Chronic Pain

Mindfulness Meditation for Chronic Pain

Pain Awareness Month in September is a month dedicated to raising awareness about the silent and often misunderstood epidemic of chronic pain.

My ideas about this subject are shaped by my own experience with chronic pain. I am often asked ‘what do you find  helps with pain’? However, I  don’t have  a simple answer. Anyone who has read  my series of blog posts, following my stroke, and emergence of  central pain syndrome, will discover along the way I’ve tried so many things, from physio, acupuncture, massage, saunas to mindfulness and meditation. I have  been seduced into trying lotions, potions, and gadgets. After  several years I’ve learned that it takes time to come to terms with chronic pain, to accept just how difficult it is to treat, and that there are no ‘quick fixes’.

Barriers to self-management of chronic pain in primary care: a qualitative focus group study
Katy GordonHelen RiceNick AllcockPamela BellMartin DunbarSteve GilbertHeather Wallace

A variety of tools are beneficial for managing chronic pain

Chronic pain is a common disabling illness that does not completely respond to current medical treatments. A variety of tools are beneficial for managing it. For example, the practice of mindfulness meditation. There is growing evidence  that mindfulness practice produces real changes in the brain , and may lead to changes in pain tolerance and pain intensity ratings.

Ball EF, Nur Shafina Muhammad Sharizan E, Franklin G, Rogozi?ska E. Does mindfulness meditation improve chronic pain? A systematic review. Curr Opin Obstet Gynecol. 2017 Dec;29(6):359-366. doi: 10.1097/GCO.0000000000000417. PMID: 28961631.

What is  mindfulness?

It’s a mental practice that involves paying focused and non-judgmental attention to the present moment. In other words being fully aware of your thoughts, feelings, bodily sensations, and the environment without trying to change or judge them. Mindfulness encourages acceptance of the present moment as it is and can be cultivated through meditation, breathing exercises, or simply by consciously being present in everyday activities. Research has shown that mindfulness is a simple but powerful way to enhance several cognitive functions. It can improve attention, relieve pain and reduce stress.

Below is video that provides a more detailed explanation of  mindfulness meditation for  chronic pain from Stanford Medicine.

September is Pain Awareness Month

Shedding light on the silent suffering

September is a month that signifies the end of summer, the beginning of fall, and for many, the return to routines and responsibilities. However, September also holds another important role—it’s Pain Awareness Month. This dedicated month seeks to raise awareness about the silent and often misunderstood epidemic of chronic pain.

Graphic, pain isn't always black or white

Understanding Chronic Pain

Chronic pain is not just a physical sensation; it’s a life-altering experience that affects millions of people worldwide. It is typically defined as pain that persists for at least 12 weeks, beyond the expected time for healing. Chronic pain can result from various underlying conditions, including arthritis, fibromyalgia, neuropathy, and many others. It doesn’t discriminate by age, gender, or background and can strike anyone at any time.

Chronic pain affects more Americans  adults than heart disease,cancer and diabetes combined ~ Stanford Institute of  Medicine

Chronic Pain is Like a Car With Four Flat Tires

One of the greatest challenges with chronic pain is its invisibility. Unlike a visible injury or illness, chronic pain is often hidden beneath the surface, leaving those who suffer from it feeling isolated and misunderstood. This can lead to feelings of depression, anxiety, and a sense of hopelessness. Friends, family members, and even healthcare providers may not fully grasp the extent of the suffering endured by those with chronic pain.

Pain Awareness Month is a vital initiative aimed at addressing the challenges of those who suffer with chronic pain. It serves several essential purposes:

  1. Education: It provides an opportunity to educate the public, healthcare providers, and policymakers about the complexities of chronic pain, its various causes, and the importance of effective pain management.
  2. Empowerment: By raising awareness, Pain Awareness Month empowers individuals living with chronic pain to seek help, connect with support networks, and advocate for their needs.
  3. Research and Advocacy: It supports research efforts to better understand and treat chronic pain and advocates for policies that improve access to pain management resources.

Living with pain

If you are living with chronic pain, or caring for a family member who is, listed below are  a  list of organizations, information and helpful resources.

Pain BC is a registered charity that is transforming the way chronic pain is understood and treated.

Making Sense of Pain Making is a self-management program designed for people with pain who experience marginalization and face barriers to accessing care.

American Chronic Pain Association  The mission of the ACPA is to facilitate peer support and education for individuals with chronic pain and their families so that these individuals may live more fully in spite of their pain, and to raise awareness among the health care community, policymakers, and the public at large about issues of living with chronic pain.

Pain, is it all in your head?

Pain is it all in your head

Kathy James DALL·E 2023-01-01 17.23.49

As I read back through the posts that I have written over the years following my stroke, I recognize that was not a passive recipient of treatment.

In my initial posts I weaved the tapestry of my recovery, postulating and problem solving, often getting the answers wrong.

What I needed right from the very beginning was someone to sit me down and tell me what to expect. This simply didn’t happen, and stroke turned my life upside down. Through all of this I have become my own clinical reasoner and problem solver.

I have written previously that as a consequence of suffering a thalamic stroke, I now have central post stroke pain (CPSP), this condition affects about 12% of those affected by stroke. It is also known as thalamic syndrome or thalamic pain syndrome, it is a neurological disorder and is extremely difficult to treat. CPSP occurs when there is damage to an area of the brain that carries lots of sensory pathways, no particular type of stroke causes CPSP, rather strokes in particular areas of the brain do. Continue Reading

Stress management helps chronic pain sufferers

pain in the back

Image: istockphoto

For chronic pain sufferers, such as people who develop back pain after a car accident, avoiding the harmful effects of stress may be key to managing their condition.

 
This is particularly important for people with a smaller-than-average hippocampus, as these individuals seem to be particularly vulnerable to stress. These are the findings of a study by Dr. Pierre Rainville, PhD in Neuropsychology, Researcher at the Research Centre of the Institut universitaire de gériatrie de Montréal (IUGM) and Professor in the Faculty of Dentistry at Université de Montréal, along with Étienne Vachon-Presseau, a PhD student in Neuropsychology. The study appeared in Brain, a journal published by Oxford University Press.

“Cortisol, a hormone produced by the adrenal glands, is sometimes called the ‘stress hormone’ as it is activated in reaction to stress. Our study shows that a small hippocampal volume is associated with higher cortisol levels, which lead to increased vulnerability to pain and could increase the risk of developing pain chronicity,” explained Étienne Vachon-Presseau.

As Dr. Pierre Rainville described, “Our research sheds more light on the neurobiological mechanisms of this important relationship between stress and pain. Whether the result of an accident, illness or surgery, pain is often associated with high levels of stress Our findings are useful in that they open up avenues for people who suffer from pain to find treatments that may decrease its impact and perhaps even prevent chronicity. To complement their medical treatment, pain sufferers can also work on their stress management and fear of pain by getting help from a psychologist and trying relaxation or meditation techniques.”

Research summary

This study included 16 patients with chronic back pain and a control group of 18 healthy subjects. The goal was to analyze the relationships between four factors: 1) cortisol levels, which were determined with saliva samples; 2) the assessment of clinical pain reported by patients prior to their brain scan (self-perception of pain); 3) hippocampal volumes measured with anatomical magnetic resonance imaging (MRI); and 4) brain activations assessed with functional MRI (fMRI) following thermal pain stimulations. The results showed that patients with chronic pain generally have higher cortisol levels than healthy individuals.

Data analysis revealed that patients with a smaller hippocampus have higher cortisol levels and stronger responses to acute pain in a brain region involved in anticipatory anxiety in relation to pain. The response of the brain to the painful procedure during the scan partly reflected the intensity of the patient’s current clinical pain condition. These findings support the chronic pain vulnerability model in which people with a smaller hippocampus develop a stronger stress response, which in turn increases their pain and perhaps their risk of suffering from chronic pain. This study also supports stress management interventions as a treatment option for chronic pain sufferers.

Source: University of Montreal
Étienne Vachon-Presseau, Mathieu Roy, Marc-Olivier Martel, Etienne Caron, Marie-France Marin, Jeni Chen, Geneviève Albouy, Isabelle Plante, Michael J. Sullivan, Sonia J. Lupien et Pierre Rainville. “The stress model of chronic pain: evidence from basal cortisol and hippocampal structure and function in humans”, February 18, 2013, BRAIN.