Research shows that in addition to the physical sensations of pain, there are cognitive, emotional and behavioral processes that contribute to the cycle of chronic pain [1]. People who engage in catastrophizing (believing something is worse than it is) and rumination (constant worrying) develop fear of their pain, which leads to avoidance of activities, functional disability and increased future pain [1, 2]. Therefore, introducing a technique that corrects catastrophizing and rumination can help break the cycle of chronic pain.
Mindfulness is a cognitive behavioral strategy that promotes present-moment awareness of body sensations, such as the experience of pain. In contrast to pain catastrophizing, mindfulness is intentional and non-judgmental. Mindfulness meditation has been shown to reduce symptoms of physical pain, depression and anxiety while increasing factors such as sleep quality and psychological well-being [3-5].
The reason mindfulness can be so effective when used to treat chronic pain is because, unlike medication, mindfulness interventions target the cognitive, emotional and behavioral aspects of the pain experience [6, 7]. Participants learn how to identify emotionally charged thoughts that lead to anxiety, behavioral avoidance and future pain by observing the pain experience in a non-judgmental, objective way [8]. By separating the physical sensation of pain from the emotional experience, pain is reduced [8].
References
[1] Vlaeyen JWS, Linton SJ. Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain 2000;85:317–32.
[2] Bailey KM, Carleton RN, Vlaeyen WS, Asmundson GJG. Treatments addressing pain-related fear and anxiety in patients with chronic musculoskeletal pain: a preliminary review. Cogn Behav Ther 2010;39:46–63.
[3] Carmody J, Baer RA. Relationships between mindfulness practice and levels of mindfulness, medical and psychological symptoms and well-being in a mindfulness-based stress reduction program. J Behav Med 2008;31:23–33.
[4] Chan RR, Larson JL. Meditation interventions for chronic disease populations:a systematic review. J Holist Nurs 2015;33:351–65.
[5] Zhang J, Liu X, Xie X, Zhao D, Shan M, Zhang X, Kong X, Cui H. Mindfulness-based stress reduction for chronic insomnia in adults older than 75 years: a randomized, controlled, single-blind clinical trial. Explore 2015;11:180–5.
[6] Schutze R, Rees C, Preece M, Schutze M. Low mindfulness predicts pain catastrophizing in a fear-avoidance model of chronic pain. Pain 2010;148:120–7.
[7] Curtin KB, Norris D. The relationship between chronic musculoskeletal pain, anxiety and mindfulness: Adjustments to the Fear-Avoidance Model of Chronic Pain. Scand J Pain. 2017;17:156-166.
[8] Kabat-Zinn J, Lipworth L, Burney R, Sellers W. Four-Year Follow-up of a meditation-based program for the self-regulation of chronic pain: Treatment outcomes and compliance. Clin J Pain. 1986;2:159–73.
