Using Mindfulness to Manage Chronic Pain 

While it’s normal to feel pain from time to time, especially after an injury, chronic pain is different. When you have chronic pain, your body will continue to hurt months or even years after the initial injury or illness.  

Feelings of pain stem from a series of messages that are sent through the nervous system. When you get injured or become sick, pain sensors in that area light up and send the message to the brain of the problem. The brain processes these signals and sends the message to the rest of the body that your hurt. With acute pain, the messages stop once the injury is repaired. But with chronic pain, the nerve signals continue to fire long after healing. 

The Center for Disease Control reports that about 50.2 million adults in the United States live with chronic pain. Symptoms for chronic pain can range from mild to serve and may feel dull, achy, throbbing, sore, or stiff. If you have chronic pain, you may also feel fatigued, have difficulty sleeping, and experience changes in appetite.  

Treatment for chronic pain depends on the root of the condition, like arthritis, back pain, or fibromyalgia. Until recently, the standard treatment for chronic pain was medication. Doctors would often rely on things like muscle relaxers, nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, or opioids.  

These medications aim to dull, minimize or entirely eliminate pain. The problem with medications is they sometimes don’t work, require frequent use, and may cause negative side effects or addiction.  

New research has shown that meditation can serve as a better treatment option with significantly fewer side effects and with greater long-term benefits compared to taking medications.  

What is Mindfulness? 

Mindfulness is a state of being that allows you to be fully present and aware of where you are and what you are doing, without judgment. It’s the practice of bringing your full attention to the internal and external experiences happening in the moment, like feelings and emotions, thoughts, body sensation, and the five senses (sight, smell, sound, taste, and touch). 

This ancient practice is rooted in various religious and secular traditions including Christianity and Buddhism, yoga, and therapy. While it was originally practiced in the Eastern world, Professor Jon Kabat-Zinn brought the practice to the West in 1979 when he founded the Stress Reduction Clinic at the University of Massachusetts Medical School. He was the first to study the connection between mindfulness and pain.  

In his first study, 90 patients with chronic pain were trained in Mindfulness-Based Stress Reduction (MBSR). Results from the study showed significant reductions in present-moment pain, negative body image, mood disturbance, anxiety, and depression. It also decreased pain-related drug use and increased feelings of self-esteem. The improvements observed during the 10-week program were maintained up to 15 months after the training and participants reported implementing meditation practice in their daily routine. Additional studies have come to similar conclusions.  

How Mindfulness Helps 

Mindfulness works by changing the way the mind perceives and responds to pain. In one study, researchers used brain images to see how mindfulness reduced activation in the pain centers of the brain. The study proved that meditation and mindfulness reduced the amount of activity in the somatosensory cortex, the part of the brain that tells the body where the pain is and how intense it is.  

How you respond to the physical sensation of pain has a significant impact on how the nervous system perceives and responds to pain. The automatic response to pain, including thoughts and emotions surrounding what you are physically feeling, can activate the sympathetic nervous system, leading to the fight-or-flight response. This leads to increased stress hormones in the body that communicate to the brain that they are not safe, amplifying the pain. When the nervous system is continuously fighting a perceived threat, the body cannot heal.  

By changing your response to pain through mindfulness, you can change the way your brain perceives pain and give your body the calm environment it needs for healing. 

Types of Mindfulness 

There are many types of mindfulness and many ways to practice. Grant yourself the time you need to experiment to find which one works best for you.  

Breathing Exercises 

The simplest way to practice mindfulness is through breathing exercises. These exercises can be performed anywhere, at any time and you only need a few minutes to practice.  

  1. Start by sitting down with your feet touching the floor and back upright or lying in a comfortable position with eyes closed. 
  2. Try to notice your body – it’s weight, sensations, connection to the floor or chair, and any areas of tension. Continue to breathe normally.  
  3. Tune into your breath and feel the natural flow of your inhales and exhales. You don’t need to change your breathing to long or short breaths, just natural. Start to notice where you feel your breath in your body. It may be your chest, throat, abdomen, or nose. Try to notice when one breath ends and the next begins. 
  4. Be kind to your mind, as you may notice it starts to wonder. This is completely normal and not a problem. Remember, mindfulness is a nonjudgement practice. If you notice your mind starts to drift and you find yourself thinking about your to-do list, work, or family, simply acknowledge it and bring your attention back to your breath.  
  5. Stay here for a few minutes. When you first start practicing mindful breathing, two minutes may seem like a lifetime. Each time you practice, try to increase the amount of time spent on breathing. Continue to redirect yourself back to your breath if you get lost in thought.  
  6. When you’re ready, slowly bring yourself back to the present. You can start by noticing your body, creating tension in your extremities like making a fist or crinkling your toes to “wake” the body up. As you begin to feel more awake, slowly open your eyes, notice how you feel, and show yourself some appreciation for taking the time to engage in the practice.  

As you start to get more comfortable with mindful breathing, you can start incorporating more advanced breathing techniques like inhaling for 4 seconds, holding the breath for 2 seconds, and exhaling for 6 seconds. 

Body Scan  

Another effective mindfulness practice to help with pain reduction is the body scan technique. This practice gives you the ability to identify physical discomfort in different parts of the body and allows us to be aware of sensations that arise and separate the experience from our perceptions. By non-judgmentally identifying what you feel and where you feel it, you can train your mind to focus away from each painful body part and instead, focus on the body as a whole. As you better understand what your body endures, you can learn to accept your pain for what it is, cultivate compassion towards your experience and stop trying to escape it.  

  1. Sit upright or lay down in a comfortable position and start taking deep breaths in through the nose and out through the mouth.  
  2. Close your eyes and begin to notice how your body feels against the surface you are on.  
  3. Starting at the top of your head, slowly scan down your body and notice what feels comfortable and where you feel tension, tightness, or discomfort. Remember, the goal is not to change how you feel, but to observe it non-judgmentally. Try to spend 20-30 seconds on each body part. You may find it helpful to spend more time on the parts where you frequently feel pain.  
  4. Remember to breathe. As you come across body parts with greater discomfort, breath deep and visualize the tension leaving your body.  
  5. Take note and observe what you are feeling. When you are ready, begin to move your extremities, like wiggling your fingers and toes, and come back to the present. 

The first time you try to practice a body scan, it may be a little difficult and you may get frustrated. Don’t give up! Mindfulness takes time and practice so be patient with yourself.  

Progressive Muscle Relaxation 

Progressive muscle relaxation (PMR) involves alternating between tension and relaxation in all the body’s major muscle groups. When you suffer from chronic pain, your muscles can become tense often and you may also experience anxiety from your condition.  Practicing PPMR can help you learn how relaxed muscles feel compared to tense muscles, how to identify when you are feeling tense, and reduce levels of anxiety.   

  1. Find a comfortable place to lay down that’s free from distractions and disturbances, like pets, family members, or the TV. The quieter and secluded the space, the better.  
  1. Gently shut your eyes and start to notice your breath. As you begin breathing, try to notice your body and observe any physical sensations or emotions.  
  1. You can start at the head and work your way down to your toes, or vice versa. Most people find it easier to start at the feet and begin by curling your toes like you’re trying to squeeze an object with them.  
  1. Hold the tension for 5 seconds and relax back to a normal position for 15 seconds. Perform as many cycles as you need to feel a release in that body part.  
  1. Once you are ready to move onto the next body part, move your way up your body by bringing tension to your thighs, then butt, back, and so on until you have reached the forehead.  

Throughout the practice, it’s important to maintain your breathing at a slow, even pace. The goal is to bring relaxation to your body, so if you find it to be causing more tension than relief, take a break and try again another day.  

Mindful Movement 

Easy, flowing movement can be an incredibly useful and helpful way to practice mindfulness. When practicing mindful movement, the goal is to keep your focus on your breathing and how your body is moving in the moment. Unlike more traditional exercise, which can seem daunting when you’re struggling with chronic pain, mindful movement aims to increase body awareness in the present moment.  

Mindful movement can look different to everyone. For some, going for low-intensity walks in nature helps ground them in the present, while for others, yoga can provide more structure and flow. No matter what movement you choose, remain focused on your breathing and how your body is moving. If your mind starts to wander, gently bring yourself back to the moment and the sensations of your body.  

As you continue to practice intentional mindful movement, you can start to incorporate it into your daily life, like when you are walking to the store or folding laundry. By learning how to maintain a state of calm during exercise you can reduce any fears that may come along with movement, like the fear of making pain worse, and make movement a more enjoyable experience.  

Daily Mindfulness 

Once you’ve become intentional about mindfulness practice, you can start incorporating it into your daily routine. Learning how to become present in the moment can help you be more aware of your thoughts, emotions, feelings, and any pain you are experiencing so you can live a fuller life.  

A few ways you can practice daily mindfulness include: 

  • Mindful mornings: Take a few minutes before getting out of bed (and checking your phone), to connect with your body and breath. Notice what you are feeling and set some intentions for the day.  
  • Mindful eating: Most of the time, we rush through meals and don’t realize what we are doing. Give yourself some extra time around meals so you can slow down and bring your full attention to your body. Before eating, take a few slow, deep breaths in and out of your nose. After breathing, notice how hungry you are and try to eat accordingly. Take a few bites of your meal and experience the taste, texture, and smell – notice how much enjoyment you are getting from the meal. Eat what you enjoy 
  • Mindful chores: Sometimes, chores can be a bore. Take daily chores as an opportunity to practice mindfulness. When washing the dishes, be aware of the smell of the dish soap and how the warm water feels running over your hands. If you’re doing laundry, notice how soft your clothes feel. Being fully engaged in the present can help these chores become a little more enjoyable.  
  • Create new patterns: Write yourself some sticky notes to remind you to take a breathing break from your day or set an afternoon intention. If you want to start adding things into your routine, like exercise, put your exercise equipment (shoes, yoga mat, gym bag) in a place you can’t miss, like by the door. 

You are not alone 

When you’re living with chronic pain it’s hard to take your focus away from your pain. Sometimes this focus can be so overwhelming that it’s all you think about. You may even become fearful of making your pain worse, which can lead to depression. Mindfulness aims to help you overcome your pain and take back control over your life.  

Whether you’ve been living chronic pain for a few months or a few years, you are not alone. At PatientsLikeMe, there are over 150,000 members experiencing chronic pain. Join the conversation today to connect with others who are like you, and are sharing their experience, strength, and hope for healing. 

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