Can mindfulness help you manage chronic pain?

 

As a more holistic approach to pain management gains traction, the use of mindfulness and hypnosis has been shown to block out pain – some people have even been known to have surgery without anaesthetic ...

Fri 5 Oct 2018 

 

Pain management techniques include mindfulness-based stress reduction, which encourages sufferers to learn to be in the moment. Illustration: Thomas Pullin

“Pain is inevitable, suffering is optional” reads very much like something a Love Islander might caption a workout video on Instagram with – but the platitude is increasingly being backed up by science.

In recent years, the advent of functional brain imaging has brought with it a new understanding of the distinct biological and psychological components to pain. While pain is perceived in the brain when signals that something is wrong are transmitted through the central nervous system, suffering is increasingly defined as our interpretation of that pain signal. For instance, the biological root of pain could be a back injury, while suffering might arise as understandable emotional responses to that pain, including thoughts such as “this is unbearable” and “why me?” Because of this interplay, the International Association for the Study of Pain defines pain as being both a sensory and an emotional experience.

According to Dr Sarah Jarvis, GP and clinical director of Patient.info, for people suffering from chronic pain, there is a direct correlation between negative thought patterns and increased discomfort. “We know that there is a cause and an effect,” she says. “For instance, people who are depressed or stressed are more likely to feel pain more acutely. But being in chronic pain can itself cause psychological distress, which in turn worsens the pain.”

Of course, that’s not to say that people suffering from chronic pain are responsible for their own symptoms. “It’s impossible for pain or profound physical symptoms of any sort not to have an emotional impact,” says Jarvis. “But while we can’t always get rid of pain, there are ways to work on 
Techniques include mindfulness-based stress reduction, which encourages sufferers to learn to be in the moment. While you may assume that this would lead them to focus on their pain, the idea is to passively observe their emotional state. Progressive muscular relaxation, on the other hand, works on the premise that tensing and then releasing tension in specific muscle groups will lead to deep relaxation, inhibiting feelings of anxiety.

At the extreme end of the spectrum are people who manage to master their pain responses so successfully that they are able to undergo surgery without anaesthesia. Last year, in a world’s first, hypnosis was used instead of anaesthetic for deep brain surgery to cure an elderly patient’s trembling hands.

“At a basic level, it’s about people who have practised mindfulness to the extent that they can focus on one element of their being, and block out another,” says Jarvis. “We all know, for instance, that somebody who lives next to a busy road can sleep through a juggernaut, but wake up immediately if their baby whimpers. [Being operated on under hypnosis] is the same principle. Some people are exceptionally good at training the mind so that their entire focus is on the specific stimulus that they are focusing on, for instance their breathing, or a visualisation.”

While staying awake during surgery may be many people’s worst nightmare, a number of studies suggest that some patients feel less anxious doing so than at the perceived risk of being sedated and not waking up. Advocates of hypnosis argue that it has no side effects, makes operations quicker, is cheaper than general anaesthetic and (because it does not affect the workings of the body) allows patients to recover faster.

Jarvis cautions that there is a lack of high-quality studies into hypnotherapy, because it is difficult to conduct randomised placebo trials (where the patient doesn’t know whether they are under hypnosis or not). However, she does foresee a future where we rely on a more holistic approach to pain management. “It’s absolutely something that will increase,” she says. “There is increasing awareness that there is only so much we can do with drugs, and a much bigger focus on a multidisciplinary approach.”

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Link: https://www.theguardian.com/freedom-to-move/2018/oct/04/can-mindfulness-help-you-manage-chronic-pain