How Yoga, Mindfulness, and Meditation Can Help Relieve Chronic Pain
As the number of people dealing with chronic pain steadily increases, in tandem with the ongoing opioid crisis, both doctors and patients are becoming ever more interested in how to manage chronic pain conditions with non-pharmacological treatments. The tools of yoga, mindfulness, and meditation offer the potential to effectively help people cope with these conditions and improve quality of life.
A common chronic pain condition—one that perhaps could serve as a model for other pain conditions—is low-back pain. According to recent statistics, about 80 percent of Americans will experience chronic low-back pain in their lifetime, and 25 percent of Americans are currently experiencing it. And yet—as with other chronic pain conditions—definitive treatment is lacking.
Can yoga help relieve chronic low-back pain and, if so, how could the lessons learned offer a road map for other chronic conditions?
The Physical Relief of Yoga
A growing body of research is showing that yoga can, in fact, be helpful for people with chronic low-back pain. Specifically, studies have shown that yoga can reduce pain intensity and improve overall function and mobility. One study found that yoga, even more than exercise or education, resulted in improvement on important outcomes, including functional disability. This study not only looked at outcomes post-treatment, it also included a 14-week follow-up. At 14 weeks, the yoga group was still faring better than the education group and equally as well as the exercise group in improving mobility.
Another study found that yoga was equal to physical therapy and to education in reducing pain and improving functional disability. This study found that those who participated in the yoga or physical therapy group reported using less medication post-intervention. This is a positive finding, as it shows that yoga has the potential to be just as effective as more traditional interventions.
The Mental Relief of Mindfulness
Mindfulness-Based Stress Reduction (MBSR) has also been shown to be an effective treatment for chronic pain, specifically chronic low-back pain. In a study published in the Journal of the American Medical Association, people with chronic low-back pain were assigned to either cognitive behavioral therapy (CBT), MBSR, or a conventional care group. Results showed that after an eight-week class, significant reductions in functional disability were found for the MBSR and CBT group, but not the conventional care group. In addition, both the MBSR and CBT groups reported close to 45 percent reductions in how bothered they were by the pain.
The beneficial effects of both these interventions, which were aimed at changing one’s relationship to physical sensations and thoughts, show that chronic pain is not just a physical problem, but one that can be worked with on various levels of one’s experience—in this case, mentally. The advantage of an intervention like MBSR is that it provides mindfulness training, as well as gentle yoga—both body-based and mind-based tools for pain relief.
It makes sense that mindfulness would be another important tool in the management of chronic pain. Mindfulness is a practice of paring away additional layers of thinking from an experience. Whether it be a strong emotion that is coming up or a strong sensation, mindfulness offers the chance to notice what our mind brings to that experience—judgment, fear, resistance, etc. For people with chronic pain, there can often be a judgmental narrative (“It’s my fault that this is happening”) or a fear-based narrative (“This is never going to change"). These narratives are sometimes correct, but often are not good representations of how the day will actually go. Mindfulness helps people stay with a painful sensation without adding a painful narrative to it.
The Heart Connection of Loving-Kindness Meditation
Recent research has pointed to the beneficial effects of social support and connection in relieving chronic pain. A small study published in Pain found a connection between one’s experience of social rejection and one’s experience of pain, in that the more a person felt socially rejected the more likely they were to feel physical pain. This was true the other way around as well: People who felt physical pain were more likely to feel social distress and rejection.
One practice that has been shown to increase feelings of social connection is loving-kindness meditation (LKM). This is a practice of sending yourself and others well wishes, and is often paired with mindfulness. It is perhaps these intentions that help people feel more socially connected. A pilot study on LKM for chronic low-back pain sufferers found that this meditation, when practiced for just 10 to 30 minutes a day, was correlated with reductions in pain and psychological distress.
An Ongoing Support for Chronic Pain
To the extent that other chronic conditions share some similarities to low-back pain, such as physical limitations and the mental and emotional suffering that can come with the pain, people with other pain conditions might find similar relief through yoga and meditation. While none of these studies showed that these tools completely alleviate chronic pain conditions, they can offer a powerful ally and support in managing and reducing pain. They can help people lower their medication dosages, find a little more mobility in their daily life, and feel a little more in control of their experience.
Due to the complexity of many chronic pain conditions, people who would like to try yoga or meditation to help cope with their chronic pain might consider finding a class that would be sensitive to their condition, or work with a yoga therapist or a doctor or mental-health professional who is trained in yoga. This would allow increased benefit of the practice while minimizing some of the risks that could come with just popping into your local yoga or meditation class.
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Angela Wilson, LMHC, RYT 500, is a Kripalu faculty member who has conducted research and written about the intersection between yoga, Western psychology, and science.
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