Meditation for Pain

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Meditation is a complementary and alternative mind-body therapy that has been used for thousands of years to promote well being, reduce stress and anxiety, and decrease tension. It produces a deep state of relaxation and clear mind. During the process of mediation, an individual focuses their attention on a particular concept or image, essentially eliminating extraneous thoughts, sounds, and other stimuli. The resulting effects are therapeutic to both body and mind.

Meditation can be useful to help reframe the understanding of a stressful event or situation, improve stress-management skills, promote self-awareness, and decrease negative thoughts and feelings. Meditation may also be particularly useful for individuals with medical conditions that are aggravated by stress. Although the emerging scientific evidence in support of these associations remains debated, meditation has been studied for its effects on allergies and asthma, depression and anxiety, eating disorders, cancer, fatigue, heart disease, high blood pressure, pain, sleeping difficulties, and substance abuse.

There are a variety of mind-body therapies that utilize meditation techniques. Guided imagery, or guided meditation, utilizes mental images of relaxing places or situations in order to induce a calm and relaxed state of mind. Mantra meditation involves the silent repetition of a calming word, thought, or phrase in order to prevent intrusion of distracting thoughts. Mindfulness meditation is rooted in mindfulness, or the state of having an increased awareness and acceptance of living in the present. This form of meditation enables individuals to focus their awareness on what they are currently experiencing, such as their respiration or heartbeat. Qi gong is a traditional Chinese medical therapy that uses a combination of meditation, relaxation and physical movement similar to tai chi to restore energy balance within the body. Transcendental meditation is another form of meditation and is similar to mantra meditation.

Meditation is best performed when attention can be focused and breathing can be relaxed. This is most often best achieved in a quiet setting and when performed in a comfortable position.

Meditation and Fibromyalgia

Meditation has been investigated in a number of studies related to fibromyalgia. Rasmussen et al. demonstrated that a form of transcendental meditation effectively and sustainably reduced impaired working ability, pain, fatigue, morning tiredness, stiffness, and anxiety in a small sample of female fibromyalgia patients who received tailored treatment at a Norwegian alternative medicine center (Rasmussen et al., 2012). Another recent pilot study found that eight weeks of combination therapy consisting of yoga and meditation was successful at improving the overall health status of 11 fibromyalgia patients, as well as improving their symptoms of stiffness, anxiety, and depression. Patients’ number of “feel good” days also improved, as did their employment attendance (Hennard, 2011).

A larger, randomized controlled trial (considered the “gold standard” for research study design) also evaluated the use of meditation and yoga to treat fibromyalgia symptoms. In this study, 177 female fibromyalgia patients were randomly assigned to receive one of three therapies: 1) mindfulness-based stress reduction, 2) an active control group that received relaxation training, stretching exercises, and homework, and 3) a wait list group. At the end of the trial, the researchers found no significant differences between any of the three groups with regard to health-related quality of life, which was the primary outcome of interest. However, health-related quality of life was improved somewhat during the short-term follow-up period. Overall, the study did not provide compelling evidence to support the use of mindfulness-based meditation as a treatment for fibromyalgia (Schmidt et al., 2011). Other studies have also failed to demonstrate a significant impact of mindfulness meditation on fibromyalgia symptoms (Astin et al., 2003). Of interest, however, is a small study by Lush and colleagues (2011) which evaluated various physiological measures in a small group of fibromyalgia patients who were treated with mindfulness-based meditation. This study found that mindfulness-based meditation may induce certain physiological responses within the central nervous system that might have an impact on fibromyalgia (Lush et al., 2011).

Other studies have shown more promising results for the use of mindfulness-based meditation in fibromyalgia. Sephton used a randomized-controlled trial to evaluate the effectiveness of mindfulness-based meditation led by a licensed clinical psychologist trained to administer mindfulness therapy. The study found that those fibromyalgia patients who received eight weekly 2.5 hour sessions of mindfulness-based meditation had significant improvement in their depression symptoms when compared to patients who did not receive the therapy (Sephton et al., 2007). Group therapy involving a combination of cognitive-behavioral therapy, education, meditation, and Chinese movement therapy has also been demonstrated to be effective at improving overall functioning in fibromyalgia patients, as well as tender point counts and pain threshold (Creamer et al., 2000).

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References

1.        Stress management. Meditation: A simple, fast way to reduce stress. Mayo Clinic. April 21, 2011; Accessed April 26, 2012.

2.        Rasmussen LB, Mikkelsen K, Haugen M, Pripp AH, Fields JZ, Førre OT. Treatment of fibromyalgia at the Maharishi Ayurveda Health Centre in Norway II-a 24-month follow-up pilot study. Clin Rheumatol. 2012 Jan 27. [Epub ahead of print]

3.        Hennard J. A protocol and pilot study for managing fibromyalgia with yoga and meditation. Int J Yoga Therap. 2011;21:109-21.

4.        Schmidt S, Grossman P, Schwarzer B, Jena S, Naumann J, Walach H. Treating fibromyalgia with mindfulness-based stress reduction: results from a 3-armed randomized controlled trial. Pain. 2011;152(2):361-369.

5.        Lush E, Salmon P, Floyd A, Studts JL, Weissbecker I, Sephton SE. Mindfulness meditation for symptom reduction in fibromyalgia: psychophysiological correlates. J Clin Psychol Med Settings. 2009;16(2):200-207.

6.        Sephton SE, Salmon P, Weissbecker I, Ulmer C, Floyd A, Hoover K, Studts JL. Mindfulness meditation alleviates depressive symptoms in women with fibromyalgia: results of a randomized clinical trial. Arthritis Rheum. 2007;57(1):77-85.

7.        Creamer P, Singh BB, Hochberg MC, Berman BM. Sustained improvement produced by nonpharmacologic intervention in fibromyalgia: results of a pilot study. Arthritis Care Res. 2000;13(4):198-204.

Astin JA, Berman BM, Bausell B, Lee WL, Hochberg M, Forys KL. The efficacy of mindfulness meditation plus Qigong movement therapy in the treatment of fibromyalgia: a randomized controlled trial. J Rheumatol. 2003;30(10):2257-62.

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