CD Review: Mindfulness Meditation for Pain Relief

Although the purpose of meditation is not to relieve pain, it often does. I suppose you could call this a beneficial side effect. In Mindfulness Meditation for Pain Relief: Guided Practices for Reclaiming Your Body and Your Life, Jon Kabat-Zinn shares meditation practices that were developed at Massachusetts General Hospital’s Mindfulness Based Stress Reduction Clinic. Over 30 years of research has demonstrated the effectiveness of medication for many conditions such as blood pressure, stress and pain relief.

This CD set includes two discs. In the first, Kabat-Zinn explains how and why meditation works and gives a soothing pep talk for those ready to try this for the first time. He outlines the seven principles that underlie mindfulness:
1. “As long as you are breathing, there is more right with you than wrong.”
2. The power of the present moment is a resource that is often overlooked.
3. The present moment isn’t always to our liking. That’s true whether you have chronic pain or not. Most of us spend a lot of energy distracting ourselves from the present.
4. The common two ways to deal with the present are to turn away from it through escape activities or to obsess on it and feel victimized.
5. A third way is to open to and befriend current experience to the degree you choose.
6. Whatever is happening, have kindness and compassion toward oneself. And suspend judgment, which contracts the mind and body and compounds pain and suffering.
7. The purpose is to not make anything go away or fix something. It is simply to find a respite through non-doing so life’s natural propensity for change and healing can take its course.

If you’re already familiar with the history and effectiveness of mindfulness practices, you might be tempted to skip to the second disc and that’s OK, but the first one is quite interesting.

The second disc includes several meditations of varying lengths, starting with a simple, short breathing meditation and one 18 minute practice. Even if you’re not the type to sit still with hands folded in your lap for any length of time, I think the way it is presented is a good start for anyone who is coping with chronic pain.

In The Pain Chronicles, Melanie Thernstrom tells of Franz Mesner who was able to tranquilize patients with his voice, which coined the term “mesmerize.” Jon Kabat-Zinn’s voice has this quality. Just by listening to the CDs, without even doing the meditations, I dropped into the calm, soothing nature of his voice and let go of a layer of stress.

Nine Things I Learned From The Pain Chronicles

Pain is the body’s way of grabbing the mind’s attention and demanding action. For short-term situations, this relationship works well. But when pain lasts for weeks, months or even years, the ability to take action is overwhelmed and confused by the failure of remedy after remedy. The Pain Chronicles by Melanie Thernstrom is beautifully written and explains the latest analgesic research in everything from medicines to genetic disposition to brain scans. It offers invaluable options for anyone who struggles with chronic pain.

The following summarizes the most insightful and newsworthy topics from the book. I invite you to join me for a book club discussion of The Pain Chronicles on Wednesday, February 23rd from 5:00 to 6:45 at the King County Library Administrative Service Center.

1.
Damage to pain circuitry results in greater pain. While acute pain is a protection sign, ongoing distress can create a new disorder in the body’s pain-modulating system. Nerves that have been transmitting ongoing pain messages can amplify the signal, shouting when only a whisper is needed. Also, damaged sensory nerves may not repair optimally and then fire haphazardly. The longer pain lasts, the more likely the pain-modulating system will be damaged – including aging of the brain.

2.
Pain relief improves healing. In other words, toughing it out through an injury doesn’t improve your chances for recovery. The most dramatic example is when anesthesia was first introduced for surgery. Patients who had took advantage of the advance (or more accurately, patients whose surgeons offered this alternative) tripled their chances of surviving the surgery.

3.
The power of the mind to mitigate pain has been potent enough to mimic anesthesia for patients. Franz Mesmer, a German physician in the middle 1800s, successfully hypnotized over a hundred patients to feel no pain during surgery. (This is where the word mesmerize comes from.) Acupuncture is sometimes used for anesthesia in China and its success can be attributed to patients’ belief as well as its effect on the energetic channels. Like the placebo, mind control over pain requires the patient’s desire to be healed and belief in the person administering the treatment.

4.
The relationship between the client/patient and her provider has as much to do with the possibility for recovery as the treatment. Patients who believe that their provider is personally invested and will do everything to help them are more likely to believe in and follow the treatment, which increases its chances of success. Likewise, having a partner who is supportive aids the chances of healing, while a partner who is dismissive gets in the way.

5.
One of the many difference between male and female brains affects how their brains mitigate pain. Receptors on brain cells determine how well opioids such as codeine and morphine work. Men respond better to medicines that target mu receptors. Women respond better to medicines that target kappa receptors. Most opioids currently on the market target mu receptors.

6.
Side effects of the War on Drugs create an underuse of the most effective pain-relief medications. Physicians are concerned about prescribing opioid medicines, which leaves some people under-treated. Patients are concerned about becoming addicted, which reduces their compliance and diminishes the pain relief. There is a difference between being physically dependent on a drug (which occurs for everyone with opioids) and being addicted (which occurs only for a small percentage of people who take these drugs). Also, while concern over opioid use is rampant, long-term use of anti-inflammatories and acetometaphine can actually produce more harm to the body, as they damage the stomach and liver.

7.
Serotonin is an important hormone that regulates both mood and pain, facilitating the brain’s ability to modulate sensation. Chronic pain consumes serotonin like a sponge soaks up water. Not surprisingly, depression is a common consequence of chronic pain. Research shows that depression is the result of pain much more often than depression causes pain, and the level of depression correlates to the degree of pain.

8.
A common treatment for fibromyalgia could be helpful for many more people. Gentle stretching in a warm shower for 20 minutes at a time, twice a day, can relieve tension and small muscles aches. Like pain that gathers cumulatively, this treatment diminishes tension gradually.

9.
A theme arose over and over again through The Pain Chronicles and although I already had witnessed it in my practice Thernstrom explained why it is so. Two people can have the same illness, the same pain, but experience a different level of suffering. One factor is brain chemistry. Dopamine, a chemical that is associated with feelings of love, diminishes pain. A study showed that people in love were less bothered by the same stimuli than their not-in-love counterparts. Also, frequency of pain is associated with the emotional state of the patient.

The most destructive pain undermines the person’s sense of self. Catastrophizing thoughts (“I’ve always been in pain; This will never stop; This pain keeps me from living my life.”) actually increases activity in the pain-sensing part of the brain. Arthur Kleinman, a medical anthropologist, suggests an alternative that has been shown to decrease activity in the pain brain. Creating . . . “an illness narrative that will make sense of and give value to the experience.”

Exercise of the Month: Bridge Pose or Pelvic Lift

Your core and your low back depend on a close relationship. Use a Pelvic Lift (also called Half Bridge) to traction your low back (which feels great!) and train your core to protect your spine.

1. Lie on your back with your knees bent, with a few inches between your knees and feet so they are lined up with your hip sockets.
2. Press your feet into the floor. Refer to the Engage Your Core Through Your Feet exercise to be sure that you are using the entire span of each foot.
3. As your footprints deepen into the floor, move your knees away from your face.
4. The focus is on pressing down and away so the lift comes as a natural result. Do not contract your buttocks to press up from below.
5. Hover or continue to lift up vertebra by vertebra into full bridge.
6. Come down slowly and consciously with the continued emphasis on pressing down into your feet, moving your knees away from from your torso, and keeping your tailbone lifted toward the ceiling until the very last moment when your weight is back on the ground.

Everyday Exercise 3: Bending Over

We bend over every day, to unload the dishwasher, pick something off the floor, or put on our shoes. Each forward bend gives you the opportunity to create tension in your neck -- or to let go of it.

Notice the tendency for your eyes to be the center of movement with the head craned forward to see what you're doing. This excess contraction creates tension in the back of your neck, right where many of us feel pain.

Instead, let your neck relax and your head hang down before you come back up.

Also, press into your feet and use the muscles through your entire legs, front and back, to start the movement. Be sure that your tush muscles contract before your low back and that your abdominal muscles are engaged.

It's a very different experience, one of relaxation and strength, rather than the typical one of contraction and tension.

How many times can you build this into your day?

Bellows, Undulation of the Week

Like a bellows that fuels a fire with air, your side can pump energy into your discs and muscles, vitalize your breath, and tighten your waist.

Yoga Blaze Community Event

I'm pleased to be co-sponsoring an event for yoga professionals (teachers, teachers-in-training, therapists) together with the Yoga Barn and Yoga Blaze on Saturday, Sept. 13 from 2:00 to 4:30.

The Yoga Barn

660 NW Gilman Blvd., Suite C6, Issaquah, WA

Directions: http://www.yogabarn.com/issaquah.html

Enjoy an afternoon in the company of yoga teachers. Have fun. Share experiences. Hear how yoga was clinically proven to be effective for low back pain, more effective than physical therapy or home exercises in a recent scientific study.

You have the opportunity to participate in two free workshops and partake of refreshments and sangha. Come for all or drop in for any part that fits your schedule.

2:00 to 2:30 Undulation and Yoga led by Anita Boser
2:30 to 3:45 Social Time with light refreshments
3:45 to 4:30 Robin Rothenberg presents Safe Yoga Tips for the Low Back, including elements of the Essential Low Back Program, a yoga practice based on the National Institutes of Health study, published in the Annals of Internal Medicine, Dec. 2005.

There are several comfy places for tea, coffee or dinner in Issaquah, so the socializing can continue afterwards, as well.

UNDULATION AND YOGA, with Anita
Undulation is the vital movement that nourishes joints and muscles. You’ll learn fun and easy movements to incorporate into Setu Bandha Sarvangasana (bridge pose), Vrksasana (tree pose), and Chakravakasana. You can also use this technique to create ease after strenuous poses, to warm up, or to encourage your students with injuries or chronic illness.
Anita is a Certified Hellerwork Practitioner and viniyoga student-teacher. http://www.undulationexercise.com/

SAFE YOGA TIPS FOR THE LOW BACK, with Robin
Learn some simple sequencing secrets to keep your students’ lower backs stable and pain-free. Easy to work into any style of yoga practice, these principles reduce risk, especially in vinyasa and other flow practices that emphasize mobility. Based on the scientific study that has established yoga as a therapeutically healing practice for the lower back.
Robin has presented on low back pain at SYTAR (Symposium for Yoga Therapy & Research) and at the 2007 NAMA conference on anxiety. She is on the advisory board for IAYT, (International Association of Yoga Therapy) and is an adjunct faculty member at Mt. Royal College in Calgary. http://www.essentialyogatherapy.com/

If you have any questions, feel free to call me at 425-765-2713.