Mindfulness meditation is a powerful weapon against chronic pain

Meditation is a powerful tool for managing pain, far beyond mere physical sensations. How we perceive and process pain shapes our overall experience, and this is where meditation plays a pivotal role.

Traditionally, it’s been assumed that mindfulness meditation, a centuries-old practice, alleviates pain by activating the placebo response – where an improvement in symptoms is attributed to an inactive treatment.

However, recent research challenges this long-held belief, revealing that mindfulness meditation operates through distinct neurobiological mechanisms, separate from the placebo effect.

Brain mechanisms of mindfulness meditation

A breakthrough study unveiled in the Biological Psychiatry journal uncovers that mindfulness meditation uses separate brain mechanisms than those activated by the placebo response to alleviate pain.

Researchers from the University of California San Diego School of Medicine used sophisticated brain imaging techniques to distinguish between the pain-relieving effects of mindfulness meditation, placebo cream, and a counterfeit mindfulness meditation method, referred to as “sham” mindfulness meditation among healthy participants.

The experts found that mindfulness meditation resulted in significant reductions in pain intensity and unpleasantness, and also downregulated brain activity patterns associated with pain and negative emotions.

However, the placebo cream only affected the brain activity pattern synchronized with the placebo effect, leaving the person’s primary experience of pain untouched.

Power of meditation in pain management

“The mind is extremely powerful, and we’re still working to understand how it can be harnessed for pain management,” noted Fadel Zeidan, an anesthesiology professor at the UC San Diego Sanford Institute for Empathy and Compassion.

“By separating pain from the self and relinquishing evaluative judgment, mindfulness meditation is able to directly modify how we experience pain in a way that uses no drugs, costs nothing and can be practiced anywhere.”

Focus of the study

Engaging 115 participants from two separate clinical trials, the researchers explored the effects of four interventions. These included guided mindfulness meditation, sham-mindfulness meditation with only deep breathing, a placebo cream (petroleum jelly) that participants were led to believe reduces pain, and an audiobook serving as a control.

After administering a painful yet harmless heat stimulus to the back of the participant’s leg, their brains were scanned before and after the interventions.

Using a novel method, multivariate pattern analysis (MVPA), the experts analyzed the brain activity patterns of participants. These patterns revealed whether mindfulness meditation and placebo engaged similar or separate brain processes.

The placebo-mindfulness overlap myth

The findings indicate that although the placebo cream and sham-mindfulness meditation decreased pain, mindfulness meditation was markedly more effective at pain reduction as compared to the other tested methods and controls.

Additionally, mindfulness-based pain relief reduced synchronization between brain areas involved in introspection, self-awareness, and emotional regulation, known collectively as the neural pain signal (NPS).

On the other hand, placebo cream and sham-mindfulness meditation failed to show a significant change in the NPS compared to controls, interestingly engaging separate brain mechanisms with minimum overlap.

These findings challenge the commonly held view that the placebo effect overlaps with brain mechanisms triggered by active treatments, specifically regarding pain.

“Instead, these two brain responses are completely distinct, which supports the use of mindfulness meditation as a direct intervention for chronic pain rather than as a way to engage the placebo effect,” said Zeidan.

Meditation and chronic pain relief

In conventional medicine, therapies are usually deemed effective if they surpass the placebo in their effects. As this study found mindfulness meditation to be more potent than a placebo and not engaging the same neurobiological processes, it opens up new avenues for developing treatments for chronic pain.

Further research is needed to validate these results in individuals living with chronic pain, not just healthy participants.

In the long run, the researchers aspire to create more effective and accessible interventions by understanding the distinct brain mechanisms underlying mindfulness meditation and its power to reduce pain in people with various health conditions.

“Millions of people are living with chronic pain every day, and there may be more these people can do to reduce their pain and improve their quality of life than we previously understood,” said Zeidan. “We are excited to continue exploring the neurobiology of mindfulness and how we can leverage this ancient practice in the clinic.”

The study is published in the journal Biological Psychiatry.

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