New Findings on Meditation and Pain Management

Meditation for pain and stress management has been studied for decades. It is fairly well established that meditators can decrease their sensitivity to pain and reduce their stress levels, but a new study suggests that these benefits can be obtained without weeks of initial training. It also employs brain scans to identify some of the key areas activated by the practice and shed some light on how the pain management effect works on a physiological level.

In the study, researchers mildly burned 15 men and women in a lab on two separate occasions, before and after the volunteers attended four 20-minute meditation training sessions over the course of four days. During the second go-round, when the participants were instructed to meditate, they rated the exact same pain stimulus -- a 120-degree heat on their calves -- as being 57 percent less unpleasant and 40 percent less intense, on average.

"That's pretty dramatic," says Fadel Zeidan, Ph.D., the lead author of the study and a postdoctoral researcher at the Wake Forest University School of Medicine, in Winston-Salem, North Carolina. The reduction in pain ratings was substantially greater than those seen in similar studies involving placebo pills, hypnosis, and even morphine and other painkilling drugs, he adds.

It's pretty remarkable to see that meditation was able to achieve greater levels of pain reduction than clinically effective drugs like morphine. There has been a lot of debate lately in the medical research community surrounding the placebo effect and how it might work, and my guess is that these meditators may be tapping into the same mechanism. It would be interesting to take a look at some brain scans of subjects who report strong therapeutic effects in drug trials even though they are part of the placebo control group and see how similar they are to those of Zeidan's meditators.

The findings, which appear in the April 6 issue of the Journal of Neuroscience, aren't entirely surprising. Past research has found that Buddhist-style meditation -- also known as mindfulness meditation -- can help people cope with pain, anxiety, and a number of other physical and mental health problems. But in most cases the training takes weeks, not days.

The fact that Zeidan and his colleagues achieved these results after just 80 minutes of training is "spectacular," says Robert Bonakdar, M.D., the director of pain management at the Scripps Center for Integrative Medicine, in San Diego.

What Zeidan and his team seem to have discovered is what many of us who meditate on a regular basis already know. Meditation is not difficult to learn, and even though and enormous amount has been written regarding the practice the biggest problem most people have with it is failing to understand that they are succeeding at the practice even when their minds are not completely blank. The point of mindfulness meditation is not to stop thoughts as though by force of will but rather to observe them dispassionately. As long as you can keep bringing your attention back to that perspective stray thoughts will slowly subside on their own without any apparent effort on your part.

Brain scans conducted during the pain experiments showed that this technique appeared to cause a number of changes in how the participants' brains responded to pain.

The researchers looked, for instance, at a part of the brain called the somatosensory cortex, which contains a kind of map of the body. Before meditation training, the area corresponding to the right calf was quite active when the heat was applied to the volunteers. But there was little activity in this region when they were meditating, which suggests that "meditation reduces pain by reducing the actual sensation," Zeidan says.

Areas of the brain responsible for maintaining focus and processing emotions were also more active during meditation, and the activity was highest in the volunteers who reported the greatest reductions in pain. "There's not just one thing happening," Zeidan says. "Mindfulness meditation incorporates multiple mechanisms, multiple avenues for pain relief."

The conventional wisdom has been that meditation relieves pain not by diminishing sensation but by helping people consciously control their perception of pain, says Katharine MacLean, Ph.D., a meditation researcher and postdoctoral fellow in psychology at Johns Hopkins University, in Baltimore.

However, she says, the brain scans make it clear that both processes take place: Mediation changes the nature of pain before it's perceived and also allows people to better handle it. "Meditation is really kind of retuning your brain," MacLean says.

In fact the best analogy for meditative progress in my experience is that of an acclimatization process. As you spend time with your mind in the meditative state it slowly becomes more used to detaching from random thoughts and your focus becomes clearer. One of my meditation teachers liked to explain that when people would come to her and ask her if they were succeeding at their meditation her response was always the same. She would ask, first of all, if they were keeping up their meditative practice. If the answer was yes, she would reply that they were succeeding at it. As with many other aspects of magical and spiritual work, in meditation it truly is persistence and determination that is required, not some intellectually complex trick that takes weeks to learn.

While the study concentrated on the physical benefits of the practice the same state of mind that manages pain and stress is also particularly conducive to spiritual realization. The spiritual side of the practice is similarly simple, so simple in fact that once you "get it" you generally find yourself amazed that you ever found it confusing. A lot of that confusion is rooted in pop culture that tells you things like you are a terrible meditator if you are unable to hold your mind entirely blank. In fact, striving for such a state with great effort is completely counter to the nature of mindfulness meditation and can prevent any sort of stress mediation, let alone realization.