For this post, I wanted to look at some recent research done on patients with fibromyalgia who have participated in mindfulness meditation programs for chronic pain. The purpose of these studies was to assess to what extent mindfulness training could improve the well-being of people living with fibromyalgia.
The first study compared the effects of an eight week Mindfulness Based Stress Reduction program with a control support group (Grossman et al., 2007). The MBSR intervention was first implemented by Jon Kabat-Zinn and it is structured so that participants attend weekly sessions where they learn “different types of formal mindfulness practice, mindful awareness during yoga postures, and mindfulness during stressful situations and social interactions” (227, Grossman et al., 2007). Improvements were seen in the MBSR group across all of the different measurements used, which included pain scales, somatic complaints and quality of life scales. These improvements were not found in the control group (Grossman et al., 2007). Interestingly, the researchers interviewed about half of the original participants from the mindfulness training group 3 years later, and found sustained long-term benefits among those who continued their mindfulness practice (Grossman et al., 2007). The authors suggest that, because mindfulness does not simply aim to reduce symptoms, but to change mental processing and experience in the direction of greater patience, acceptance and awareness, this may partly explain the residual benefit. Furthermore “development of self – acceptance, mastery, purpose and positive social relations may facilitate enhanced well-being even in the face of continued symptoms” (232, Grossman et al., 2007).
Secondly, Rosenzweig et al., (2010) studied the effect of MBSR programs for participants with mixed chronic pain conditions and the significance of at-home practice to results. The investigators measured results in terms of bodily pain, quality of life and psychological symptoms for each chronic pain condition (neck/back pain, arthritis, fibromyalgia, chronic headache, and two or more coexisting conditions). The researchers discovered that the degree of benefit of participating in mindfulness programs varied depending on the chronic pain condition, but that overall improvements were seen in almost every category (Rosenzweig et al., 2010). In terms of fibromyalgia, there were significant improvements in pain measurements, and quality of life measurements, but in the area of psychological distress, fibromyalgia patients reported the least degree of improvement (Rosenzweig et al., 2010). For the other chronic pain conditions: chronic neck/back pain and ‘two or more conditions’ reported the largest reduction in pain severity, arthritis patients reported the largest improvement in quality of life measurements, and the largest reduction in psychological distress was shared among neck/back pain, arthritis and ‘two or more conditions’ patients (Rosenzweig et al., 2010). Chronic headache patients had lower degrees of improvement on the different measurement scales. The results for the impact of at-home meditation practice across the different chronic pain conditions are interesting. Greater adherence to formal meditation practice at home was correlated with greater reduction in overall psychological distress, improvement in self rated health and bodily symptoms (Rosenzweig et al., 2010). However, greater adherence was not associated with improvement in subscale measurements of bodily pain, anxiety, depression or physical functioning (Rosenzweig et al., 2010). The mixed results indicate a need for further research into the importance of the amount of at-home meditation practice and the type of practice.
This study presented at interesting discussion of the different possible causes for how meditation practice can improve chronic pain conditions. First of all, nervous system pathways to parts of the brain associated with stress can be inhibited through mindfulness practice. Secondly, reducing psychological symptoms like anxiety and depression can help because those symptoms can amplify the perception of pain. Third, mindfulness practice can help improve emotional regulation and coping skills in stressful situations. Fourth, mindfulness contributes physical self-awareness which could help lead to better self-care. Finally, mindfulness can help activate nervous system function associated with rest and calm (parasympathetic nervous system), which in turn can lead to deep muscle relaxation that may reduce pain (Rosenzweig et al., 2010).
It’s interesting how the scientific study of meditation is so different from the first-hand experience of meditation. If I were asked, I’d say the greatest benefit has come from being more aware of negative patterns of thinking and feeling. But I like knowing that if I keep working at it I may also experience less physical pain and a greater quality of life – as well as a smaller degree of improved psychological well-being. I think that the scientific studies are helpful for giving hope and motivation for anyone suffering from chronic pain.
Paul Grossman, Ulrike Gilmer, Annette Raysz and Ulrike Kesper. 2007. Mindfulness Training as an Intervention for Fibromyalgia: Evidence of Postintervention and 3-Year Follow-up Benefits in Well-being. Psychology and Psychosomatics 76: 226-233.
Steven Rosenzweig, Jeffrey Greeson, Diane Reibel, Joshua Green, Samar Jasser and Denise Beasley. 2010. MIndfulness-based stress reduction for chronic pain conditions: Variation in treatment outcomes and role of home meditation practice. Journal of Psychosomatic Research 68: 29-36.