Pain medications are great for acute pain, but cause a whole host of problems when used on a long term basis. These problems include constipation, opioid induced hyperalgesia (this means you become more sensitive to pain), inability to function and tolerance (having to take more and more to achieve the same results).
Further, they rarely do an adequate job of bringing the pain down to a manageable level. (Notice I don't mention addiction. I think this is an overblown problem and not especially relevant to chronic pain patients.) This all begs the question of what options remain.
One of the best remaining options is mindfulness. Mindfulness may sound completely foreign or inappropriate for people who identify with a religion other than Buddhism, but it's actually a very simple, nonreligious concept.
Mindfulness is the awareness that is not thinking (but that which is aware of thinking, as well as aware of each of the other ways we experience the sensory world, i.e., seeing, hearing, tasting, smelling, feeling through the body). Mindfulness is non-judgmental and open-hearted (friendly and inviting of whatever arises in awareness). It is cultivated by paying attention on purpose, deeply, and without judgment to whatever arises in the present moment, either inside or outside of us. By intentionally practicing mindfulness, deliberately paying more careful moment-to-moment attention, individuals can live more fully and less on "automatic pilot," thus being more present for their own lives. Mindfulness meditation practices seek to develop this quality of clear, present moment awareness in a systematic way so that the practitioner may enjoy these benefits. - UCSD Center for Mindfulness
Mindfulness is thought to help people living with chronic pain cope by keeping their brains from focusing on anticipating pain. This makes sense given that mindfulness meditation is about staying in the present moment, not agonizing over the past or worrying about the future. Perhaps even more importantly, meditation is useful for helping you cope with the emotions that arise in association with chronic pain, such as anger, resentment and sadness. This is important because while pain may be permanent for many of us, suffering is optional. If you can separate the two concepts you can live a happier, less stressful life despite continuing to live with chronic pain.
The idea of mindfulness for coping with chronic pain was first explored in the United States by Jon Kabat-Zinn. Kabat-Zinn was the first to bring Eastern meditation together with Western science to develop a system of mindfulness that enables chronically ill people to cope with their symptoms. He founded the Stress Reduction Clinic at the University of Massachusetts and began teaching Mindfulness Based Stress Reduction (MBSR) there in 1979. In 1995 Kabat-Zinn established the Center for Mindfulness at UMass as an outgrowth of the Stress Reduction Clinic. He also wrote what many consider the most important book on using mindfulness to cope with pain, illness and stress, Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness. This book is an excellent way to get started with mindfulness and learn about MBSR techniques. Another great option to start with is A Mindfulness-Based Stress Reduction Workbook by Bob Stahl and Elisha Goldstein. (Another great resource for starting a meditation practice is Tara Brach's free PDF download, How to Meditate.)
You can practice mindfulness on your own by gathering the appropriate resources to learn the techniques (such as the books mentioned above) and then practicing. It's truly as simple as that. There are many different guided meditations available on audio CDs that can be extremely helpful when you're learning. I will list some of the ones I especially like at the end of this article. If you'd rather be taught by someone in person you can search for MBSR programs in your area at this link: MBSR Programs Worldwide.
To introduce you to the basic concepts, the National Center for Complementary and Alternative Medicine (NCCAM) says these are the basic common features of a meditation practice:
- A quiet location. Meditation is usually practiced in a quiet place with as few distractions as possible. This can be particularly helpful for beginners.
- A specific, comfortable posture. Depending on the type being practiced, meditation can be done while sitting, lying down, standing, walking, or in other positions.
- A focus of attention. Focusing one's attention is usually a part of meditation. For example, the meditator may focus on a mantra (a specially chosen word or set of words), an object, or the sensations of the breath. Some forms of meditation involve paying attention to whatever is the dominant content of consciousness.
- An open attitude. Having an open attitude during meditation means letting distractions come and go naturally without judging them. When the attention goes to distracting or wandering thoughts, they are not suppressed; instead, the meditator gently brings attention back to the focus. In some types of meditation, the meditator learns to "observe" thoughts and emotions while meditating.
Like most things in life, you get out of mindfulness meditation what you put into it. I've been practicing for a while now and was recently able to call upon what I've been learning in a moment of need for the first time. It was exhilarating to find it easier to cope. I say this mainly to point out this is no easy fix. It takes a lot of dedication to keep practicing even when you haven't yet seen dramatic results. But I also think the calm you experience day to day once you start practicing can help keep you going when you're new to the concept.
Have you tried mindfulness? Where are you at in your practice? Do you have questions about mindfulness meditation that aren't covered in this article? Please share in the comments.
Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness by Jon Kabat-Zinn
Break Through Pain: A Step-by-Step Mindfulness Meditation Program for Transforming Chronic and Acute Pain by Shinzen Young
Mindfulness Meditation for Pain Relief: Guided Practices for Reclaiming Your Body and Your Life by Jon Kabat-Zinn
Guided Mindfulness Meditation by Jon Kabat-Zinn
Mindfulness for Beginners by Jon Kabat-Zinn
Radical Acceptance: Embracing Your Life With the Heart of a Buddha by Tara Brach
Meditation for Beginners by Jack Kornfield
Opioids for Chronic Nonterminal Pain
Brain Scans Show How Meditation Calms Pain
Meditation: An Introduction
UCSD Center for Mindfulness: What is Mindfulness?
What is Mindfulness Based Stress Reduction?
UMass Center for Mindfulness in Medicine, Health Care and Society
Content by Diana E. Lee.DISCLAIMER: Nothing on this site constitutes medical or legal advice. I am a patient who is engaged and educated and enjoys sharing my experiences and news about migraines, pain and depression. Please consult your own health care providers for advice on your unique situation.