of pain

patients complain that they have difficulty with attention, and

fifty-four percent of chronic pain patients have complained of some

cognitive impairment, which could also be a consequence of

decreased cortical volume in the DLPFC. A decrease in activity in

the DLPFC is often correlated with an increased intensity and

unpleasantness of painful stimuli, suggesting that the DLPFC plays

some top-down role in the perception of pain. Lower activity in the

DLPFC could lead to a decrease in cortical grey volume of the

region. In addition, the DLPFC is connected to the anterior cingulate

cortex (ACC). Patients who suffer from chronic pain and its often

associated depression often have less activity in the DLPFC and a

more active ACC.

Since meditation focuses on accepting negative sensations and

focusing attention elsewhere, the practice could be effective for

those who experience chronic pain. While the sensation of pain

arises from physiological components of the sensory nervous

system, the perception of pain is heavily influenced by cognitive

states and unique subjective experiences on the perception of pain.


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Several studies have indicated that various types of meditation can

diminish the perceived intensity and unpleasantry—and associated

anxiety—of pain. Most studies use mindfulness meditation, a

practice of Buddhist origin in which practitioners focus their attention

on their breath. Patients can then monitor their attention and bring it

back to their breath when it has wandered elsewhere.

How mindfulness meditation mitigates chronic pain has yet to be

determined although scientists have found that mindfulness

meditation leads to an increase in cortical volume in areas, including

the prefrontal cortex, that process somatosensory, visual, auditory,

and proprioceptive stimuli. The DLPFC, as stated earlier, is

observed to be thinner in subjects experiencing chronic pain. The

DLPFC has previously been linked to attentional processing in pain;

however, these higher cortical functions and their control over pain

have not been researched as extensively as has how the spinal and

lower level brain controls pain.

Chronic pain severely decreases the quality of life for those who

suffer from it by, among other symptoms, causing depression or

anxiety. But because meditation has previously been shown to

effectively treat anxiety in patients with generalized anxiety disorder,

it is hoped meditation will also help pain patients cope with anxiety.

Furthermore, one study has indicated that depression can be

correlated with higher activity in the ACC and lower activity of the

DLPFC, similar to what is observed in those living with chronic pain.

Recovery from depression is associated with reciprocal changes in

activity in the ACC and DLPFC, suggesting that those brain areas

are involved in the development of and recovery from

depression—and might also be instrumental in coping with chronic

pain. Another study showed that those who recovered from chronic


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pain had decreased reciprocal coactivation of the DLPFC and the

ACC, corresponding to reduced evaluative and emotional

responses.

Currently, research suggests that we should think about top-down

treatments for chronic pain when the better characterized—but often

detrimental—bottom-up, conventional treatments, like taking

prescription medications or surgery, fail. Meditation could change

the way future pain is perceived: teaching patients how to perceive

pain might open up new avenues for treatment. Through mindful

meditation practices, patients who suffer from chronic pain can

improve their quality of life and can increase their tolerance for pain.

Jon Kabat-Zin. Mindfulness Meditation for Pain Relief: Guided

Practices for Reclaiming Your Body and Your Life

Image Credit: Rob Ireton via flickr


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can meditation help ease chronic pain

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