Chronic Pain – How Can Mindfulness Help?

Chronic pain, or pain lasting longer than three months, impacts more than 50 million adults in the United States, according to the CDC. It affects people’s everyday lives, work, and is linked to depression, dementia syndromes, substance abuse, and higher suicide risk.

Our brains and bodies have a complex system for processing pain.

- First, pain is detected through nociceptors (sensory receptors located throughout the body) and peripheral nerves.

- Second, pain signals are transmitted to the spinal cord and the spinothalamic tract carries the pain signals to the brain, specifically the thalamus.

- Third, various regions of the brain are involved in pain processing.

The limbic system and prefrontal cortex are involved in remembering past experiences and emotional aspects of pain, as well as attention, interpretation, and response to current pain being experienced. It is these brain regions that are impacted when mindfulness-based approaches to pain are practiced.

Mindfulness is the practice of focusing attention on the present moment in a non-judgmental and accepting way. It helps manage and decrease pain through these mechanisms:

1. Attention Regulation:

• Shifting Focus: Mindfulness helps individuals shift their focus away from the pain, reducing the intensity of pain perception.

• Decreased Rumination: By reducing negative thought patterns and rumination aboutpain, mindfulness can diminish the emotional distress associated with it.

2. Emotional Regulation

• Reducing Stress and Anxiety: Mindfulness practices can lower stress and anxiety levels, which can exacerbate the perception of pain.

• Enhanced Emotional Resilience: Improved emotional regulation can help individuals cope better with the emotional aspects of chronic pain.

3. Sensory Modulation

• Pain Perception: Mindfulness can alter the way the brain processes pain signals, potentially reducing the subjective experience of pain.

• Increased Tolerance: By fostering a non-reactive awareness, mindfulness can increase pain tolerance and decrease pain-related distress.

4. Brain Changes

• Neuroplasticity: Regular mindfulness practice can lead to structural and functional changes in the brain, such as increased gray matter density in areas involved in pain modulation and emotional regulation.

• Functional Connectivity: Mindfulness can enhance the connectivity between brain regions involved in attention, sensory processing, and emotional regulation.

HOW?

Many people resist pain, and adopt a punishing or resentful attitude toward their bodies for experiencing it. Instead, mindfulness experts tell us to acknowledge our pain, label it (where, intensity, nature of the pain, such as whether it is shooting or dull), and accept it. Using a mantra such as, “I feel and accept this pain” can be helpful.

Next, redirect your attention to areas of strength. Rather than focusing your attention on what the pain won’t let you do, how have you been strong today? Maybe you were able to fold a load of laundry, maybe just getting out of bed was the victory. However, small, notice, label, and celebrate the ways big and small that you accept your pain and keep going.

It is also helpful to make yourself feel safe and calm in the midst of pain. Breathing exercises and body scans can be helpful to calm the nervous system and reduce reactivity to pain.

Harvard Health Publishing has a body scan practice here

Our brains are skilled at holding on to negative experiences and emotional reactions to pain, so it is important to counteract that by intentionally turning our focus toward the positive. Mantras likes the ones below can help:

 I feel you. I hear you. And I accept you.

 I am strong. I am resilient. I trust my body.

 Is this a mountain or a molehill?

 I am safe, I am loved.

 Look how far I’ve come.

Try saying these, even when it doesn’t feel genuine – you may be surprised at how quickly they begin to feel like your truth. Meditation apps like Headspace have meditations that specifically address pain and may be helpful as you get started.

Know this, though: You are more than your pain, and you can have experiences that aren’t painful. Wishing you pain free moments in the summer ahead!

Sources:

Chronic Pain Among Adults — United States, 2019–2021 | MMWR (cdc.gov)