meditation, neuroscience, pain management

Mindfulness meditation alleviates pain by separating it from the self.

The neural circuitry supporting mindfulness-induced pain reduction is revealed by University of California San Diego research.

Neuroscientists have just lately been able to investigate if and how mindfulness meditation truly works, despite the fact that people have been practicing it to attempt to relieve their pain for millennia. In the most recent of these initiatives, scientists at the University of California San Diego School of Medicine assessed how mindfulness affected both brain activity and perception of pain.

meditation, neuroscience, pain management

Fadel Zeidan, Ph.D., is an associate professor of anesthesiology at UC San Diego School of Medicine. Credit: UC San Diego Health Sciences

The research, which was just published in the journal PAIN, demonstrated that practicing mindfulness meditation cut off the communication between the parts of the brain responsible for feeling pain and those that generate self-awareness. In the proposed mechanism, pain signals still go from the body to the brain, but since the person has less ownership over those painful feelings, they experience less pain and suffering.

“One of the central tenets of mindfulness is the principle that you are not your experiences,” said senior author Fadel Zeidan, Ph.D., associate professor of anesthesiology at UC San Diego School of Medicine. “You train yourself to experience thoughts and sensations without attaching your ego or sense of self to them, and we’re now finally seeing how this plays out in the brain during the experience of acute pain.”

On the first day of the experiment, 40 individuals had their brains scanned while having their legs exposed to intense heat. The experiment required volunteers to rate their typical pain levels after being exposed to a series of various heat stimuli.

Two groups of participants were then formed. Four distinct 20-minute mindfulness training sessions were completed by the group’s participants. They were told to concentrate on their breathing and lessen self-referential processing during these visits by noting their thoughts, feelings, and sensations before letting them go without analyzing or reacting to them. Participants in the control group listened to an audiobook for their four sessions.

On the final day of the study, both groups had their brain activity measured again, but participants in the mindfulness group were now instructed to meditate during the painful heat, while the control group rested with their eyes closed.

Researchers found that participants who were actively meditating reported a 32 percent reduction in pain intensity and a 33 percent reduction in pain unpleasantness.

“We were really excited to confirm that you don’t have to be an expert meditator to experience these analgesic effects,” said Zeidan. “This is a really important finding for the millions of people looking for a fast-acting and non-pharmacological treatment for pain.”

When the team analyzed participants’ brain activity during the task, they found that mindfulness-induced pain relief was associated with reduced synchronization between the thalamus (a brain area that relays incoming sensory information to the rest of the brain) and parts of the default mode network (a collection of brain areas most active while a person is mind-wandering or processing their own thoughts and feelings as opposed to the outside world).

One of these default mode regions is the precuneus, a brain area involved in fundamental features of self-awareness, and one of the first regions to go offline when a person loses consciousness. Another is the ventromedial prefrontal cortex, which includes several subregions that work together to process how you relate to or place value on your experiences. The more these areas were decoupled or deactivated, the more pain relief the participant reported.

“For many people struggling with chronic pain, what often affects their quality of life most is not the pain itself, but the mental suffering and frustration that comes along with it,” said Zeidan. “Their pain becomes a part of who they are as individuals — something they can’t escape — and this exacerbates their suffering.”

By relinquishing the self-referential appraisal of pain, mindfulness meditation may provide a new method for pain treatment. Mindfulness meditation is also free and can be practiced anywhere. Still, Zeidan said he hopes that training can be made even more accessible and integrated into standard outpatient procedures.

“We feel like we are on the verge of discovering a novel non-opioid-based pain mechanism in which the default mode network plays a critical role in producing analgesia. We are excited to continue exploring the neurobiology of mindfulness and its clinical potential across various disorders.”

Reference: “Disentangling self from pain: mindfulness meditation-induced pain relief is driven by thalamic-default mode network decoupling” by Gabriel Riegner, Grace Posey, Valeria Oliva, Youngkyoo Jung, William Mobley and Fadel Zeidan, 7 July 2022, PAIN.
DOI: 10.1097/j.pain.0000000000002731

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