Friday, June 11, 2010

Meditation May Help to Calm the Turmoil of Pain

Briefly NotedMeditation is part of a growing list of noninvasive complementary and alternative practices that may benefit patients with pain. Results from a new study suggest that people who meditate regularly may find pain less unpleasant because their brains can better manage the stress of anticipation and the distress of pain.

In an upcoming report in the journal Pain scientists from the University of Manchester in the UK describe testing the effects of meditation practices on the anticipation and appraisal of pain [Brown and Jones 2010]. Subjects with a diverse range of meditation experience, spanning months to decades, and using a variety of “mindfulness meditation” techniques were compared with a control group of non-meditators. Measurements of anticipatory and pain-evoked brain activity, along with self-reported pain unpleasantness, were recorded in response to a painful stimulus provoked by a laser beam. The laser energies required to induce pain were equivalent in the two groups; however, meditators perceived the pain as less unpleasant than controls and the more experience with meditation a subject had the greater the reduction in perceived pain.

Analyses of brain signals showed that while they were anticipating the painful stimulus meditators had greater activity than control subjects in the prefrontal cortex. Then, during the application of pain meditators had lower activity in several key brain regions: cingular, insula, and S2 somatosensory cortices. [For our recent blogpost discussing the roles of these brain regions in acute and chronic pain, click here]. The authors note that the implications of these neurobiological effects are need further clarification; although, it seems plausible that the practice of mindfulness-based meditation techniques — which involve developing present-focused attention to reduce stress and control emotion — may facilitate greater activity by the prefrontal cortex (a cognitive-control center) in squelching perturbing anticipation of pain followed by a more relaxed response than usual by other brain areas that might otherwise amplify the pain experience.

COMMENT: This was a small-scale study, as is typical of such experiments, and it involved artificially induced acute pain. The benefits of meditation for actual patients with acute or chronic pain conditions may depend on the type of meditation practiced and extent of experience in meditating, the particular pain condition, and individual patient characteristics. However, as we have previously suggested, any modality that favorably modulates activity in key brain structures could be a potent aid for pain management, and practices such as Tai Chi [discussed here], coping skills training [here], cognitive behavioral therapy [here], and even music listening [here] have been demonstrated by research as being of value for ameliorating pain in some patients. Recently, Zen meditation was observed to enhance brain structure and function in relieving pain [study abstract here] and this present research by Brown and Jones [2010] suggests that various meditation practices might be added to the list helpful modalities. Learn more about meditation at the U.S. National Center for Complementary and Alternative Medicine (NCCAM) [here] and a lengthy evidence-based report — Meditation Practices for Health: State of the Research — is available from the Agency for Healthcare Research and Quality (AHRQ) [PDF here].

REFERENCE: Brown CA, Jones AKP. Meditation experience predicts less negative appraisal of pain: Electrophysiological evidence for the involvement of anticipatory neural responses. Pain. 2010(Jun); online ahead of print [abstract].