Yoga and meditation reduce chronic pain

Participants in an eight-week mindfulness-based stress reduction course reported significant improvement in levels of pain, depression and disability

October 1, 2020

Science Daily/American Osteopathic Association

A mindfulness-based stress reduction (MBSR) course was found to benefit patients with chronic pain and depression, leading to significant improvement in participant perceptions of pain, mood and functional capacity, according to a study in the Journal of the American Osteopathic Association. Most of the study respondents (89%) reported the program helped them find ways to better cope with their pain while 11% remained neutral.

Chronic pain is a common and serious medical condition affecting an estimated 100 million people in the United States, which correlates with annual costs of approximately $635 billion. The small-scale study was conducted in a semi-rural population in Oregon where issues of affordability, addiction and access to care are common. Participants received intensive instruction in mindfulness meditation and mindful hatha yoga during an eight-week period.

"Many people have lost hope because, in most cases, chronic pain will never fully resolve," says Cynthia Marske, DO, an osteopathic physician and director of graduate medical education at the Community Health Clinics of Benton and Linn County. "However, mindful yoga and meditation can help improve the structure and function of the body, which supports the process of healing."

Healing and curing are inherently different, explains Dr. Marske.

"Curing means eliminating disease, while healing refers to becoming more whole," Dr. Marske says. "With chronic pain, healing involves learning to live with a level of pain this is manageable. For this, yoga and meditation can be very beneficial."

The study found mindful meditation and yoga led to significant improvements in patients' perceptions of pain, depression and disability. Following the course, Patient Health Questionnaire (PHQ-9) scores, a standard measure of depression, dropped by 3.7 points on a 27-point scale. According to Dr. Marske, some patients experience a similar drop from the use of an antidepressant.

"Chronic pain often goes hand-in-hand with depression," says Dr. Marske. "Mindfulness-based meditation and yoga can help restore both a patient's mental and physical health and can be effective alone or in combination with other treatments such as therapy and medication."

Study participants received instruction in MBSR, a systematic educational program based on training people to have an awareness of the self in the present moment and a nonjudgmental manner. The findings bolster other evidence that MBSR can be a useful adjunctive treatment for chronic pain while improving perceived depression.

"The bottom line is that patients are seeking new ways to cope with chronic pain and effective non-pharmaceutical treatments are available," says Dr. Marske. "Our findings show meditation and yoga can be a viable option for people seeking relief from chronic pain."

https://www.sciencedaily.com/releases/2020/10/201001133227.htm

Stressed at school? Art therapy reduces teenage girls' headaches

July 30, 2019

Science Daily/University of Washington

In a pilot study, researchers explored art-based mindfulness activities that schools could use to reduce headaches, a common side effect of stress in adolescent girls. After three weeks of twice-weekly mindfulness and art therapy sessions, 8 teenage girls reported experiencing significantly fewer headaches.

Teenagers report higher levels of stress than adults, and cite school as the highest contributing factor, according to the American Psychological Association's annual report. A summary from 2013 concluded that while stress among Americans was not new, "what's troubling is the stress outlook for teens in the United States."

In response, recently some schools have turned to mindfulness-based programs as a way to alleviate stress among their students. These programs could benefit from more research into what activities students find most useful.

In a pilot study led by the University of Washington, researchers explored art-based mindfulness activities that schools could use to reduce headaches, a common side effect of stress in adolescent girls. The test group of eight teenage girls gave feedback on which activities they preferred.

After three weeks of twice-weekly mindfulness and art therapy sessions, the girls reported experiencing significantly fewer headaches. At the beginning of the study, the girls reported 7.38 headaches, on average, within the previous two-week period. At the end of the study, that number had dropped to 4.63 -- almost a 40% decrease. This drop remained even seven weeks after the study had ended. The researchers published their findings May 22 in the journal Art Therapy.

"This study highlights one of my main research missions: We should be making interventions in cooperation with teenagers if we want these strategies to work," said corresponding author Elin Björling, a senior research scientist in the UW's human centered design and engineering department. "There's something powerful about saying 'I'm inviting you to start thinking about how you could get better. Come have a conversation with me about how we could do this.' I think that's why we saw such a strong response even in this tiny study."

The team recruited eight girls between the ages of 14 to 17 from a high school in Seattle. All of the participants reported experiencing three or more headaches not related to an injury within a two-week period, and five of the eight mentioned tension or stress as the main reason for headaches.

During the program, the students met twice a week for a 50-minute session with the research team. Each session began with an activity in which students would map where they were feeling stressed on a drawing of a body. Then the teens would participate in mindfulness and art activities before closing the session with another body map.

"After the study, we looked at all the before and after body maps side by side. It was so clear that something significant was going on," Björling said. "In the beginning everything was in pieces, and in the end everything was flowing through the whole body."

The teens tried different mindfulness techniques in each session so they could find which ones worked the best for them.

What teens liked: square breathing, a technique that encourages people to take slow breaths by concentrating and counting.

"I thought: 'No teen ever wants to do counted breathing, and they're never going to do it,'" Björling said. "But a few of them said 'That's my favorite. I do it all the time now.'"

What teens didn't like: mindful eating, a technique that asks people to focus on what and how they're eating.

"They hated it," Björling said. "This was a technique straight out of a lot of mindfulness programs for teens, but it didn't connect with them. It just annoyed them. It goes to show I need them to be experts in their own lives."

The researchers also asked the students to participate in different mindful art activities. During each session, the students tried a new art medium -- they particularly liked using oil pastels -- and different types of art therapy projects, including one where they worked together to create mandalas before and after a meditation exercise.

While the teens experienced fewer headaches after the study ended, their overall stress levels didn't change much. But the students reported feeling better in the moment, saying that they felt like they could handle whatever happened for the rest of the day.

The team was surprised to see any differences, given the small size of the group.

"It's not just about this study," Björling said. "This problem of teen mental health and headaches is so big that I'm worried about what happens if we don't take it on. Somistine Stevens, a nursing professor at UW Tacoma, and Narayan Singh, a psychology doctoral student at Seattle Pacific University, are also co-authors on this paper.e teens will want nothing to do with art mindfulness. So we need to come at this in lots of different ways. We're going to need an army of people and a cornucopia of options."

https://www.sciencedaily.com/releases/2019/07/190730092626.htm

For busy medical students, two-hour meditation study may be as beneficial as longer course

Two-hour intro class on mindfulness is as relaxing as an eight-week immersive course

April 15, 2019

Science Daily/Rutgers University

For time-crunched medical students, taking a two-hour introductory class on mindfulness may be just as beneficial for reducing stress and depression as taking an eight-week meditation course, a Rutgers study finds.

The study, conducted by researchers at Rutgers Robert Wood Johnson Medical School, is published in the journal Medical Science Educator. The researchers say many medical students would like to use meditation to avoid burnout and provide better medical care, but are daunted by the prospect of making time for a daily meditation routine.

"What we found should encourage even the busiest medical students and physicians," said lead author Periel Shapiro, an MD candidate at Rutgers Robert Wood Johnson Medical School. "There are shorter, sustainable ways to bring meditation into your life, and they can help you reduce stress and depression and improve your medical study and practice."

Mindfulness is defined as maintaining nonjudgmental awareness of the present moment, and continuously returning to that awareness when pulled away by distraction. Mindfulness practices are believed to have physiological and psychological benefits resulting in reducing the mind's negative focus on feelings of distress and increasing the body's ability to relax.

Studies have shown that medical students are at disproportionately high risk for depression and anxiety, and that mindfulness can help them develop coping mechanisms to reduce these feelings. Previous studies have also shown, however, that medical students often drop out of meditation courses because of a perceived lack of time and other support.

The Rutgers practitioners found that there has been a lack of research into identifying meditation methods that may be most accessible to busy medical students and physicians. For their study, they assigned random groups of medical students to a two-hour introductory course or a full eight-week course on mediation. Those who took the eight-week course became more familiar with mindfulness techniques and felt more comfortable recommending mindfulness to patients.

Both groups described benefits in reducing their feelings of stress and depression -- and many students viewed mindfulness as a safe alternative to treating those feelings with medication. Many students also described mindfulness as providing a deeper sense of happiness and fulfillment.

The findings suggest that the full eight-week course is helpful in promoting greater awareness of how to practice mindfulness in everyday life and that the brief introductory course is an effective and efficient way to help students begin practicing mindfulness and experiencing its benefits. The authors said the study can help guide medical schools to introduce mindfulness courses or fine-tune them in ways that will benefit students.

https://www.sciencedaily.com/releases/2019/04/190415154705.htm

Even a single mindfulness meditation session can reduce anxiety

People with anxiety show reduced stress on the arteries after 1-hour introductory session

April 23, 2018

Science Daily/Experimental Biology 2018

Mindfulness meditation programs have shown promise for the treatment of anxiety, one of the most common mental health disorders in the US. New research suggests people can begin to derive psychological and physiological benefits from the practice after a single introductory session.

"Our results show a clear reduction in anxiety in the first hour after the meditation session, and our preliminary results suggest that anxiety was significantly lower one week after the meditation session," said lead study author John J. Durocher, PhD, an assistant professor of physiology in the department of biological sciences at Michigan Technological University. "Participants also had reduced mechanical stress on their arteries an hour after the session. This could help to reduce stress on organs like the brain and kidneys and help prevent conditions such as high blood pressure."

Understanding the effects of mindfulness meditation on the body can help improve the design of anti-anxiety therapies, according to Durocher. He will present the research at the American Physiological Society annual meeting during the 2018 Experimental Biology meeting, held April 21-25 in San Diego.

Anxiety can be a risk factor for cardiovascular disease. Previous studies have indicated that arterial stiffness (a predictor of cardiovascular disease) can be increased by traumatic life events, job strain, depression, temporary anxiety and long-term proneness to anxiety. Cardiovascular changes associated with anxiety can also lead to high blood pressure and long-term damage to various organs.

Researchers recruited 14 participants who had normal blood pressure but high levels of anxiety. They measured factors related to cardiovascular functioning -- including heart rate, blood pressure, aortic blood pressure (blood pressure in the aorta, specifically) and arterial stiffness -- before and after a 60-minute guided introductory session of mindfulness meditation. This type of meditation emphasizes focusing on breathing and awareness of one's thoughts.

The results demonstrate that even a single, brief intervention can yield measurable improvements in people with anxiety. Researchers said most participants reported continuing to use mindfulness after the initial session and anxiety scores were reduced even further one week later.

"This study is different because we examined the effect of a single mindfulness meditation session on anxiety and cardiovascular outcomes, while other studies have examined the effect of several days or weeks of mindfulness meditation," Durocher said. "The results suggest that a single mindfulness meditation session may help to reduce cardiovascular risk in those with moderate anxiety."

Durocher and colleagues recently started a new study to assess the effects of mindfulness-based stress reduction in people with moderately elevated blood pressure.

https://www.sciencedaily.com/releases/2018/04/180423135048.htm

Functional MRI shows how mindfulness meditation changes decision-making process

April 21, 2011

Science Daily/Virginia Tech

Neuroimaging research shows that Buddhist meditators use different areas of the brain than other people when confronted with unfair choices, enabling them to make decisions rationally rather than emotionally.

Their research shows that Buddhist meditators use different areas of the brain than other people when confronted with unfair choices, enabling them to make decisions rationally rather than emotionally. The meditators had trained their brains to function differently and make better choices in certain situations.

The research "highlights the clinically and socially important possibility that sustained training in mindfulness meditation may impact distinct domains of human decision making," the researchers write.

The researchers conclude, "Our results suggest that the lower-level interoceptive representation of the posterior insula is recruited based on individual trait levels in mindfulness. When assessing unfair offers, meditators seem to activate an almost entirely different network of brain areas than do normal controls. Controls draw upon areas involved in theory of mind, prospection, episodic memory, and fictive error. In contrast, meditators instead draw upon areas involved in interoception and attention to the present moment. …This study suggests that the trick may lie not in rational calculation, but in steering away from what-if scenarios, and concentrating on the interoceptive qualities that accompany any reward, no matter how small."

http://www.sciencedaily.com/releases/2011/04/110420112328.htm

Meditation may help the brain 'turn down the volume' on distractions

April 21, 2011

Science Daily/Massachusetts General Hospital

The positive effects of mindfulness meditation on pain and working memory may result from an improved ability to regulate a crucial brain wave called the alpha rhythm. This rhythm is thought to "turn down the volume" on distracting information, which suggests that a key value of meditation may be helping the brain deal with an often-overstimulating world.

Researchers from Massachusetts General Hospital (MGH), Harvard Medical School and the Massachusetts Institute of Technology report that modulation of the alpha rhythm in response to attention-directing cues was faster and significantly more enhanced among study participants who completed an eight-week mindfulness meditation program than in a control group. The report will appear in the journal Brain Research Bulletin and has been released online.

"Mindfulness meditation has been reported to enhance numerous mental abilities, including rapid memory recall," says Catherine Kerr, PhD, of the Martinos Center for Biomedical Imaging at MGH and the Osher Research Center at Harvard Medical School, co-lead author of the report. "Our discovery that mindfulness meditators more quickly adjusted the brain wave that screens out distraction could explain their superior ability to rapidly remember and incorporate new facts."

Brain cells use particular frequencies or waves to regulate the flow of information in much the same way that radio stations broadcast at specific frequencies. One frequency, the alpha rhythm, is particularly active in the cells that process touch, sight and sound in the brain's outmost layer, called the cortex, where it helps to suppress irrelevant or distracting sensations and regulate the flow of sensory information between brain regions.

Previous studies have suggested that attention can be used to regulate the alpha rhythm and, in turn, sensory perception. When an individual anticipates a touch, sight or sound, the focusing of attention toward the expected stimulus induces a lower alpha wave height in cortical cells that would handle the expected sensation, which actually "turns up the volume" of those cells. At the same time the height of the alpha wave in cells that would handle irrelevant or distracting information increases, turning the volume in those regions down. Because mindfulness meditation -- in which practitioners direct nonjudgmental attention to their sensations, feelings and state of mind -- has been associated with improved performance on attention-based tasks, the research team decided to investigate whether individuals trained in the practice also exhibited enhanced regulation of the timing and intensity of alpha rhythms.

The study tested 12 healthy volunteers with no previous experience in meditation. Half completed the eight-week Mindfulness-Based Stress Reduction Program developed at the University of Massachusetts. The other half were asked not to engage in any type of meditation during the study period. Using magnetoencephalography (MEG), an imaging technique that detects the location of brain activity with extreme precision, the researchers measured participants' alpha rhythms before, during and after the eight-week period. Specifically, they measured alpha rhythms in the brain area that processes signals from the left hand while participants were asked to direct their attention to either their left hand or left foot. Participants' abilities to adjust the alpha rhythm in cortical cells associated with the hand, depending on where their attention was directed, were recorded during the milliseconds immediately after they received an attention cue.

Although all participants had showed some attention-related alpha rhythm changes at the beginning of the study, at the end of the eight weeks, those who completed the mindfulness meditation training made faster and significantly more pronounced attention-based adjustments to the alpha rhythm than the non-meditators did. "This result may explain reports that mindfulness meditation decreases pain perception," says Kerr. "Enhanced ability to turn the alpha rhythm up or down could give practitioners' greater ability to regulate pain sensation."

The study also sheds light on how meditation may affect basic brain function, explains Stephanie Jones, PhD, of the Martinos Center, co-lead author of the paper. "Given what we know about how alpha waves arise from electrical currents in sensory cortical cells, these data suggest that mindfulness meditation practitioners can use the mind to enhance regulation of currents in targeted cortical cells. The implications extend far beyond meditation and give us clues about possible ways to help people better regulate a brain rhythm that is dysregulated in attention-deficit hyperactivity disorder and other conditions." Kerr is an instructor in Medicine and Jones an instructor in Pediatrics at Harvard Medical School (HMS).

http://www.sciencedaily.com/releases/2011/04/110421122337.htm

Mindfulness Therapy Might Help Veterans with Combat-Related PTSD

Apr. 17, 2013 —

Science Daily/University of Michigan Health System

Mindfulness exercises that include meditation, stretching, and acceptance of thoughts and emotions might help veterans with combat-related post-traumatic stress disorder find relief from their symptoms.

A new collaborative study from the University of Michigan Health System and the VA Ann Arbor Healthcare System shows that veterans with PTSD who completed an 8-week mindfulness-based group treatment plan showed a significant reduction in symptoms as compared to patients who underwent treatment as normal.

Mindfulness-based cognitive therapy, or MBCT, combines the practice of cognitive therapy with the meditative approach of mindfulness that stresses an increased awareness of all thoughts and emotions.

Previous research has shown stress reduction classes that use mindfulness meditation have been beneficial to people with a history of trauma exposure -- including veterans, civilians with war-related trauma and adults with a history of childhood sexual abuse -- but the new study is the first to examine the effect of mindfulness-based psychotherapy for PTSD with veterans in a PTSD clinic.

The study was published online today in Depression and Anxiety.

"The results of our trial are encouraging for veterans trying to find help for PTSD," says Anthony P. King, Ph.D., the study's lead author and research assistant professor in the U-M Department of Psychiatry, who performed the study in collaboration with psychologists at the VA Ann Arbor Healthcare System. "Mindfulness techniques seemed to lead to a reduction in symptoms and might be a potentially effective novel therapeutic approach to PTSD and trauma-related conditions."

Veterans in the mindfulness treatment groups participated in in-class exercises such as mindful eating, in which they focus on sensations associated with eating very slowly; "body scanning," an exercise where patients focus on physical sensations in individual parts of the body, paying special attention to pain and tension; mindful movement and stretching; and "mindfulness meditation" including focusing on the breath and emotions. The participants were also instructed to practice mindfulness at home through audio-recorded exercises and during the day while doing activities such as walking, eating and showering.

After eight weeks of treatment, 73 percent of patients in the mindfulness group displayed meaningful improvement compared to 33 percent in the treatment-as- usual groups.

King says the most noticeable area of improvement for patients in the mindfulness group was a reduction in avoidance symptoms. One of the main tenets of mindfulness therapy is a sustained focus on thoughts and memories, even ones that might be unpleasant.

"Part of the psychological process of PTSD often includes avoidance and suppression of painful emotions and memories, which allows symptoms of the disorder to continue," King says. "Through the mindfulness intervention, however, we found that many of our patients were able to stop this pattern of avoidance and see an improvement in their symptoms."

Mindfulness techniques also emphasize focus and attention to positive experiences and nonjudgmental acceptance to one's thoughts and emotions. Because of this, the researchers found that the patients in the mindfulness group experienced a decrease in feelings of self-blame and a trend toward decreased perception of the world as a dangerous place.

King says the results of this pilot study are encouraging, but further studies with a larger sample size are needed to fully explore the breadth of mindfulness intervention benefits. He added that the U-M-VA group is currently conducting a larger study including military veterans returning from Iraq and Afghanistan.

"Further studies will help us understand whether mindfulness training is more aptly considered an adjunct option to gold-standard trauma-focused treatments such as prolonged exposure or EMDR, or whether it can function as an intervention in its own right for treating avoidance and other symptoms," he says.

"Either way, mindfulness-based therapies provide a strategy that encourages active engagement for participants, are easy to learn and appear to have significant benefits for veterans with PTSD."http://www.sciencedaily.com/releases/2013/04/130417130007.htm