Mindful or Mind Full? Making Meditation One of Your Pain-Management Tools
‘Oh, you should try meditation!’ Throughout my years of dealing with chronic pain, I heard this suggestion – many times. Sitting still to meditate? My body was too sore, in pain and my mind too busy.
There were days when I was desperate and my curiosity was aroused but then I’d get overwhelmed by other questions such as ‘what kind?’, ‘where do I start?’ It wasn’t until I was introduced to mindfulness meditation during a pain management course that I realized how easy it actually was and how much it could help me. In this article, I plan to debunk the myths, dispel any hesitation and open your mind to meditation for chronic pain!
Now, meditation is a non-negotiable part of my day.
What is meditation?
Meditation is about developing and training the mind to be more aware of the present moment (so, not worrying about the future or going over the past). Whilst its roots are in ancient religions, modern meditation is a way of connecting the mind and body with formal or informal practices of attention training without judgment.
It's this last part that can trip most of us up as we have a tendency to resist unpleasant experiences and cling to pleasant ones, judging things as good or bad. This can involve focus on the breath, and awareness of body sensations, sounds, and images, or repetition of positive mantras.
If it helps, think of meditation like ‘sport’, it has many types – football, netball, swimming, and so on. There are many different types and styles of meditation, so you can find out which one works best for you to help manage your pain. Investigating your own body and your own thoughts can be an important first step in pain self-management. As Rumi says, “Don’t look for the remedy for your troubles outside yourself. You are the medicine. You are the cure for your own sorrow.” Meditation may be a chance to search for that medicine inside yourself, an opportunity to turn inwards.
Sometimes it can be easier to define meditation by saying what it is not. Many people get put off by the stereotypical perfect meditator - sitting still like a statue, crossed legged or twisted like a pretzel, a picture of calm as the wind dancing through their robes against the backdrop of a snow-capped mountain.
Let's agree to let that image go. Meditation can be as simple as taking a long, slow, deliberate breath. It can be done sitting, lying, standing, or even walking. Meditation is not about emptying your mind. Meditation is about noticing some of the 80,000 thoughts we have each day and maybe, over time, becoming less reactive to them. When you’re living with pain, becoming less attached to thoughts can be helpful. Being less attached to thoughts means allowing them to come and go without judging them as ‘right/good’ or ‘wrong/bad’.
Stress often comes not from thoughts and feelings themselves, but from fighting with them. Meditation provides an opportunity to cultivate the ability to ‘allowing things to be’ and when you’re living with pain, this can help ease the constant battle with your situation. And meditation is not a magic pill – it may form part of your pain management approach but is not a substitute for medical care (and please seek advice from your health care team).
The great thing about meditation is that there is no one right way. You can decide the when, where and how, so it can be easily adapted and tailored to your lifestyle and needs. It can be practiced alone, in groups (online or in person) or with the guidance of a coach, a therapist or a recording.
It can be just as simple as incorporating some of the mindful ways of being into your life like letting go of some judgment of thoughts, sensations etc.
The mindfulness & meditation overlap
Mindfulness and mediation sometimes get used interchangeably and it can spark a bit of confusion. Even as I wrote this article, I had to think hard about how best to articulate the difference! I like to think this way: mindfulness is a way of being in the world – being present in the moment without judgment – and meditation is a formal practice – directing your attention to a specific focus such as the breath, a mantra or a visualization – with many different styles available.
The overlap is when you practice mindfulness mediation as a way to formally cultivate your present moment awareness without judgment. Mindfulness often gets used as an umbrella term and research and interest in mindfulness has seen an exponential growth trajectory as reflected by rapid increase in references to mindfulness in both news media and scientific literature.
Why meditation helps with chronic pain
While there are many Mindfulness-Based Interventions (MBIs) available, each have varied types of practice, methods of participant training, and duration of instructional courses associated with them. So figuring out the effect of meditation is tricky. It is limited by the length of studies, types of interventions offered and the amount of following up with participants. There is still plenty to be done and researchers still believe that more well-designed, rigorous studies are required to provide more conclusive evidence on the efficacy of meditation for chronic pain.
The latest research tells us that meditation can:
Relax your nervous system
Meditation allows you to take a break, to pause. Sitting in stillness or lying down can be a way of allowing muscle tension and tightness in the body to soften. Research has shown meditation can calm a heightened nervous system from the fight/flight/freeze mode to the rest/digest mode. This can help activate the immune system, aid in the healing process and help stabilize mood.
Cultivating the ability to be present, non-judgmentally also means not worrying about the future or ruminating over the past (and we know this kind of future/past thinking can be super stressful).
Decrease pain intensity/symptoms
Unlike some other forms of pain management, meditation invites you to turn towards your pain, bringing an accepting, non-judgmental, curiosity to the physical sensations in the body. Fighting with sensations can be stressful and make them worse. Strangely, accepting them can improve them.
Studies have shown mindfulness meditation can reduce pain symptoms, improve quality of life variables and improve opioid-related outcomes (less medication use and potential for misuse and cravings). Meditation has been shown to help build resilience, greater understanding of conditions and acceptance of situations in people with backgrounds of trauma, which we know can very often be linked to chronic pain conditions.
Other reported benefits include improved sleep quality, social connection and feelings of empowerment by taking positive action towards managing pain. But the important thing is to see how meditation benefits you, and you’ll only know that by really giving it a go and practicing it with an open mind over a sustained period of time.
How to start meditating to reduce pain symptoms
Everyone is different so meditation is something best explored yourself to see what type, style, duration etc. works best for you.
Below are some different types of meditation you may want to explore:
Breathing exercises
Focusing on the breath is part of almost every type of meditation ever invented. This can’t be an accident, and must mean that there is something powerful about focused attention on the breath. Breath-focused meditation can be a simple place to start. Taking a deep breath down into the belly can help calm you down when you’re stressed. Breathing in this way slows the heart rate and brings down blood pressure.
Diaphragmatic breathing has been demonstrated to impact emotions and reduce cortisol levels (a hormone produced when stressed). Watching a bubble expand and contract in time with your breath can be a soothing way to get started. Maybe placing the hands low on the abdomen as well and watching as they rise and fall with your breath.
Mindfulness meditation
Mindfulness explores the flow of your experience, noticing sensations, thoughts and emotions. According to Jon Kabat Zinn, founder of modern mindfulness, it is about ‘paying attention, in the present moment, without judgment’. When I began practicing mindfulness meditation, after a while I found, I spent less time lost in thought, operating on automatic pilot, overwhelmed by thoughts about my pain, ruminating about the past or catastrophizing about the future.
Breaking this cycle meant I was less likely to overdo it and notice early warning signs of pain flares. This allowed me to find joy in the little things, be more connected to those around me and changed my relationship to pain by bringing more acceptance and compassion. And the research backs this up too. There are a number of mindfulness-based strategies to help manage chronic pain. Some beginner mindfulness meditation practices include awareness of breath and the body scan. This simple introductory practice, connecting to the body and has been widely used as a clinical practice showing benefits for people living with pain.
Progressive relaxation
Progressive muscle relaxation involves alternating between tensing and relaxing muscles throughout the body. For me, noticing this was enlightening. It helped me realize that for most of the day I was bracing (tense and bracing to avoid or in anticipation of pain). This meditation can help identify the early warning signs of a pain flare. Are your shoulders up near the ears – perhaps you’re feeling a bit tense.
Self-compassion
We are often our own harshest critics so it can be helpful to practice being kind to yourself. Meditation can provide a great opportunity to take time out of your day to turn inward and getting to know yourself a little better. Self-compassion meditations can build skills for learning to soothe and comfort yourself when distressed and they have been shown to reduce pain acceptance, pain interference, catastrophizing and anxiety.
Mantra
This is a meditation that involves the continuous repetition of a word, phrase, or set of syllables either silently or aloud (imagine the “ooooohhhmmmmm”). You may have heard of Transcendental Meditation? This is a form of silent mantra meditation. When I did my pain management course, I would often say to myself, “pain is just a physical sensation in the body – it doesn’t mean damage.”
Whenever the sensation of pain distracted me or grabbed my attention, I would slowly repeat this and it helped reduce some of the associated emotions. Mantra based meditation was shown to have a small-moderate reduction in anxiety, depression, stress, post-traumatic stress and mental health related quality of life. A mantra can also help to maintain focus on something, like the breath. Renowned meditation teacher Thich Nhat Hanh in his book Peace in Every Step, suggests this simple mantra ‘Breathing in, I calm my body. Breathing out, I smile.’
Other meditation types
There are many ways to meditate. Meditations which focus on listen to music or relaxing nature sounds such as the sound of the waves, forest noise, rain or relaxing word free music can be a way of soothing the mind and body. Visualization is another option. Bringing to mind a visual image can be helpful as a distraction from pain but also can give options for imaging yourself in healthy and enjoyable situations or even imagining yourself undertaking certain movements or exercise. Everyday activities also can provide an opportunity to practice meditation - particularly cultivating more mindfulness. Making a coffee in the morning, washing the dishes or walking the dog - these are all opportunities to cultivate your awareness of the present moment.
Bonus tips to get you started with meditation
There's no right or wrong. There are no meditation rules, just find what works best for you.
Create space for yourself. There is no use having a goal to meditate if you don’t set time aside in your day and in your calendar. Or perhaps you link it to a daily activity such as before your morning cup of tea. You don't need a fully decked out meditation room but having a cozy, comfortable space can help build the sense of ease.
Posture matters. You don’t need to sit cross-legged. Play around with sitting in a comfortable chair, on a cushion, in bed. Ideally, it can help to consider a posture where your hips are higher than your knees as this can be maintained comfortably for longer periods. If you find your body finds sitting uncomfortable or stillness challenging, remember it is okay to move. Over time your tolerance might change and you can try different postures.
Let go of the outcome. If you become fixated on meditation as a way of getting you somewhere (out of pain) or achieving an outcome (relaxation), that puts pressure on your practice and may end in frustration and disappointment. Also, here’s a gentle reminder from me - meditation does not take away pain but it can definitely change your relationship to it.
And, like trying anything new, it does require patience and practice. Many people try meditation, decide they’re no good at it (usually because of some initial high and unrealistic expectation) and then give up. Bringing a playful curiosity – don’t take it too seriously.
Bring a friend. Sounds strange but sometimes when you are just beginning, mediating with others can help, especially for extra motivation and accountability. There are many meditation classes available – try your local Buddhist center, community house or, when in doubt, just ‘Google it’. Try a search for ‘group meditation near me’ or see resources below.
Start small. Like everything else we are learning about, when trying a new pain management technique, it’s about a slow and steady build up (like pacing) – reinforcing new links in our brain. Like working out at the gym, over time, it becomes easier. Maybe just a few breaths or a few minutes of practice might be a good way to get started. Keeping it consistent and trying a little every day is better than forcing yourself to sustain a longer practice every now and again.
Remember that champion athletes don’t just wake up that way, it’s about training and commitment. You will find it easier over time, try and stick with it.
So, maybe meditation becomes one of the tools in your toolkit for managing, accepting and living well with chronic pain. And, if you want to rely on it as a pain management approach when in a pain flare, try learning the practice when you are feeling well. If you want more information and support, why not reach out to us at MoreGoodDays®, we are here to help.
Ready to start? Let’s go!
There are lists of registered teachers near you in Australia on the Meditation Association of Australia website.
For me, getting started with meditation for chronic pain relief was all about reading this book: Mindfulness for Health by Vidyamala Bruch and Danny Penman.
There are many free (and subscription-based) meditation apps and these can be a good place to start. There are many different types and styles, and you can try a few out for yourself - Calm, Headspace, Smiling Mind, Insight Timer.
We know meditation and mindfulness helps too - we have multiple types of mindfulness-based strategies included in the MoreGoodDays® program. Please check your suitability.
