Can Mindfulness Really Reduce Pain?

It’s no secret that meditation calms the mind. Anyone who’s ever closed their eyes and taken a few deep breaths can attest to the power of peace and quiet. Science supports this too: Several studies have show that mindfulness-based stress reduction (MBSR)—an eight-week group therapy program that combines meditation, focus, and being present—can ease stress and anxiety as well as depression and fatigue. This mind-body approach, which was popularized in the late 1970s by Jon Kabat-Zinn, Ph.D., the founding executive director of the Center for Mindfulness at the University of Massachusetts Medical School, may offer benefits that extend beyond the brain. New research suggests that feeling zen may aid in physical pain relief, too.

A recent study published in the journal JAMA observed people with chronic lower back pain who received either MBSR, cognitive behavioral therapy (a talk therapy designed to change negative thinking patterns), or whatever standard care they were using before. The results: 61 percent of those who completed the MBSR class saw meaningful improvements six months later, 58 percent of those who did cognitive behavioral therapy also benefitted, and 44 percent who kept their usual treatment strategy saw some improvements. While the results are close, it’s clear that there’s more to learn about how MBSR provides pain relief, perhaps better than other programs.

How does MBSR work? Over the eight-week course, instructors help you become more aware of everything from your thoughts to aches and pains, says Madhav Goyal M.D., a part-time assistant professor of medicine at Johns Hopkins University who co-wrote an editorial accompanying the recent JAMA study. You learn to focus on your breath and allow thoughts to enter and leave your mind without judgment (a key aspect of the practice).

Meditation, in general, moves your body away from its sympathetic (fight-or-flight) stage, activating the calming parasympathetic system. “Reaching this state leads to the decrease of pro-inflammatory, or pro-pain, chemicals in the body as well as a release of chemicals that are anti-inflammatory, or anti-pain,” explains Adam Perlman, M.D., executive director of Duke Integrative Medicine. “This leads to a physiological response that can be beneficial to someone experiencing pain.” Of course, there’s a component of pain that’s emotional, and that’s where things can get complicated. “You could hit someone in the thumb with the exact same amount of force, but two different people may experience that pain very differently,” he says.

MBSR may reduce the degree of the ‘catastrophizing’ we do, Goyal says. In other words, say you feel a migraine coming on. Before symptoms worsen, you may start thinking that your day will be ruined. You decide that the pounding headache will become so unbearable, you won’t be able to tackle your massive workload. “There’s an emotional package that comes along with initial symptoms that can augment the amount of pain we end up having,” Goyal says. “A mindfulness program may help us stop that snowball.”

Being more accepting of a situation—and knowing that pain is finite—provides a sense of control, says Arthur Jenkins, M.D., an associate professor of neurosurgery at the Icahn School of Medicine at Mount Sinai.

You don’t have to suffer from chronic pain to reap the rewards of MBSR. Experts agree that meditation for pain relief works on a lesser scale, too, helping with smaller physical woes. “I think we have enough evidence right now that this should be an option that’s offered to patients. In many hospitals and healthcare centers, it’s already being offered,” Goyal says.

The best way to learn MBSR would be to sign up for an official eight-week class, such as the online program available at the Center for Mindfulness at University of Massachusetts’ Medical School. Picking up MBSR on your own is also an option, but it’s a bit like practicing tennis against a backboard. “You can do the exercises and get better, but having someone guide you, at least initially, is beneficial,” Jenkins says. You’ll likely hit some roadblocks when you first get started, so it’s wise to have an expert on-hand to help you through these obstacles. Many large universities offer in-person classes, too, as do some health and wellness centers.

If you’d prefer to start solo, the app Mindfulness for Beginners delves into Kabat-Zinn’s teachings. You can also find guided meditations here on Sonima.com. Follow this tip from Perlman: Begin each session with five to 10 minutes of mindfulness. Taking deep breaths and focusing on your inhales and exhales can have an instant and profound physiologic effect.