Chronic pain has become an epidemic affecting at least 10% of the world's population. Medication remains the most common treatment approach for pain. However, this has contributed to a growing opioid addiction crisis worldwide, with opiate-related deaths having quadrupled in the past 20 years with the prevalence of chronic pain remaining constant.
This has sparked interest for non-pharmacological treatment options for patients with persistent pain. One of them being Mindfulness Based Interventions. This article summarises the current research on the effectiveness of mindfulness based interventions in a chronic pain setting.
What is Mindfulness?
Mindfulness is the basic human ability to be fully present, aware of where we are and what we’re doing, and not overly reactive or overwhelmed by what’s going on around us.
Through careful, objective focus on present thoughts and emotions, one can gain a fuller understanding of passing events and make clearer decisions to improve their outcomes in the future. Mindfulness practice has shown to increase life satisfaction and overall well-being. It improves decision-making skills, alongside building strong emotional resilience.
How is Mindfulness Related to Chronic Pain?
Viktor Frankl, an Austrian neurologist, psychiatrist, philosopher, writer, and Holocaust survivor, who wrote "Man'w search for meaning" has really captured the essence of Mindfulness beautifully:
“Between stimulus and response, there is a space. In that space lies our freedom and our power to choose our response. In our response lies our growth and our happiness.”
Pain is a complex experience involving sensory, emotional and cognitive components. Patients living with persistent pain can use Mindfulness as a way of developing a new perspective on the thoughts they have about their pain. By allowing space and removing judgment from one’s thoughts the connection between the sensory component of pain and the cognitive and emotional components can theoretically be separated. This reduces the sense of suffering from chronic pain in addition to pain intensity.
Mindfulness Practices may not cure chronic pain conditions, but they have been shown to be effective for reducing pain and improving patients’ ability to live a normal life while managing their condition. They also work to alleviate the psychological variable such as anxiety and depression associated with pain.
How can Mindfulness-Based Interventions be Used to Treat Chronic Pain?
In a review by the Asian Journal of Psychiatry researchers investigated the effectiveness of Mindfulness Interventions for a variety of chronic pain conditions including lower back pain, musculoskeletal pain & migraines. In each of these areas, they analysed several studies and compared the results to develop a clear picture of the efficacy of Mindfulness based Interventions compared to different types of traditional treatment approaches.
Lower Back Pain
In one large-scale 2016 study with over 340 participants, mindfulness was found to be significantly more effective for reducing lower back pain as compared to treatment as usual. In the study, patients were divided into three groups. The control group received pharmaceutical treatment, while a Cognitive and Behavioral Therapy (CBT) group and a mindfulness-intervention group received the respective non-pharmacological treatment. Patients in the Mindfulness group showed a 50% improvement compared to the control group on the Roland Disability Questionnaire (RDQ) after 26 weeks, and this effect was shown to persist after 56 weeks post-intervention. Effects appear to be long-lasting. Scores for the CBT group were not significantly different from those of the Mindfulness group, suggesting mindfulness is at least as effective for treating lower back pain as other leading non-opioid treatment options and significantly more effective than traditional treatment using medication.
Migraine
Two small studies found that mindfulness decreased the frequency of migraines as well as patients’ perceptions of self-efficacy, pain acceptance, and pain catastrophizing. A larger study found that treatment with mindfulness practice was just as effective as medication-based treatment in reducing the frequency and severity of migraines as well as long-term medication use. However, patients in the mindfulness group were observed to have none of the negative side effects associated with pain medication, indicating that mindfulness is a safe, equally effective alternative to medication in patients with chronic migraines.
Musculoskeletal Pain
Though research specifically on musculoskeletal pain alone is limited, existing studies highlight the effectiveness of mindfulness interventions in this area. In one study, patients treated using mindfulness interventions showed statistically significant improvements in pain self-management, perceived control over pain, and mental health as compared to patients treated as usual.
Conclusion: Mindfulness Can Be effective in the Treatment of Chronic Pain
There is consistent evidence that mindfulness-based interventions are effective in reducing pain and improving quality of life in patients experiencing chronic pain. Mindfulness Interventions have shown to be equal or of greater benefit compared to treatment with prescription medication and other leading non-pharmacological options. Additionally, mindfulness is a safe intervention without any negative side effects. Based on current and emerging research, mindfulness presents a promising, cost-effective alternative to medication while exposing patients to less risk.
References:
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