For centuries, people have used mindfulness meditation to try to ease their pain, but neurologists have only recently been able to test whether and how it really works. In the latest of these efforts, researchers at the University of California, San Diego School of Medicine measured the effects of mindfulness on pain perception and brain activity.
Research published on July 7, 2022 in PAIN, showed that mindfulness meditation disrupted the connection between brain regions involved in pain perception and those that create well-being. In the proposed mechanism, pain signals still travel from the body to the brain, but the person does not feel as much ownership of these pain sensations, so their pain and suffering is reduced.
“One of the core principles of mindfulness is the principle that you are not your experience,” said senior author Fadel Zeidan, PhD, assistant professor of anesthesiology at UC San Diego School of Medicine. “You train yourself to experience thoughts and sensations without attaching your ego or well-being to them, and now we’re finally seeing how that happens in the brain during the experience of acute pain.”
On the first day of the study, 40 participants had their brains scanned while painful heat was applied to their leg. After a series of these thermal stimuli, the participants had to rate their average pain level during the experiment.
The participants were then divided into two groups. Members of the mindfulness group completed four separate 20-minute mindfulness training sessions. During these visits, they were asked to focus on their breathing and reduce self-referential processing by first acknowledging their thoughts, feelings, and emotions and then letting them go without judging or reacting to them. Members of the control group spent their four sessions listening to an audiobook.
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 excruciating heat, while the control group rested with their eyes closed.
The researchers found that participants who actively meditated reported a 32 percent reduction in pain intensity and a 33 percent reduction in unpleasant pain.
“We were very excited to confirm that you don’t need to be an expert in meditation to experience this pain-relieving effect,” Zeidan said. “This is a really important finding for millions of people who are looking for a fast-acting, non-pharmacological treatment for pain.”
When the team analyzed the participants’ brain activity during the task, they found that mindfulness-induced pain relief was associated with reduced synchronization between the thalamus (a brain region that relays incoming sensory information to the rest of the brain) and parts of the default mode network (a collection of brain regions , most active when a person wanders in his mind or processes his own thoughts and feelings in contrast to the outside world).
One of these default mode areas is the precuneus, a brain region involved in fundamental features of self-awareness and one of the first areas 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 evaluate your experiences. The more these areas were disconnected or deactivated, the more pain relief the participant reported.
“For many people struggling with chronic pain, what most often affects their quality of life is not the pain itself, but the mental anguish and frustration that comes with it,” Zeidan said. “Their pain becomes part of who they are as individuals – something they can’t escape – and it makes their suffering worse.”
By moving away from the self-referential assessment of pain, mindfulness meditation may be a new treatment for pain. Mindfulness meditation is also free and can be practiced anywhere. Still, Zeidan said he hopes the training sessions can be made even more accessible and integrated into standard outpatient procedures.
“We feel we are on the cusp of uncovering a novel non-opioid pain mechanism in which the default mode network plays a critical role in generating analgesia. We are excited to continue exploring the neurobiology of mindfulness and its clinical potential in a variety of disorders.”
Co-authors include Gabriel Rigner, Valeria Oliva and William Mobley of the University of California, San Diego, as well as Grace Posey of Tulane University and Yangkyu Jung of the University of California, Davis.