Pain and Mindfulness
Pain is something that we’ve all experienced at various times in our life. There are many types of pain – nociceptive, neuropathic, phantom limb, acute, chronic. Pain is completely subjective. That means it is completely individual to the sufferer. Everyone tolerates and copes with pain differently. Chronic pain is a particularly interesting type of pain. Chronic pain refers to pain that has usually been there for at least three months. Unfortunately, living with daily pain for months on end is something that lots of people suffer with. The pain may be constant or it may come and go but chronic pain can have a huge impact on quality of life and many patients find that they have tried lots of options – painkillers, manual therapy, sometimes even surgery and still live with pain.
The brain is where pain is created. It controls the sensations of pain and how unpleasant they are to you. It can also control both the intensity and duration of these pain sensations. The brain does this because it is processing your pain. It is trying to find the underlying cause to avoid further pain or damage. Unfortunately when the brain zooms in on the pain like this, it often amplifies the pain that you experience. When this happens, unsettling thoughts about the pain can occur - ‘why won’t the pain stop?’ or ‘will I spend the rest of my life in pain?’ These thoughts can further amplify this zooming in on pain and unfortunately for some, can lead to a vicious pain cycle where these stresses and fears feed back into the body creating more tension, leading to longer lasting pain. Higher stress levels reduce the efficiency of the immune system meaning the body will heal more slowly and be more vulnerable to other illnesses and injuries. Unfortunately the longer the brain spends in this state, the more it begins to ‘fine-tune’ itself to sense pain more quickly and with more intensity. You can see this in the brain scans of people who suffer with chronic pain – the pain sensing part of the brain takes up a larger space than someone with no pain. It all sounds very negative but the key of getting out of this cycle, is to trick the brain into turning down its ‘pain volume’ again.
I’d also like to point out that I’m not saying that chronic pain is all in the head and doesn’t exist. Of course it is real. Think of pain as primary pain and secondary pain. Primary pain arises from the illness, injury or damage to the body. Secondary pain can be seen as the mind’s reaction to primary pain. This pain has been heavily processed before we consciously feel it. But this also means that we can gain control over secondary pain. It is thought that chronic pain is a type of secondary pain. Secondary pain can also be viewed as ‘suffering’. And this is where mindfulness comes in. Learning that you can be in pain but you don’t need to ‘suffer’ is an important factor for learning to manage chronic pain.
Mindfulness is something that we hear lots about and it is something that I have looked into more and more recently. Mindfulness refers to a mental state of being aware of the present moment, acknowledging and accepting of our feelings, thoughts and body sensations. It sounds complicated and when first beginning to explore mindfulness, it can feel like you’re not sure if ‘you’re doing it right’ or ‘you’re not feeling what you think you should’. These feelings are completely natural and are actually all part of the mindfulness experience. Mindfulness is not something that you do. It something that you feel. It is a skill and therefore requires practice. I have been experimenting with mindfulness meditation since the Covid-19 lock-down began and it has now become part of my daily routine. Because mindfulness is great for more than just pain management. It’s also a great tool for coping with stress, anxiety and depression – something I know lots of us are feeling more of in this current time. Over the past few years, there has been more focus on mindfulness as a coping mechanism for pain and some studies have shown it to be as effective as prescription painkillers. In fact, imaging studies have shown that people who use mindfulness meditation regularly actually alter the pain perception parts of the brain so that they no longer feel pain with the same intensity. It is because of these studies that many hospitals run pain clinics which focus on mindfulness to help patients cope with issues such as musculoskeletal pain, migraine, fibromyalgia, coeliac disease and other autoimmune diseases. The list seems endless.
However, there are lots of people (myself included until very recently), that may be a little sceptical about mindfulness meditation. Some useful things to understand about mindfulness meditation include:
Meditation is simply a form of mental training that has been scientifically proven to help people cope with pain, illness, anxiety, stress and depression.
Meditation does not lead you to adopt a fake ‘positive’ attitude to life. It helps you to understand how to accept and cope with stress and pain which helps you to enjoy life more.
As little as 10-20 minutes a day is enough and you can practice mindfulness meditation anywhere.
Although meditation is not difficult, it is a skill so does require practice and persistence.
My own experience
Like most of us right now as we experience the Covid-19 lock-down, I have had to drastically change how I live my life. Having to temporarily close my business down in a matter of hours after years of building it up had a huge impact on my mental health. As I write this, I’m approaching the end of week five since having to close. And although I know the close is temporary, lots of uncertain factors are in the future. During the first week or so of lock-down, my levels of anxiety hit the roof. I decided that I couldn’t carry on like that and wanted to find some way to control how I processed these thoughts. I read copious amounts about mindfulness and meditation and even though I’ve tried aspects of them in the past, I’ve never fully committed to it before. With having to stay at home whilst the pandemic goes on, I thought now is the perfect time to try again and commit to it in an effort to manage my mental health as we go through this period. So I decided to download the Headspace app. The app contains lots of free content including a ten day ‘basics’ programme for people who are new to mindfulness meditation. I gave it a go and I’ll be honest, the first few days I struggled, thinking I wasn’t ‘doing it right’. But I persevered and by the time I got to day four, I found that I could relax more into my meditation and that’s when I noticed a change in my mental outlook. In the end, I completed my free ten days and decided to buy the app to unlock the rest of its content – literally hundreds of mindfulness meditations and now I look forward to my daily meditation. I’m not saying this to make you go out and buy the Headspace app. However I would definitely recommend you try out its free content if you want to explore mindfulness meditation yourself.
A quick mindfulness meditation to try
For those who don’t want or don’t have access to the Headspace app, why not try this short meditation when you get a spare few minutes in your day. You don’t need any special equipment to meditate. You can meditate wherever you feel most comfortable – sitting upright on a chair, on the floor, laying down, whichever you prefer. You don’t have to sit with your legs crossed in that classic lotus yoga pose. Just make sure you are comfortable.
Get into your comfortable meditation position – sitting, lying, with your arms and hands as relaxed as possible and gently close your eyes.
Focus your mind on your breath as you breathe in and out. You don’t need to make a special effort with your breathing here. You’re not trying to change anything or expect anything special to happen. Simply observe the body breathing, feeling the sensations as air flows in and out, feeling your chest and belly move as you breathe.
Your mind will wander – this is normal! Do not get frustrated with yourself for having a wandering mind. When you notice it wander off, simply bring your focus back on the breathing again. You can count your breaths if you’d like. Count each breath up to ten and then start at one again.
Your mind may eventually calm or it may not. There is no right or wrong. Wondering thoughts and sensations are normal. The key to mindfulness meditation is to acknowledge and accept these thoughts rather than resist them.
After a few minutes, gently open your eyes and take in your surroundings.
The topic of mindfulness is huge and ever growing and this blog just gives a snapshot to what it’s all about. As an osteopath, seeing patients in pain, whether it’s acute, chronic, mental, physical, helping them to understand and manage pain is a huge part of my job. Just as my stress levels increased, I know that during this period where our stress levels are likely to be higher, my chronic pain patients are more likely to suffer greater pain. Unfortunately I can’t treat you in person yet. But I can help you manage your pain remotely which is why I wanted to share my mindfulness experience with you. I’m sorry it’s a little longer than my usual blogs – I tried to keep it as brief as possible without leaving out what I think is really useful information. If you’ve stuck with me until the end, you are a trooper!
For me personally, mindfulness started off as something to help me manage this lock-down period and keep my mental health strong. I’m pleasantly surprised to find that I intend to now make it a part of my daily routine even after this period is over. Whether you are suffering with chronic pain, anxiety, depression or any other injury or disease, I strongly recommend you give it a try and I hope it helps you just as much as I has helped me.