Can Meditation Help Ease Chronic Pain

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 unpleasantryand associated
anxietyof 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
depressionand 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 characterizedbut often
detrimentalbottom-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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