Chronic pain is an everyday reality for many people with neurologic conditions such as multiple sclerosis, neuropathy, and fibromyalgia. Now they may have another tool to manage this difficult symptom.
A new study in the Journal of Neuroscience shows that mindfulness meditation may reduce perceptions of pain by as much as 24 percent—and that meditation may use a different pathway in the brain than opioids to block pain.
In a randomized, double-blind study, researchers at Wake Forest Baptist Medical Center in Winston-Salem, NC, divided 78 healthy volunteers with no history of pain into four groups: meditation plus naloxone (a drug that blocks opioid receptors); naloxone but no meditation; meditation with placebo; and placebo with no meditation. Participants were asked to meditate 20 minutes each day over four days. The meditation consisted of sitting up straight with eyes closed, focusing on sensations of breathing, letting go of thoughts without judging, and then bringing attention back to the breath.
To simulate pain, the researchers applied heat of 120 degrees Fahrenheit to the backs of the legs of participants who then rated their degree of pain by moving a colored sliding scale to indicate more or less pain. The researchers quantified the scales into percentages.
After four days, the meditation/naloxone group pain ratings were reduced by 24 percent—even when the brain's opioid receptor pathway was blocked by naloxone. That suggests that meditation uses a different pathway in the brain to block pain. In the meditation group that received the placebo instead of naloxone, pain ratings were reduced by 21 percent. By contrast, the non-meditation groups reported increases in pain regardless of whether they received naloxone or placebo.
Having another effective nondrug therapy for treating chronic pain is especially important on the heels of the recent US Centers for Disease Control and Prevention (CDC) guidelines for opioid prescriptions, says Fadel Zeidan, PhD, an assistant professor of neurobiology and anatomy at Wake Forest University in Winston-Salem, NC, and the lead author of the study on mindful meditation.
Millions of people in the US are addicted to opioids, some as a result of treatment for chronic pain, says Thomas Frieden, MD, MPH, director of the CDC. The guidelines recommend that physicians treat chronic pain initially without drugs, or with nonopioid pain relievers such as ibuprofen. When opioids are prescribed, doses should be low and short-term, to help prevent the chance for addiction. "At the very least, we believe that meditation could be used in conjunction with other traditional drug therapies to enhance pain relief without producing the addictive side effects and other consequences that may arise from opiate drugs," says Dr. Zeidan.
Dr. Zeidan acknowledges the limitation of his study—it included a small cohort and lasted only four days—but says, "We can show you that if you meditate you can feel immediate relief. It may not be long lasting, but neither are opioids." Dr. Zeidan says his group will continue to look at meditation and pain control to determine how long people need to meditate for optimal pain relief.
For information on how to practice mindfulness meditation, visit the UCLA Mindful Awareness Research Center. For more information on the guidelines for prescribing opioids, read the CDC guidelines.