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Meditation 101 for Chronic Pain Management

Meditation: How New Age Do You Want to Go?

You may well be relieved to discover that when it comes to meditation, there’s absolutely no need to go the whole “crystals, rainbows, unicorns” New Age route. I mean, you can, if you want to, but you don’t have to.

Personally, I find a few well-placed props that help set the mood to be a welcome addition. Soy candles and the occasional incense stick or powder in a darkened room with a little spa-type music playing in the background help my way-too-active consciousness let go of its death-like grip on controlling my life and embrace relaxation.

Do be careful about using incense, though, especially if your respiratory system is in any way compromised.

But if that makes you uncomfortable, or merely roll your eyes mightily, then rest assured: no New Age props are required. Neither is chanting “Om” or anything else.

Meditation is simply the act of focusing your thoughts, or alternatively letting go of the need to obsess — the act of utter relaxation, tuning in to your body and mind, and allowing yourself simply to be in the moment. Sometimes props help with that, but if you find yourself uncomfortable at the thought of all the trappings, then don’t go that route. Just wear comfortable clothing, unplug the phone (and turn off the cell), get quiet and sit.

How to Meditate

Meditation is not some weird, scary thing. It’s something you already know how to do, but in a possibly new context.

You can meditate in any number of ways:

Visualizing some desired outcome or a peaceful natural setting
Counting your breaths
Focusing mentally on one phrase or word
Simply sitting and allowing your thoughts to float away like butterflies

There are also more advanced techniques you can pick up from traditions like yoga or Transcendental Meditation, or other practices. But for our purposes, we’re going to outline a simple breath-focused practice that I use to help manage my pain.

What You’ll Need to Get Started

Comfortable clothing
A comfy place to sit that supports your back (lying down isn’t advisable, at least at first, as it can signal the body it’s time to sleep — and since chronic pain patients are often sleep-deprived, this will be counterproductive to meditating; however, you can practice a form of this meditation lying down in bed before you sleep, and it should improve the quality of your rest)
Silence — no interruptions of the human or electronic kind
If you like, you can use New Age or spa background music. I advise against candles at first – you might find yourself worried about a fire starting, especially with your eyes closed

The Practice

Get comfortable – either cross-legged, perhaps with pillows supporting your knees, or with your feet on the floor. Cover yourself with a blanket if you’re the least bit cool. Place your hands in your lap, palms up, left hand on top of the right, so that your hands are basically right in front of your pelvis.

Close your eyes, and:

Phase One: Breathe. Just breathe. In and out, without trying to control the breath. Turn your awareness to your scalp, and check in with your body there. How does it feel? Don’t try to change it, just observe. Then slowly scan your body, moving from the scalp to the forehead, to the eyes, the chin, the neck, the shoulders, etc. – all the way down to your toes. This doesn’t have to take a long time — just check in briefly, observe, and move on.
Phase Two: Focus on the Hurting Parts. Find the part that hurts the most from your body scan in Phase One. Settle your awareness on this spot. Talk to it silently — not the way you usually do (“God, I hate you! Why do you HURT all the time?!”) but as if that body part were a small child in pain. What would you say to that child? You wouldn’t tell her you hate her! You’d comfort her. You’d tell her how much you love her. You’d say how sorry you are that she hurts. You’d tell her how proud of her you are. So say that to your in-pain body part. Offer it love and compassion.
Phase Three: Rinse, Repeat. Do the same for any other intensely pained parts of your body.
Phase Four: Envision Health. Now, bring your awareness back to the center of your self — somewhere around your solar plexus, usually, but wherever feels “right” to you. Allow an image of perfect health — your perfect health — to come to mind. See yourself doing the things you long to do, feeling great, moving easily. Try to bring as much sensory awareness into it as possible — not just sight but scents, the sensation of touch, sounds, tastes. Make it as real as you can. Stay with this image for as long as you can, up to ten minutes or so. When you’re ready, imagine that scene in your mind being enveloped in a glowing golden-pink bubble, and floating up to the universe where it will start to gather energy and begin to manifest. (Or if that’s too “whoo-whoo” for you, then just let it fade.)
Phase Five: Coming Out. Don’t rush the re-entry! Once you’ve let go of the vision of health, slowly bring your awareness to what’s going on around you — but don’t open your eyes just yet. Take a minute or two to become aware of your surroundings. Then slowly open your eyes. You might find it helpful to shake your hands vigorously for a few seconds to ground yourself again. Drink some water, get up and move around — basically, reconnect to your body.

That’s it.

This practice can take as little as ten minutes or as much as an hour – it’s totally up to you. Better to do it for a few minutes every day, than for an hour once a week, though. Set your schedule, ease into it if you must, but try to do it daily.

The Benefits

What can you expect from a regular meditation practice? It varies from person to person, of course, because we’re all different, but basically you can expect:

Heightened sense of connection to your body
Lessened pain
More restorative sleep
Lower blood pressure
Reduced stress
Increased ability to deal with flareups of pain and stress

That’s worth giving meditation a good trial run, isn’t it?

Photo Credit : AlicePopkorn via photopin cc

How Meditation Relieves Chronic Pain

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In order to understand the process by which meditation works to improve our experiences with chronic pain, we should examine the evidence supporting the premise itself. In short: how do we know that meditation works at all?

Studies Establish Meditation’s Effectiveness in Chronic Pain Management

Numerous studies have consistently found the same thing: meditation works on chronic pain — not just in our emotional reaction to it, but also the pain itself.

One study, published in the Journal of Neuroscience (Feb. 2008), found that chronic back pain patients demonstrated an always-active area in the frontal cortex associated with emotion, whereas healthy brains (in healthy non-pained patients) show those areas “go dark” from time to time. As columnist Jackie Gingrich Cushman notes in this article, meditation can help train the brain over time to “take a break,” as it were.

A Canadian physician found in one study that meditation of 10 to 20 minutes a day, over a period of ten weeks, significantly helped many patients to manage their pain. One participant, whose pain was so intense that she’d even considered suicide, noted she was “shocked” at how significant the impact on her pain was. (You can read more about the mindfulness method developed by Jon Kabat-Zinn which was used in the Canadian study here at NPR.)

In fact, Kabat-Zinn is somewhat of a pioneer in this area of study. His own studies served as the catalyst for many subsequent researchers. The abstract from one of those studies is here at his site, Wild Mind.

Another fibromyalgia study, this one conducted in Switzerland at the University of Basel Hospital, showed that a mindfulness meditation program yielded several key benefits in patients, including pain-induced suffering, anxiety, and depression. A follow-up three years showed continued benefits for those who stayed with the process.

Studies have also shown that a relaxed mind, one of the major benefits of meditation, is more capable of remembering and processing information, which might help alleviate that fibro fog and similar fuzzy states of mind we all hate so much.

The Mechanism Behind Mindfulness Meditation’s Impact on Chronic Pain

To get to the “whys” and “wherefores” we should review what happens in a normal pain response in a healthy individual:

A painful stimulus is applied — be it a hand on a hot stove or an injury in a car wreck;
The nervous system sends the “IM” as it were to command central: “Injury: Possible Pain Ahead”
The brain then acts like a relay station of sorts. It sends out the message, much like a PA system, to what’s been called “the pain matrix” — an association of brain areas responsible for different functions that, collectively, help us process and learn from the experience (more on this below)
Those areas jump into action, sending the signal to the rest of the body to either stop interacting with the painful stimulus (“take your hand off the stove, idiot!”) or prepare for biophysical stress (“this is gonna hurt”)
The brain’s various structures then learn from the experience thanks to a characteristic known as neuroplasticity.

To get to the heart of how meditation works, we need to focus on steps 3 and 4 — the sending of the signal to the pain matrix, and the various commands that then issue from the brain to the rest of the body in response.

The Functions of the Pain Matrix

In step 3, the PA message goes out to the pain matrix, which consists of those areas of the brain with the following functions:

Turning the signal into a physical pain sensation — so you become aware of all this stuff (that’s happening at lightning speeds, of course — much too fast to discern separately)
Keeping track of goals and conflict — so you can start to solve the problem of how to make this unpleasant experience better
Processing emotions, thereby triggering fear and anger — so you become motivated to protect yourself

That last one, in particular, is important. It’s easy to look at this process and say “well, the emotional stuff, it should just go away. Who needs to feel such negative emotions all the time?” But in fact that’s a crucial part of the healthy pain response! Without it, you’d likely just keep doing the same thing over and over, because it wouldn’t have become something you desire to avoid .

Now, that’s a healthy response. But in chronic pain, the response gets all screwed up. Those hormones that flood our body in step 4, preparing us to “fight or flee”, don’t dissipate like they should. The emotional response continues longer than it would otherwise. In short, we get stuck in this cycle. Like the Energizer bunny — it all just keeps going and going and going …

What meditation does is akin to short-circuiting that cycle. It breaks the emotional response (which only serves to amp up our suffering). It calms the biochemical stress response. It allows us to experience the pain without suffering through it.

My personal experience with this phenomenon tells me that the benefits are not only immediate but also cumulative. That is, you get an initial improvement in your well-being, sure — but over time, those benefits add up.

Now, when I go into a flare now (and of course, it still happens) my meditation practice has now retrained my brain to approach the experience with equanimity:

I don’t get upset.
I don’t feel nauseated afterwards (which is due to the overflow of adrenaline that’s produced in the pain response).
I don’t feel that rage and debilitating fear that grips so many of us — and used to grip me tight, to be sure.

Want to Know More?

In a few days, I’ll share some solid tips and tools on how to implement a meditation practice, even if you’ve never meditated before.

If you want the full New Agey “whoo-whoo” experience, I’ll give you some suggestions to bliss out with the incense for the whole experience. If you’d rather keep it simple, I can help you there, too. No matter what your preferences, there is a meditation practice that’s right for you, and it will help you feel better. I promise.

Do you meditate? How has your experience with your chronic pain changed as a result of the meditation practice? Share your stories with us in the comments!

Photo Credit: kattebelletje via photopin cc

Does Meditation Work to Relieve Chronic Pain?

No, It’s Not “All in Your Head” … But Quieting Your Mind Can Help

For a lot of us, any suggestion of remedy that even sniffs of “it’s all in your head” is automatically suspect. For some of us, meditation falls into that category.

Look, I’m as anti-head-caser as anyone (being a fibromite, it comes with the territory) but I’m here to tell you: this meditation stuff works.

Let me make this point clear, though: I’m no guru. I hate the word and think it’s overused both as an honorific and as a criticism. What I am is someone who’s tried a lot of coping mechanisms and treatment options – someone with a pretty clear understanding of which of those options worked for me and which didn’t.

I’ve also done a fair bit of (OK, extensive) study on the subject, and while there’s absolutely no treatment for chronic pain that will work across the board — even for a particular illness — it seems that more and more evidence is piling up that meditation works. Specifically, it helps someone in pain cope with the pain by removing the suffering component. For me, it also goes beyond that and actually helps reduce the pain.

The Difference Between Pain and Suffering

First, we need to establish what we mean when we say “pain” and “suffering.” Interestingly tidbit: I used to be a lawyer, as most readers know. In preparing a complaint (the document that starts a lawsuit) for personal injury, lawyers will frequently use the phrase “pain and suffering.” Some of us in first-year torts class in law school wondered why use both? We chalked it up to typical lawyer-speak.

Fact is, though, they aren’t the same thing at all. The lawyers were right!

Pain is the unpleasant sensory perception we’re all too familiar with. It’s the biochemical response to certain stimuli — or, in our cases, the mere state of being alive with a chronic pain condition.

Suffering , however, is something very different. While pain is a physical phenomenon, suffering is entirely emotional and mental. It does, in fact, lie completely in your mind. Suffering, put simply, is the emotional resistance to the pain that we throw up, consciously or subconsciously, and it’s usually based on fear or anger, or both.

Suffering is what makes us think:

Why me?!
This will NEVER go away.
I’ll feel like this until the day I die.
What the hell is WRONG with me?!
OhGodohGodohGodohGod…

You get the drift.

There’s one more key difference: pain is a fact of life for the chronically pained. Suffering, however, is completely optional.

The Impact of Meditation on Suffering

Meditation works to relieve the suffering component of the chronic pain experience in several ways.

It quiets the mind.
It brings you out of the future-based fear you’re experiencing and grounds you back in the present.
It reduces the physical stress caused by the experience of pain.
It steadies and slows your breathing, which further reduces physical stress.
It fosters a stronger sense of well-being.
It moves you gently out of the “freak-out” mode into a more objective perspective.
It improves your mood.

Why There’s No Contradiction Between Meditation’s Effectiveness and the Biological Reality of Chronic Pain

So, this is the part of the post where I tell you why those jerks who insist that it’s all in your mind are still bone-crushingly wrong and meditation works, anyway, and these two things are not the contradiction that they might appear to be initially.

Let’s say it again, just to make it clear: it is not all in your head . But meditation can help you reduce the suffering that accompanies your pain. And that can make it all just a little bit easier to bear.

This is true because — again — there’s a difference between pain and suffering. Pain is the biological response; suffering is the entirely emotional/mental response that accompanies the pain.

In future posts, we’ll look at how to start a meditating practice for chronic pain relief.

A Summertime Meditation to Relieve Chronic Pain

Why Meditation Coupled With Visualization Works To Relieve Chronic Pain

Many of us resist the advice to meditate when it comes to managing our chronic pain. Yet meditation can have profoundly beneficial physical effects when it comes to our body’s ability to heal itself. When you couple meditation with visualization — the practice of envisioning certain scenes or images — you can ramp up the healing power of meditation.

Why do we resist meditation? I think it’s because it “smells” like “it’s all in your head.” Yet the connection between the body and mind is just beginning to be understood in Western medicine. Studies have shown that our brains’ entrenched beliefs can and do have powerful impacts on our health; witness the many studies that show placebos often work, even if they’re nothing more than sugar pills.

Meditation works on so many levels. First, it relaxes your body physically. Especially with fibromyalgia, our muscles have “memories” that bring them back to a painfully tense state time and again. Meditation can retrain those muscles over time to relax, which can ease the pain levels tremendously. Secondly, it works to reduce overall physical stress levels, lowering the amounts of hormones that in large quantities wreak havoc with our body’s systems. Finally, it feels good — and we can all us as much of that as we can get.

Preparing to Meditate

You need no special training or equipment to meditate. Wherever you are, whatever you’re doing (except driving a car!) , you can meditate. But for the best results, try this meditation when you’re alone. You can be outside or inside, although outside would be very helpful for this particular meditation.

If you are lucky enough to have access to a beach, that’s ideal. But even if you can’t get to the ocean, you can bring the water’s healing powers to you, wherever you are. Look for a pool, or failing that, use a bathtub or even an indoor fountain.

Wear comfortable clothes (unless you’re in the pool or beach, in which case a swimsuit is best, or in the tub, in which case no clothing is necessary). Make sure you won’t be disturbed for half an hour or so.

If you’re using a tub, fill it with warm but not hot water. Add some Epsom or sea salt to the water, to make it as close to the real thing as possible. If you’re in a pool, float on your back if possible, or simply sit comfortably on a step in the shallow end, letting the water cover your feet and ankles. At the beach? Anywhere will do, but if you can move your chair, or just sit on the sand, in the surf, that’s ideal.

Lastly, if you’re outside, make sure you put on sunblock! We’ll be working with the power of the sun to heal — but we all know the sun’s rays can be dangerous to unprotected skin, too. So, lather the white stuff on, and make sure you hit the areas that we always forget — the ears, the tops of feet and toes, the scalp.

Ready?

The Summer Sun-And-Waves Meditation

Begin by relaxing your body. Focus your awareness on each part of your body, starting with your toes, moving up to your feet, your ankles, your calves, and so on, until you reach the top of your head. At each point, pause and gently (silently) tell that part of your body to relax. Continue up your body until you reach the top of your head. Relax your eyes, your mouth, your forehead, your scalp.

When you’re thoroughly relaxed, focus on the sound of the waves coming in and going out. If you’re not actually at the beach, that’s OK — just call that sound to mind. (If you have a CD or sound machine that can recreate waves, great! If not, just use your imagination and memory.) Just focus on the waves for several minutes.

Now, turn your awareness to the warmth of the sun beating down on your body. Again, even if you’re not outside, it’s OK — just visualize the sun’s rays enveloping your body in warmth. See them in your mind’s eye as golden rays of pure healing energy.

Now, begin to direct those rays in your mind’s eye to the parts of your body that hurt. One at a time, “move” the rays of golden light to target a painful area. Let the rays do their job — visualize them sinking in (only the good parts, of course — the sunblock’s taking care of the bad stuff) and working magic on the tissue, the fascia, the very cells that make up your painful muscles. After awhile, you’ll feel a distinct tingle in each area. That’s your cue that you can move on to the next painful area.

When you’ve moved the sun’s rays over every painful area, and felt that little tingle in each one, now it’s time to move on to the water portion. Bring your attention gently back to the waves — listen to the sounds of the waves coming in and going out. Really listen — note every single nuance in sound between the coming and the going until you can hear each difference distinctly.

Now, imagine that the ocean’s waves are bringing in health and wellbeing, and then they’re picking up all the bad stuff in your body that causes pain as they take that bad stuff back out to sea. Way out there somewhere is a magic well where all the “bad stuff” is deposited and transformed into healthful energy. The waves pick up that energy and bring it back in to you, in a never-ending cycle of healing. Stay with this image for as long as you can, feeling the waves bring you health and vitality and take away your pain.

After ten or fifteen minutes or so (or however long you wish to perform the meditation, mindful always of the need to reapply sunblock if you’re outside), bring your attention slowly back to your body and your surroundings. Slowly stretch, blink a few times, and massage your hands and shoulders to bring yourself back to full waking consciousness. You might feel like you just dozed off for a bit — and if you did, that’s great! Sleep heals, too. (Just make sure you don’t fall asleep in the sun without someone to rouse you in case you sleep too long.)

I’d love to hear your reactions to this meditation. Did you try it? Do you use a meditation or visualization sequence that’s different? Share it in the comments!

Euston Arch

One Doll's Story of Life With Chronic Pain