Mindfulness and pain
Learn practical tips about mindfulness and meditation, and how these can help you manage your pain.
Learn practical tips about mindfulness and meditation, and how these can help you manage your pain.
As you know, chronic pain can be devastating. Maybe you can’t do all the things you love the way you used to before you had pain. You might feel shut off from the rest of the world, even shut off from yourself. Your mind might race with lots of worries or self-critical thoughts. Maybe you feel anxious without knowing why.
Well, this is actually a really common and understandable reaction to having ongoing pain. And because your mind and body are connected, the mental anguish can make your body feel worse. Your pain alarm system gets really sensitive and you might get more physically tense, as you feel more distressed. Read more about making sense of your pain here.
Practising mindfulness meditation helps bypass some of the worries and frustrations that creep in when you’re in pain. Think of it like learning how to duck-dive under a dumper at the beach. Or even better, learning to surf that wave.
Meditation teaches us to ride the waves of pain, anxiety, stress, and fatigue. This builds our confidence and gets us in a position to ride the positive waves too, like feelings of enjoyment, connection, pleasure, and achievement.
Mindfulness is no magic pill. Like any skill worth learning, it takes practice and patience. But millions of people have experienced the life-changing benefits of meditation for everything from pain to better relationships, creativity, mental focus, and greater peace of mind. And so can you.
Let’s take a deeper look.
Mindfulness means paying attention to what’s happening in each moment as it unfolds. Often this happens through meditation, but it doesn’t have to. Mindfulness and meditation are closely related. Usually, the word ‘mindfulness’ means the state of mind you’re in when you’re present, accepting and compassionate. Some people call it kind, connected presence.
‘Meditation’ on the other hand is an activity, a way to practice dropping into that state of mindfulness. So you can be mindful without meditating. Sometimes we call meditation a ‘formal’ mindfulness practice, while ‘informal’ mindfulness practice involves trying to be more aware and present in your daily routine. Both are helpful and reinforce each other.
People have been practising mindfulness for thousands of years. Science is now showing us why it seems to help.
There’s heaps of scientific research on mindfulness now and it’s really encouraging. It shows that practising mindfulness meditation often helps people with chronic pain reduce their pain intensity and improve depression, coping ability, quality of life, acceptance, sleep quality and physical functioning. If this sounds like you, check out our Örebro questionnaire to help you identify other factors that are influencing your pain experience.
Overall, mindfulness-based treatments are about as good as well-established psychological treatments for persistent pain, like Cognitive Behaviour Therapy (CBT).
It is still early days in terms of understanding why meditation can be so helpful in coping with pain, but this is what we think so far, and some tips on how to apply this in your own way. Use these tips along with the resources at the end and look for professional help if you get stuck or want to go deeper:
Although meditation is not simply a relaxation technique, relaxation is often a helpful side effect. Relaxation is very important for coping with pain because pain is not only stressful in itself, but stress can fuel pain.
Relaxation helps calm down your nervous system and boosts your body’s pain killing “feel good” hormones, called endorphins.
We sometimes feel locked in a fierce battle with our pain and just want to get rid of it. While this is completely understandable, it can make us more frustrated, anxious or depressed.
Mindfulness is about accepting what is here, right now, as best we can. This doesn’t mean we’re resigned to being in pain, because that would be predicting the future. Acceptance is all about what’s happening here and now.
Research shows that people who are better at accepting their pain respond better to various treatments and have better overall pain outcomes. Of course, acceptance is just one of many things we call psychological ‘resilience factors’ (others include things like positive emotion, hope, optimism, social support, and effective problem-solving), so it’s not all about acceptance.
Meditation helps us to avoid ‘buying into’ the negative story around our pain. This frees up our attention to savour the positive things that are happening and come up with creative solutions for the problems we face.
Exciting research using brain scanning technology shows us how the brain lights up when people with pain are meditating. It looks like they are still aware of the sensory aspects of pain, but they experience pain as less unpleasant. This is probably because it doesn’t activate as many of the brain networks related to memory, emotion and self-referential thought. Shifting these brain states through meditation involves calming our emotional response to pain, practising struggling against it less, and even ‘befriending’ it, as strange as that might sound.
One of the most powerful things that meditation can teach us is how to be a better friend to ourselves. We can all be pretty hard on ourselves, sometimes downright mean! In fact, most of us would never speak to others the way we sometimes speak to ourselves.
Meditation helps us tune out from this and tune in to a kinder, more friendly way to relate to ourselves. Research shows that stoking the fire of self-compassion not only warms the heart, but it also helps with pain. One recent study found that an 8-week Mindful Self Compassion (MSC) group reduced anxiety and pain interference even more than group CBT for pain.
No, but sometimes it helps to have a regular space in your home or garden where you can be undisturbed for a while so you start to associate that place with mindfulness.
You don’t need any special equipment, just a comfortable chair or cushion or mat on the floor if you prefer to lie down. Your bed is OK, but it might put you to sleep and meditation is actually about ‘falling awake’ rather than falling asleep.
Some people find it hard to carve out a quiet spot so they do things like park their car in front of a park or beach, which can give them some alone time to meditate. Find a creative way to make meditation work for you.
Yes, mindfulness practice is an ‘inside job’, although it’s great if you find others who are into it too so you can motivate each other.
You might like to join a meditation group and do a structured meditation course. These days you can even do these online or use smartphone apps to keep your practice going (see the links below).
It’s always worth discussing trying any new intervention with your trusted health professionals, and to use meditation as a complementary therapy rather than abandoning your usual care. It’s often helpful to only have these types of conversations with the health professionals you feel comfortable with.
Meditation is generally safe and effective. But if you’re not used to paying much attention to your feelings and body, it can sometimes feel uncomfortable to really tune in at first.
Some people may get a temporary increase in anxiety which then gets better with practice. It’s a bit like how starting a new exercise program can make you a bit sore at first as your muscles get used to it. If the anxiety doesn’t start to improve after a few weeks, it’s worth getting some guidance from a meditation teacher or health professional with a strong background in mindfulness.
If you have a history of trauma then it’s best to learn meditation from an experienced psychologist or mental health professional with experience in this area so they can tailor it to you.
Paying attention to pain in a kind and accepting way is harder than paying attention to pleasant feelings. So it’s best to get a bit familiar with mindfulness meditation before delving right into pain. So you might do some mindful park walking, general body scans, and self-compassion meditations for a while before zooming right in on pain.
When you do start meditating on pain more intentionally, for example using the ‘Working with pain’ recording below, it’s best to choose times when you have more moderate or mild pain. It will be hard to get much traction if you start with 10/10 pain. Like most things, start easy and dial up the difficulty as you gain confidence.
No! You don’t have to shave your head and give away all your money to meditate. You don’t have to take on any religious or spiritual beliefs either. Mindfulness meditation is a secular practice that helps you to become more in touch with yourself.
At the same time, some people who are religious find that meditation makes them feel more connected to their faith or spirituality. It’s up to you how you use it.
You don’t have to be in pain to benefit from meditation. There are so many physical and mental health benefits – improved work productivity, sleep, creativity, sporting performance, cardiovascular health, relationship satisfaction, and general quality of life – that mindfulness is being practised by people from all walks of life. It’s being used in schools, prisons, parliaments, multinational corporations, gyms, and hospitals.
Mindfulness practice at home is free!
Attending a structured 8-week meditation course like Mindfulness-Based Stress Reduction will cost around $500. Teaching yourself at home with a book and CD like ‘You Are Not Your Pain’ (see below) will cost about $25. There are sometimes free online mindfulness courses or you can get a brief taste of meditation through the free smartphone apps below.
A good way to start mindfulness meditation is by choosing a time and place to practice, where you can be undisturbed for a while (e.g. 15 mins). Try to commit to it every day for a few weeks. But approach this experiment with balance and kindness, so if it feels better to go slowly and take bigger breaks between practices, then go for it. You could start by trying the body scan meditation or find one online (there are thousands) that you connect with. Explore what works for you.
It’s normal to feel restless and distracted at times. While this can be a great opportunity to make to work with just another kind of uncomfortable feeling and build your confidence, you don’t have to. Experiment with different ways of cultivating mindfulness. If you’re really restless, a great practice is walking meditation.
Go for a walk outside and focus on the wind on your face, the pressure in your feet, the breath in your belly, and the sounds of nature. Practice just feeling into your senses rather than analysing what you’re feeling. Another ‘dynamic’ meditation practice like walking is yoga. Check out our yoga and pain module.
If you can do at least a bit of meditation every day you’ll really notice the benefits. Meditation seems to work on ‘dose’, so if you can do more, that’s great.
And remember you can do ‘informal’ practice throughout the rest of the day. For example, eat slowly and mindfully, tasting each mouthful completely. Or try really listening and focusing on what your friend is saying when you’re hanging out, rather than thinking of the next thing to say or checking your phone. A great starting point is also to focus on pleasant experiences. Notice when you’re enjoying yourself and scan how your body feels, notice the thoughts that come up, and observe how you interact with others. Put on a song that you love and really try to listen to it while noticing your physical and emotional reactions.
Another good regular practice is to do a short 3-5 minute meditation by listening to the breathing space meditation whenever you feel you need it.
After a while, you might enjoy doing your own meditation without any audio guiding you. ‘Owning’ your own meditation practice can be really empowering.
Have a go with these two short guided meditation tracks:
Here are some helpful apps and websites to help you track your pain and set goals to increase your level of physical activity. Alternatively, if you want to talk to someone, please seek further assistance.