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19.10.2015
Ongoing scientific discoveries in the physiology of pain outline the experience as completely unique to the individual.
The heterogenous nature of pain makes it understandably difficult to develop a general approach to treatment, and perhaps goes some way to explaining the limited effectiveness of many unidimensional approaches to pain management.
Science has only recently considered meditation as being more than just an exercise in relaxation1. The aim of mindfulness meditation is to develop present-focused, non-judgmental, attention. The perception of pain is influenced by a wide variety of factors, including emotional and motivational states, expectations, environmental conditions, and pain controllability2. It is important to distinguish between the sensory perception of pain intensity and the corresponding emotional perception of unpleasantness2. A recent study by Brown and Jones (2010)3 aimed to explore this concept by comparing two groups (meditation group and control group) to test any difference in affective appraisal of pain, and whether this was related to lower anticipatory neural processing3. Perhaps the most revealing observation from this study was that the meditation group were not instructed to meditate during the administration of the painful stimulus. Dr Daniel Siegel, Clinical Professor of Psychiatry at the UCLA School of Medicine, describes observable structural changes in long term meditators involving a thickening of the insula and aspects of the middle part of the prefrontal cortex4. Internal attunement allows the person to observe their own experiences instead of trying to make them what they want them to be. There is a wide body of evidence supporting the use of mindfulness techniques in the treatment of anxiety and depression. McCracken and Keogh (2009)5 explored the role of anxiety sensitivity in subjects with chronic pain, with specific reference to subsequent pain-related disability. This is another area of our undergraduate curriculum that is currently not well developed, and you may feel that this falls outside your current clinical skill set. Buhle J 2010, ‘Does meditation training lead to enduring changes in the anticipation and experience of pain?’, Pain, vol.
Seymour B and Dolan R 2013, ‘Emotion, Motivation and Pain’ in Wall and Melzack’s Textbook of Pain (6th ed), eds McMahon, S, Koltzenburg M et al, Elsevier, Philadelphia, pp. Brown C and Jones A 2010, ‘Meditation experience predicts less negative appraisal of pain: Electrophysiological evidence for the involvement of anticipatory neural responses’, Pain, vol. McCracken L and Keogh E 2009, ‘Acceptance, Mindfulness, and Values-Based Action May Counteract Fear and Avoidance of Emotions in Chronic Pain: An Analysis of Anxiety Sensitivity’, The Journal of Pain, vol. Luke's work passion is to give help to recent graduates as they develop their clinical experience. Subscribe to keep up-to-date with the latest articles, interviews, and summaries of scientific research. A new study from Wake Forest Baptist Medical Center found mindfulness meditation reduces emotional pain by 44% and pain intensity by 27%. After four days, the groups re-entered the MRI and experienced the painful heat from the thermal probe—this time, armed with their new pain management regimen. Breaking up participants into four groups allowed Zeidan to test if reported health outcomes from mindfulness were just a placebo.
Researchers from the Duke Cancer Institute in Durham, US found that during such period even music is effective, but only to a lesser extent. Meditation also helps lower pain during biopsy, the study said."Listening to guided meditation resulted in significantly lower biopsy pain during imaging-guided breast biopsy, and both meditation and music reduced patient anxiety and fatigue," said Mary Scott Soo, associate professor at Duke Cancer Institute. There are medical approaches to ease anxiety by providing anti-anxiety drugs but they may sedate the patients, the researchers noted, adding that meditation is simple and inexpensive, and can be seen as a good alternative. Anxiety and potential pain can also have a negative impact on patient care undergoing image-guided needle biopsies for diagnosing breast cancer, which are otherwise efficient and successful, the researchers indicated. Patients who experience pain and anxiety may move during the procedure, which can reduce the effectiveness of biopsy, or they may not adhere to follow-up screening and testing, the researchers revealed in the study published online in the Journal of the American College of Radiology. The researchers enrolled 121 women undergoing breast cancer diagnosis at Duke and randomly assigned them to receive one of three approaches as they underwent stereotactic and ultrasound-guided biopsy: a recorded meditation, music, or standard care with a technologist offering casual conversation and support. Patients in the music group listened to their choice of instrumental jazz, classical piano, harp and flute, nature sounds or world music. Immediately before and after biopsy, participants completed questionnaires measuring nervousness and anxiety, ranking biopsy pain between a low of zero to a high of 10, and assessing feelings of weakness and fatigue.
Patients in the meditation and music groups reported significantly greater reductions in anxiety and fatigue after biopsy than those receiving standard care. These manifest as a complex interaction of biological, psychological, social and environmental variables, influenced also by past experiences and pre-conceptions of the individual.
In contrast, certain approaches that aim to address each contributing factor to an individual’s pain – as opposed to just signs and symptoms – may prove to be more effective in dealing with underlying pain mechanisms.
Developments in neuroscience are now observing and describing structural changes in the nervous system, as well as concurrent cognitive and behavioural changes in meditation practitioners suffering from physical pain, as well as fear, anxiety and depression.
Perception of intensity can be accurately described as a statistical estimate of the nature of pain, whereas the unpleasantness of pain involves the motivational significance to the individual2.
They found that the experienced meditators perceived the pain as less unpleasant compared to the control group, correlating with lower activity in their mid-cingulate cortex3.


The data, in fact, reflected potential long-term neurological and cognitive change, or ‘traits’, rather than a static analysis of subjects in a transient meditative state1. The assertion is that this thickening is a natural development resulting from consistent practise and strengthening of synaptic connections4. They have this kind of curious, open, accepting, loving stance to themselves, which is really the essence of what mindfulness is. In the broader biopsychosocial context of an individual’s pain, these factors can have varying degrees of relevance to the actual experience. They reported that individuals in chronic pain have more distress and disability in the presence of greater fear and anxiety, but that processes of acceptance, mindfulness, and values-based behaviours may reduce this effect5.
The evidence supporting mindfulness practice as part of a multidisciplinary management may reinforce a mindset that you already apply in your own practice, or it may present itself as a new concept, all together. The options available for you and your patients include allied health referral to a trained psychologist or appropriate practitioner, but at the very least I think physiotherapists can play an important role in advising patients regarding treatment options, and the multitude of incredible evidence-based resources available. Fadel Zeidan, assistant professor of neurobiology and anatomy, recruited 75 pain-free participants and scanned their brains in an MRI while exposing them to a 120-degree thermal probe. The trials showed that the mindfulness meditation group reported the strongest pain reduction. Standard-care patients received supportive and comforting dialogue with the radiologist or technologist.
The standard-care patients reported increased fatigue after biopsy, the researchers concluded.
Is that just reports from people doing it for 10 years, or are there good scientific studies showing specific benefits that I care about?In this massive article I have summarized several scientific discoveries on the benefits of meditation.
This implies that unpleasantness may be a more modifiable aspect of pain perception, perhaps more amenable to intervention. The meditation group also showed an association with lower cortical activity in the S2 region during the pain-evoked response3. These particular ‘traits’ were attributed to any aspect of an individual’s long term functioning that occurred without effort4. In the context of pain management, these structural changes can reflect an improving ability to observe sensations, thoughts and feelings, without judgement. Additionally, compared to the other groups, those practicing mindfulness meditation also appeared to be using a different part of their brain.
Over 100 studies were analyzed (some of which are in themselves analysis of other hundreds of studies), and categorised the findings into 76 benefits (divided into 46 subheadings). The clinical implication of these findings suggests that meditation may reduce the emotional appraisal of pain by reducing cerebral processes related to the anticipation of unpleasantness3.
However, when identified, it would be reasonable to consider meditation as part of a multidisciplinary approach to pain management. There are over 3,000 scientific studies on the benefits of meditation, but I have not found any blog that compiles hundreds of researches into an organized article, so I decided to fill in the gap.These studies were based on different types of meditation, and I have included details, whenever relevant.
Some effects, such as increased compassion and social bonding, are more salient as a result of specific meditation techniques (such as loving-kindness, which is a Buddhist meditation). However, my understanding and personal practice is that any kind of authentic meditation will include most of these benefits, in one degree or another. Good to take it every day.Click To TweetMindfulness practices decreases depressionIn a study conducted at five middle schools in Belgium, involving about 400 students (13 ~ 20 years old), Professor Filip Raes concludes that “students who follow an in-class mindfulness program report reduced indications of depression, anxiety and stress up to six months later.
Moreover, these students were less likely to develop pronounced depression-like symptoms.” Another study, from the University of California, made with patients with past depression, concluded that mindfulness meditation decreases ruminative thinking and dysfunctional beliefs. Yet another concludes that mindfulness meditation may be effective to treat depression to a similar degree as antidepressant drug therapy”. Another research concludes that mindfulness meditation may be effective to treat anxiety to a similar degree as antidepressant drug therapy. Meditators were more able to “attend moment-to-moment to the stream of stimuli to which they are exposed and less likely to ‘get stuck’ on any one stimulus. There are other studies as well, for which I simply present the link below, to avoid repetition. At the end of it, MRI scans show that the grey matter concentration increases in areas of the brain involved in learning and memory, regulating emotions, sense of self, and having perspective.
The results suggest that:Meditation provides at least a short-term performance improvement even in novice meditators. In long term meditators, multiple hours spent in meditation are associated with a significant decrease in total sleep time when compared with age and sex matched controls who did not meditate.
Another study demonstrated that even with only 20 minutes a day of practice, students were able to improve their performance on tests of cognitive skill, in some cases doing 10 times better than the group that did not meditate. They also performed better on information-processing tasks that were designed to induce deadline stress.
Scientists suspect that gyrification is responsible for making the brain better at processing information, making decisions, forming memories and improving attention.
Ron Alexander reports in his book Wise Mind, Open Mind that the process of controlling the mind, through meditation, increases mental strength, resilience, and emotional intelligence.


What they discovered is that the Zen meditation (called zazen) practitioners reported less pain. So, even though their brain may be receiving the same amount of pain input, in their mind’s there is actually less pain. Both before and after meditation training, study participants’ brain activity was examined using ASL MRI, while pain was inflicted in them by using heat. These neural relationships may be involved in the development of cognitive skills, such as maintaining attention and disengaging from distraction. Moreover, the benefits of the practice were observed also in normal state of consciousness during the day, which speaks to the transference of cognitive abilities “off the cushion” into daily life. In a research conducted by the University of Washington and University of Arizona, Human Resource personnel were given 8 weeks of training in either mindfulness meditation or body relaxation techniques, and were given a stressful multitasking test both before and after training. The group of staff that had practiced meditation reported lower levels of stress and showed better memory for the tasks they had performed; they also switched tasks less often and remained focused on tasks longer.
In an experiment conducted by the University of California, a stream of random letters was shown in a computer screen, in rapid succession. In each session, one or two numbers or blank screens would appear in the middle, and participants were later asked, immediately after the stream ended, to type the numbers they saw.
Subjects that had undergone 3 months of intense Vipassana Meditation were found to have a better control over the distribution of attention and perception resources. They showed less allocation of brain-resource for each letter shown, which resulted in reduction in “attentional-blink” size.
Participants who had followed the practice performed better in a task where they were asked to creatively come up with new ideas. An ounce of prevention is worth a pound of cure.Click To TweetMeditation reduces risk of heart diseases and strokeMore people die of heart diseases in the world than any other illness. In a study published in late 2012, a group of over 200 high-risk individuals was asked to either take a health education class promoting better diet and exercise or take a class on Transcendental Meditation.
During the next 5 years researchers accompanying the participants found that those who took the meditation class had a 48% reduction in their overall risk of heart attack, stroke and death. They noted that meditation “significantly reduced risk for mortality, myocardial infarction, and stroke in coronary heart disease patients.
These changes were associated with lower blood pressure and psychosocial stress factors.” There are also other researches pointing out similar conclusions, about related health conditions. More specifically, it was noted reduced levels of pro-inflammatory genes, which in turn correlated with faster physical recovery from a stressful situation. One of them received mindfulness training, while the other received nutritional education, exercise and music therapy.
The study concluded that mindfulness techniques were more effective in relieving inflammatory symptoms than other activities that promote well-being. As a result, the researchers found significant improvement in the overall health status of the participants and in symptoms of stiffness, anxiety, and depression.
They are also the cells that are attacked by HIV, the devastating virus that causes AIDS and has infected roughly 40 million people worldwide. Now, researchers at UCLA report that the practice of mindfulness meditation stopped the decline of CD4 T cells in HIV-positive patients suffering from stress, slowing the progression of the disease. Participants in the eight-week group showed no loss of CD4 T cells, indicating that mindfulness meditation training can buffer declines. In contrast, the control group showed significant declines in CD4 T cells from pre-study to post-study. A brief mindfulness meditation-based stress reduction intervention delivered by audiotape during ultraviolet light therapy was found to increase the resolution of psoriatic lesions in patients with psoriasis. According to a study from Emory University, such exercises effectively boost one’s ability to empathize with others by way of reading their facial expressions. Another study points out that the development of positive emotions through compassion builds up several personal resources, including “a loving attitude towards oneself and others, and includes self-acceptance, social support received, and positive relations with others”, as well as “feeling of competence about one’s life” and includes “pathways thinking, environmental mastery, purpose in life, and ego-resilience”.
These results suggest that this easily implemented technique may help to increase positive social emotions and decrease social isolation”. In a similar situation, the practitioners also experienced decreased level of worry and emotional suppression. Mindfulness For Kids Mindfulness is the hottest thing in education since the advent of the blackboard.
As a beginner who is just starting to practice meditation and struggling to find motivation, these articles help me make a lot. In a couple of places, though, I read that meditation has only been found to be harmful for certain people with extreme cases of psycotic disorder.So, in general, it’s a pretty safe practice.Are you aware of any negative effect that you would like to share about?



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