Management · 14 min read · 21 Feb 2022
Mindfulness and 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.
"We can use our mind-body connection to create a positive feedback loop"
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.
"Like yoga, mindfulness is all about the mind-body connection."
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.
What does the research say about mindfulness and pain?
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).
How does mindfulness meditation help with pain?
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:
1. Relaxation
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.
Practice tips
- Scan your body for areas of tension and imagine them softening, like a block of ice melting. Or imagine the tension spreading and diffusing, like steam in a room, or a drop of food colouring in water.
- Imagine breathing into and out of areas where you feel tense, as if you’re breathing through the pores of your skin rather than your nose.
- Be patient and kind with yourself rather than trying to force relaxation. Trying too hard or striving to reach some special state of relaxation can put you under pressure, which makes it even harder to relax. ‘Invite’ parts of your body to soften and let go, rather than ordering them to relax.
2. Acceptance
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.
"Surfing the wave we’re on, rather than thinking about the next wave"
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.
Practice tips
- Whatever you’re focusing on in your meditation (e.g. sensations in a body scan, the feeling of your breath in your nose, sounds of nature during a walking meditation in the park), get curious. Really curious. Try to notice subtle details that you haven’t noticed before. Tune into all the little changes and fluctuations that are going on. Practice noticing without evaluating or analysing.
- Take it one step at a time – this next breath, this next step, this next body part in my body scan. Tell yourself, “Just this”, or “This too”, instead of predicting what will happen in the future.
- You don’t have to like it. Accepting your experience right now isn’t the same as liking it or resigning yourself to things being this way forever. The future is a mystery. Try focusing on whether you can tolerate just this moment, regardless of what happens next. You might ask yourself, “Can I handle this, just like it is right now?”.
3. Mental flexibility
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.
Practice tips
- Give your mind permission to take a break from analysis and problem solving, so it can focus on just feeling through your senses. Just like pain tries to protect our bodies, our busy minds are often trying to protect us by solving problems. So during meditation, you might tell yourself, “Thanks brain, but I’ve got this, you can take a break”. Or you could just say, “Thinking,” to yourself each time you notice you’re lost in the daydream, and then come back to your next breath.
- Welcome distraction. We often beat ourselves up for getting distracted because we think it means we’re not meditating properly, which then makes us even more distracted! Celebrate each time you notice you were just lost in distraction because that’s the very moment you’ve woken up again. It’s a moment of mindfulness. Let yourself settle back into this moment like sinking into a comfortable armchair.
- No need to push anything away. Often we try to ‘block out’ unwanted thoughts, feelings or sensations. But that easily backfires and makes us focus more on it (e.g. what happens when you try not to think of a pink elephant?). It’s more helpful to focus on bringing your attention towards something else, rather than away from the unwanted stuff. For example, try to get really curious about the difference in temperature between the in-breath and out-breath or focus on where your body contacts the floor and see if you can feel exactly where your body ends and the floor begins.
4. Sensation vs distress
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.
"Meditation trains your brain to experience pain with less distress"
Practice tips
- Get to know the different ‘layers’ of your experience: the sensations (e.g. pressure across your scalp), the thoughts that pop up about that (e.g. “Why won’t this horrible headache just go away?!"), your feelings (e.g. frustration), urges and behaviours (e.g. tensing up, rushing things, getting grumpy with others). Then focus in on just the sensations and let the other stuff be there, but not as your main focus. The thoughts and emotions can be there as background noise. Zoom in on just the sensations.
- Get to know the different qualities of your sensations. Ask yourself, where does this sensation start and end? Does it have a texture, a colour, a shape, or maybe even a character or personality? Is this sensation stable and constant, or does it waver and fluctuate?
- Find safe sensations. While doing a body scan meditation, you’ll encounter lots of different sensations, including uncomfortable ones, and areas of pain. See if you can focus on those that feel comfortable, pleasant, or just neutral. Spend time here. Let yourself relax into these safe sensations. Even say to yourself, “I’m safe,” or “OK” while you’re here. This can become a resource you return to when you get uncomfortable, emotionally or physically (or both).
- Move your attention between these comfortable, safe sensations and more challenging sensations. Practice bringing a sense of safety into those difficult areas. Remind yourself, “I’m safe” or “My body is safe” or “OK” as you do this.
5. Self compassion
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.
Practice tips
- Start tuning into moments when you’re struggling with pain or difficult emotions. Tell yourself, “this is hard” or “this is a moment of suffering for me”. Think of all the other people in the world who are also struggling right now. Remind yourself you’re not alone and it’s OK to struggle, we all do.
- Soothe yourself. Self compassion involves taking care of yourself like you would take care of someone you love. How do you support others? Perhaps by listening, offering a kind word, a reassuring touch, or doing something with them to help ease their distress. Now how could you do that for yourself? What could you say to yourself (e.g. “It’s OK”, “You’re doing great”, “I’m here for you”, “You’ll get through this”)? What could you do (e.g. feel the warmth of your hand placed over your heart; do an activity that gives you pleasure; spend time with someone you love; cuddle a pet; connect with nature)?
- Cultivate feelings of kindness. Practice generating that compassionate, loving feeling that you have towards a pet, a family member, or a dear friend. Start by imagining them suffering in some way. Notice the feeling you get and imagine yourself being there for them. Now turn that feeling towards yourself. Imagine yourself as just another person. Perhaps imagine a younger version of yourself – 8-year-old you having a tough time. Explore the feeling of care and kindness you feel towards that person.
- Calm your inner critic. Notice what you are telling yourself when you’re having a tough time. Are you blaming or criticising yourself in some way? We’re not born self-critical, we learn it. Often it’s our brain’s way of trying to protect us by trying to find problems and fix them, or trying to motivate us. But research shows that self-criticism often backfires – being encouraging and self-compassionate actually makes us more motivated and better at solving problems than being self critical. Think of how well a kid plays soccer with a coach shouting at every mistake versus praising every pass. During your meditation, practice noticing critical self-talk and giving it permission to take a back seat as you focus on safe sensations in the body, or messages of self-kindness (e.g. “It’s OK”).
Tips to help you get started practicing mindfulness
Do I need a special place to meditate?
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.
Can I do it by myself?
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).
Do I need to tell my health care professional I am doing mindfulness meditation?
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.
Can anything go wrong?
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.
Should I dive right into meditating on pain?
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.
Am I joining a cult?
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.
Can anyone do 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.
"Why not ask a friend or family member to learn meditation with you?"
What does it cost?
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.
How do I start?
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.
What if I can’t sit still?
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.
How often should I do mindfulness meditation?
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.
Your turn!
Have a go with these two short guided meditation tracks:
Remember
Mindfulness works! It is something that you need to practice regularly.
A little bit often is a great approach, especially to get started.
There is no right or wrong position to practice, as long as you’re comfortable.
Start out for shorter periods of time and slowly increase the number of minutes you practice – remember meditation seems to work in doses.
Mindfulness is NOT about not thinking. It is about being able to not get bogged down in worry and rumination as you train your attention.
Try a walking meditation outside, or try doing some gentle yoga.
It gets easier the more you do it!
Talk to trusted members of your health care team if you feel unsure or need some tips.
Want more information?
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.
Related management modules
References
- Khoo, E. L., Small, R., Cheng, W., Hatchard, T., Glynn, B., Rice, D. B., … Poulin, P. A. (2019). Comparative evaluation of group-based mindfulness-based stress reduction and cognitive behavioural therapy for the treatment and management of chronic pain: A systematic review and network meta-analysis. Evidence-Based Mental Health, 22(1), 26–35. [PubMed]
- Lin, J., Chadi, N., & Shrier, L. (2019). Mindfulness-based interventions for adolescent health. Current Opinion in Pediatrics, 31(4). [PubMed]
- Ruskin, D., Harris, L., Stinson, J., Kohut, S., Walker, K., & McCarthy, E. (2017). “I Learned to Let Go of My Pain”. The Effects of Mindfulness Meditation on Adolescents with Chronic Pain: An Analysis of Participants’ Treatment Experience. Children, 4(12), 110. [PubMed]
- Zeidan, F., & Vago, D. R. (2016). Mindfulness meditation–based pain relief: a mechanistic account. Annals of the New York Academy of Sciences, 1373(1), 114–127. [PubMed]