Chronic neuropathic pain is one of the most debilitating conditions that traditional medicine has failed to relieve. To address this issue, an increasing number of people are turning to ancient mind-body techniques, that tap into the anterior cingulate cortex (ACC). This is an area of the brain that is known to be involved with functions of pain, emotion and cognitive control. Some studies suggest that there may be four distinct areas of the ACC which process different types of pain responses.
Importance of Relaxation Response
The relaxation response in the opposite of the stress of “fight or flight response and can be elicited with progressive muscle relaxation, meditation, self hypnosis and laughter. Relaxation response has been associated with increased pain tolerance, reduced inflammation and emotional reactivity to pain, increase the brains responsiveness to endorphins, desensitize central pain pathways and cause muscle relaxation.
The Power of Relaxation Techniques
Mind-body techniques encourage relaxation, reduce anxiety and pain, and decrease the need for medication. The goal of these techniques is to get the body and mind to relax, thereby reducing the levels of stress hormones, which impede our immune systems and ability to heal. Studies have shown decreased grey matter in the ACC region of chronic pain patients vs normal subjects. The real interesting part is that increased grey matter in the ACC area of the brain has been found in subjects that practice focused meditation techniques. Could increased grey matter and increased conscious control be a partial key to chronic pain control?
Distraction or Meditation
Many people with chronic pain use distraction as a means to cope, however studies directly comparing meditation to distraction…meditation reduced pain ratings more than distraction (Sedan et al., 2010b) and activated emotion regulatory brain regions (PFC, ACC) to a greater extent than distraction (Holzel et al. 2007). From my own experience, distraction works well to decrease pain…while in the moment. However, I’ve found that meditation provides much longer emotional and physical relief of my neuropathic pain.
Learning Relaxation Techniques
Mind-body therapies use various approaches including relaxation techniques which can help alleviate discomfort related to chronic pain. Most methods only require brief instruction from book, You tube video or experience practitioner. These techniques have been shown to be most beneficial when practiced regularly and combined with a healthy lifestyle, good nutrition and regular exercise.
Relaxation techniques covered in the article include:
Autogenic Training: This method has you focus on the physical sensation of your breathing, heartbeat and picturing your body as warm, heavy and relaxed.
Deep Breathing Exercises: During this technique you consciously slow your breathing and focus on taking regular and deep breaths… to assist in relaxing your mind and body.
Progressive Muscle Relaxation: For this method, you focus on tightening and relaxing each muscle group. Often this technique is combined with guided imagery and breathing exercises.
Meditation: Transcendental and mindfulness meditation. A person using meditation, learns to focus attention. The practitioner may be instructed to become mindful of thoughts, feelings, physical sensations and to observe them in new and nonjudgemental ways. Meditation can be done while sitting, lying down or in other positions.
Self Hypnosis: Hypnosis is a highly relaxed, trance-like state in which the conscious part of the brain is temporarily tuned out through a focus on relaxation and non-attention to distracting thoughts.
Yoga and Biofeedback have also been found to be very useful in reducing pain. However, these techniques require professional assistance.
Note: This material is provided for information purposes only and should not be taken as medical advise. Prior to making any change in your health care program, it is highly advisable to discuss proposed change with your physician. There have been rare reports that meditation could cause or worsen symptoms in people who have certain psychiatric problems, but this question has not been fully researched.
- Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network. http://umm.edu/health/medical/altmed/treatment/mindbody-medicine
- Vitetta L, Anton B, Cortizo F, Sali A. Mind-body medicine: stress and its impact on overall health and longevity. Ann N Y Acad Sci. 2005;1057:492-505.
- National Center for Complementary and Alternative Medicine (NCCAM), Meditation: An Introduction . http://nccam.nih.gov/health/meditation/overview.htm
- Craig Hassed, MBBS, FRACGP, Mind Body Therapies, AFP Volume 42, No. 3, (March 2013) http://www.racgp.org.au/afp/2013/march/mind-body-therapies/
- Astin JA. Mind-body therapies for the management of pain. Clin J Pain 2004;20:27-32.http://www.ncbi.nlm.nih.gov/pubmed?term=Astin%20JA.%20Mind-body%20therapies%20for%20the%20management%20of%20pain.%20Clin%20J%20Pain%202004;20:27 -32.
- Min Zhuo, Long-term potentiation in the anterior cingulate cortex and chronic pain, Published 2 December 2013 doi: 10.1098/rstb.2013.0146 Phil. Trans. R. Soc. B 5 January 2014 vol. 369 no. 1633 20130146 http://rstb.royalsocietypublishing.org/content/369/1633/20130146.full
- Sawamoto N, Honda M, Okada T, Hanakawa T, Kanda M, Fukuyama H, Konishi J, Shibasaki H. J Neurosci. Expectation of pain enhances responses to nonpainful somatosensory timulation in the anterior cingulate cortex and pariental operculum/posterior insula: an event related functional magnetic resonance imaging study. (2000 Oct 1);20(19):7438-45. PMID: 11007903 [PubMed – indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/pubmed/11007903
- Eur J Neurosci. (1996 Jul;8)(7):1461-73. Vogt BA1, Derbyshire S, Jones AK. Pain processing in four regions of human cingulate cortex localized with co-registered PET and MR imaging. http://www.ncbi.nlm.nih.gov/pubmed/8758953
- Zeidan F1, Gordon NS, Merchant J, Goolkasian P, J Pain. 2010 Mar;11(3):199-209. doi: 10.1016/j.jpain.2009.07.015. Epub (2009 Oct 22).The effects of brief mindfulness meditation training on experimentally induced pain, PUB MED, http://www.ncbi.nlm.nih.gov/pubmed/19853530
- M. Catherine Bushnell, Marta Ceko, Lucie A. Low, Cognitive and emotional control of pain and its disruption in chronic pain, Nature Reviews Neuroscience 14, 502-511 (2013) http://www.nature.com/nrn/journal/v14/n7/full/nrn3516.html?WT.ec_id=NRN-201307
- F. Zeidan, K.T. Matucci,[…] R.C. Coghill, Brain Mechanisms Supporting Modulation of Pain by Mindfulness Meditation, J Neurosci. Apr 6 2011; 31(14):5540-5548. doi: 10.1523/Jneurosci.5791-10. 2011 http://www.jneurosci.org/content/31/14/5540.long