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Notes on Pain Issue 3 from Stephani Sutherland, PhD.  
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The Mindfulness Edition                                July 2016

 

As much as I would love to report that a wonder drug or a miracle cure for chronic pain is just around the corner, it’s simply not. Even worse—and every researcher I talk to agrees: one probably never will be. Instead, they say, patients need to take ownership of their pain management rather than hoping for a solution in the form of pills or surgery. Non-drug therapies, they say, should be integrated with any medical treatments to reduce pain and disability as much as possible. Of course, such a strategy requires tremendous resources, including good health insurance, social support, and a whole lot of gumption—all of which can be hard to come by, particularly for people living with chronic pain. But the data show that the best hope for mitigating the hardship of chronic pain lies in a multi-disciplinary approach that addresses not only the physical sensation of pain but also its emotional and mental toll.
 
What does that approach look like? Ideally, pain patients would have a team of specialists to help tackle various aspects of the experience. The most “successful” pain patients have the support of friends and family and often a therapist of some sort. They get plenty of sleep, they exercise, they avoid foods that contribute to their pain. They know when to limit activities that might trigger a flare-up. And, increasingly, they practice yoga, mindfulness, or meditation. These practices are not meant to replace medical care but to augment it. And even the most disciplined practice won’t entirely erase chronic pain for most people, but if it can make a difference, many patients find it a worthwhile investment of their time and energy. That’s certainly my own experience. When I was 17, surgeons fused a foot-long steel rod to my spine to halt the progression of severe scoliosis. Over the years, I have developed a daily yoga and meditation practice that keeps my back pain at bay. When I skip my practice, I face the consequences.
 
While personal experience guides my own practice, doctors, patients and insurance companies have to rely on hard data to show benefits of mindfulness and other approaches. Today, that data is slowly emerging, and that is the subject of the articles I present to you this month. For RELIEF, I wrote a feature examining several complementary and integrative therapies. (Notice I don’t call them “alternative”—more about that in the article.) For Pain Research Forum and RELIEF, I covered breaking news about a clinical trial showing that mindfulness is effective for low back pain, and another study that gets at how it might work. (That study is from Fadel Zeidan, featured this month In the Spotlight.) Sadly, no miracle cure for chronic pain is on the horizon, but researchers are now providing evidence that practices such as mindfulness can help. And to me, that’s news worth celebrating.

Speaking of which, for more news, stories & behind-the-scenes glimpses of my work, why not check out my blog?

In the Spotlight

Fadel Zeidan

In May, I traveled to Austin, Texas, for the annual meeting of the American Pain Society. As at any great science meeting, some of the best conversations happened after hours. After a great dinner with a bunch of pain researchers, I ran into Fadel Zeidan on the street. “What are you up to?” he asked. “Oh, covering the meeting for Pain Research Forum,” I began. “No, no. What are you doing right now? Come with us.” A short time later, a group of us were huddled in a tiny room inside a speakeasy called Midnight Cowboy being served cocktails handcrafted by a surly but friendly mixologist named Jeff. We chatted about brain imaging, mindfulness, world travel and the challenges of parenthood until the wee hours. I always enjoy the chance to get to know the people behind the research, and talking to Zeidan was particularly fun. (The cocktails probably didn't hurt.)
 
Although he was born in Kuwait City and grew up all over the U.S. (including Wisconsin, Chicago, Pennsylvania and North Carolina), he describes his ethnicity as “100% Palestinian.” As an undergrad, Zeidan—like me—studied psychology, and—also like me—felt disillusioned by the subjective nature of that science. He wanted to understand the roots of consciousness, which led him to the burgeoning field of neuroscience. “I wanted to get at some form of an answer to these philosophical questions that were being presented in my classes, and neuroimaging and neuroscience as a whole allowed us to get closer to answering questions about consciousness with an objective, quantifiable approach.” After earning his PhD in health psychology, Zeidan turned down job offers as a pharmaceutical representative and began volunteering in the lab of Robert Coghill, a pain researcher and brain imager then at Wake Forest University in North Carolina (he is now Director of Research at Cincinnati Children's Hospital). There, Zeidan says, he “fell in love with pain” as a way to study human experience. “It’s one of the coolest ways to study consciousness, because it’s a subjective experience where sensation, cognition, and emotion all interact.” And while he recognizes the limitations of functional magnetic resonance imaging (fMRI), the tool allows researchers to tease those apart those elements that make up our minute-to-minute experience, he says.
 
In 2007, Zeidan was awarded a research grant that launched his career, from the Mind and Life Institute, an organization dedicated to the scientific study of contemplative practices. He officially joined the Coghill lab as a postdoctoral fellow and used the grant money to study the effects of mindfulness on pain. Since then, Zeidan has become a leader in the field of brain imaging of mindfulness. In 2014, he won the National Institute of Health’s esteemed Mitchell Max Prize, awarded each year to a young pain investigator. 

So, does Zeidan practice mindfulness?

“I try to be mindful. I try to be in the present moment, but I don’t have a daily practice.” Zeidan worries that if he becomes too engrossed in the practice of mindfulness, he might lose his objectivity in studying its effects. And he hopes to boil down those effects to come up with a prescription for people in pain.

Those questions are still years away from being answered, but Zeidan is encouraged by recent developments, such as the clinical trial showing that mindfulness is effective for low back pain, and particularly by the finding that its effects appear to be long-lasting.

“That’s critical for patients, because pain is not going to go away on its own.”

For Further Reading

Meditation Reduces Emotional Pain by 44%
by Mandy Oaklander, Time
 
Neuroscience Reveals the Secrets of Meditation’s Benefits
by Matthieu Ricard, Antoine Lutz, and Richard J. Davidson, Scientific American
 
How Yoga Changes the Brain
by Stephani Sutherland, Scientific American Mind
Fadel Zeidan

#AmWriting

Complementary Therapies for Chronic Pain: What Does the Research Say?
RELIEF
 
Clinical Trial Shows Mindfulness Can Relieve Chronic Low Back Pain
RELIEF
 
The Brain in Pain: An Interview with Karen Davis
RELIEF
 

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In-Depth:  The Pain Research Forum

Mindfulness Effective for Chronic Low Back Pain in Clinical Trial
 by Stephani Sutherland

2016 Annual Scientific Meeting of the American Pain Society Highlights: Part 1 
by Stephani Sutherland
 
Highlights… Part 2
by Stephani Sutherland

Highlights… Part 3
by Stephani Sutherland
 

Past Issues of Notes on Pain

Shining a Light on Pain
June 2016

A Long Time Coming
May 2016
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Stephani Sutherland, PhD · 272A Belmont Avenue · Long Beach, CA 90803 · USA

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