Meditation for pain relief

Pain is a fact of life: it can be dulled with drugs, but sometimes it’s just too intense or too persistent. Then we have to learn to live with it.

Buddhist monks are adept at doing this when they sit immobile in meditation, remaining straight-backed in the lotus position for hours on end. They are thought to achieve this by “uncoupling” the sensation of pain from their emotional reaction to it. This is more than just a parlour trick. Monks protesting the Chinese occupation of Tibet have shown they are capable of sitting unflinching as they burn to death.

The very first clinical trial of mindfulness meditation, conducted by Jon Kabat-Zinn of the University of Massachusetts Medical School in 1982, involved patients who were experiencing chronic pain that could not be alleviated by conventional treatments. After a 10-week “stress reduction and relaxation programme” based on mindfulness training, there were substantial decreases in the pain experienced by the majority of patients. As an added bonus, reported Kabat-Zinn, “large and significant reductions in mood disturbance and psychiatric symptomatology accompanied these changes and were relatively stable on follow-up.” In other words, patients’ general mental wellbeing improved.

Dozens of other studies of mindfulness and pain have followed. Meditation seems to work better for some kinds of pain than others. A study in 2010, for example, found that it worked best for arthritis, but less well for headache and migraine.

Last month, a scientist at the Max Planck Institute for Human Cognitive and Brain Sciences in Leipzig published a review of meditation and pain research conducted over the past six years. A kind of meditation called focused attention, involving focusing on the breathing or a mantra, did not appear to be effective by itself, but mindfulness meditation or “open monitoring” did. In this technique, meditators focus their attention on the painful stimulus “non-judgmentally”, without getting emotionally involved in it or getting caught up in thoughts about it.

This review, published in the Annals of the New York Academy of Sciences, strongly endorses mindfulness for alleviating pain, but how does the technique actually work? The review looks at three studies that suggest meditation is accompanied by increased activity in pain-processing centres of the brain (for example the somatosensory cortex, anterior cingulate cortex and insular cortex) and reduced activity in parts of the brain involved in thinking (such as the prefrontal cortex).

The researcher concludes that pain relief isn’t due to the person meditating being “distracted” from the pain – quite the opposite in fact, because mindfulness involves focusing attention on the painful stimulus. It also has nothing to do with increased release of endorphins, the body’s own painkilling chemicals. Instead, pain relief is achieved by suppressing the “mental narratives” and “self-related processes” that exacerbate pain.