mindful pain management

An Integrative Approach to Recovery from Chronic Pain

Mon March 21st 2016

The role of mindfulness (mental skills training) in medicine is growing rapidly, with new research studies being added every week.

There are a large number of studies around the role of mindfulness in what is called pain modulation. Modulation is how the brain either increases the resistance in the central nervous system to the messages from your body that are felt as pain, so we feel less pain; or, how it decreases resistance so we potentially feel more pain.

There are 11 areas of the brain that process these signals as pain, and under normal circumstances about 5% of these areas are used in pain processing. When pain becomes persistent 25% of these areas are allocated to pain processing and the general level of resistance in the system to these signals is reduced significantly. So the skills training is aimed at 'taking back' these areas that have been hijacked to process the signals that produce the pain. This is the process of neuroplasticity.

Pain is understood as 'an unpleasant sensory and emotional experience' and mindfulness training has been shown to impact positively on both these aspects of pain, reducing both the intensity of the pain we feel and the emotional suffering associated with the pain. Relaxation training and other forms of mental training do not have the same effect, according to a recent studies.

Another area of interest is the inflammatory response. Inflammation is implicated in a wide range of health problems from bodily pain to heart disease and autoimmune conditions. One of the key bio markers that produce the inflammatory response is Interleukin 6 (IL 6 for short) Mindfulness practice has been shown to decrease levels of IL 6 and a general decrease in the inflammatory response. This is possibly from the effect of decreasing the levels of emotional reactivity. The inflammatory response is in part a product of our 'fight or flight' reaction to stress as the body tries to defend itself from a real or perceived danger (illness, injury or mental threat the response is always the same). Less emotional reactivity therefore decreases the systems perception of danger and the uprating of the system. Whilst many of us don't necessarily feel 'emotional' our emotions are largely driven by our non-conscious brain and we may only consciously experience less than 10% of them, as they are generated to help us prepare and meet any perceived challenge as part of our survival mechanism.

The process we follow is to combine education about the neurophysiology of pain, which has also been shown to impact on pain modulation, with mental skills training to take back the hijacked areas of the brain. The course on our website uses narrated power point slides, as individual lectures combined with different mindfulness based mental training exercises. Sleep, exercise and diet are also covered in the course, a truly integrative approach to the recovery from persistent and chronic pain.

Dr Nick Penney PhD

For information on courses and events: http://drnickpenney.com/events/