How Mindfulness Can Reduce the Physical and Emotional Toll of Pain

Do you have pain? An occasional twinge in the back from sitting too long or a deeper pain from lifting something heavy? A twisted ankle from tripping on a hike or a broken arm from falling off a ladder? Arthritis, neuropathy, or other chronic condition? 

Physical pain contains emotional pain, experienced as a distraction, a weakness, a badge of failure, or fear for the future. Your mood is affected when part of your mind is dealing with pain, regardless of whether it is intermittent and minor or chronic and intense. Some pain responds quickly to treatment, but constant re-injury, age, disease, and other factors gradually increase the likelihood that at some point, you will have at least one experience of acute or chronic pain.

Physicians and researchers recognize three types of acute pain: (a) superficial pain (somatic pain), located on the skin or the tissue directly under the skin; (b) visceral pain, located in the body organs; and (c) referred pain when the pain is felt in a body part not directly damaged (for example, a heart attack may cause nausea and pain in the arms). 

Chronic pain is acute pain that goes on and on. It may be intermittent (as with migraines) or constant, but in either case, the experience and anticipation of pain causes a buildup of pain sensation in the nerve fibers, which is known as “windup.”

Pain Affects Your Emotions

Your experience of pain is difficult to share. A doctor might ask you to describe the pain or rate it from 1 to 10, but the process is sometimes equivalent to writing about music: if you could describe music in words, you wouldn’t need music. Some pain also feels beyond words.

At other times, you think that you have described the pain well, and yet no one understands. They genuinely cannot relate to your pain. Even loved ones may become impatient with your complaints or even with your attempts to hide pain; they act guilty that they cannot relieve you or are frightened as if your pain is somehow “catching.” 

You feel isolated, misunderstood, and angry. The feelings are compounded if you blame yourself for lack of courage or strength of character in bearing your pain, frustration with your inability to heal quickly, and anxiety about the future. You may feel stressed and depressed—anxiety and depression are far more likely among people who live with pain than in the general population.

The connection between your emotions and pain is eased if you:

• Gain some sense of control over the pain.
• Restore some of your normal routines, even if in a different manner or at a slower pace.
• Can better communicate with your doctor and with others in your life about your pain.
• Give yourself compassion, recognizing that you are not weak or a failure for experiencing pain.
• Avoid catastrophizing; pain is bad enough without assuming it makes you unlovable, unworthy, damaged, or in imminent danger unless you avoid all physical activity.

TIP: A visit to the physician should be the first step in dealing with any pain.

Mindfulness Practices That Help with the Emotional Experience of Pain

You may improve your emotional experience of pain with the following SMaRT mindfulness techniques:

• Journaling: By keeping a journal of your experience with pain, you will be able to better describe its location and progression for your doctors. Journaling gives you an outlet for those emotions that you feel you cannot share with others. It may also show you correlations between the pain you experience and other events or experiences in your life.
• Visualization: By visualizing a safe and quiet place where you can safely shed the emotional baggage of pain and often the physical experience of pain, you aid your resiliency and reduce your fear of the future.

TIP: The McGill Pain Questionnaire (MPQ) provides 78 words in 4 categories for describing pain. It is often used in conjunction with the Dartmouth Pain Questionnaire, which focuses on functioning and self-esteem changes. Both of these questionnaires help provide a vocabulary for pain.

Pain Affects Your Entire Body

Experts in the physical experience of pain describe four stages:

• Transduction, when the pain impulse is transmitted to the nerves.
• Transmission, when the nerve impulse travels to the brain.
• Perception, when you realize you are in pain and respond to it (for example, removing your hand from a hot stove)
• Modulation, when pain is increased or decreased depending on the chemicals released by the body in the response (for example, endorphins to decrease pain and glutamate, which amplifies pain).

Pain increases your heart rate and blood pressure, makes your breathing shallow, tenses your muscles, and interferes with your ability to concentrate, among other effects.

Your physical experience of pain is eased if you are able to:

• Remove your attention from pain; distraction can help you bear the pain.
• Decrease repetitive thinking about the pain, including thoughts that lead to self-blame and depression.
• Relieve your stress, which intensifies your experience of pain, in part because you tense muscles that would feel better if relaxed.
• Move your body gently to prevent the pain from incapacitating you further.

TIP: Many drugs work by trying to intercept pain at one of the four stages or mimic the chemicals that decrease pain. Unfortunately, some of those drugs may be addictive, may become less beneficial over time, and may have side effects that negatively affect your quality of life.

Mindfulness Practices That Help with the Physical Experience of Pain

The use of mindfulness practices to treat pain has a long history for a good reason: it works. According to the Mayo Clinic, research in the brain images of people with chronic pain showed that mindfulness reduced activity in the parts of the brain that register pain. 

Many studies have supported the ability of regular mindfulness practices to reduce or even eliminate the need for more powerful opiates. By regularly using mindfulness as a treatment option, you change the way your brain transmits and perceives pain messages, you modulate pain by encouraging the delivery of chemicals that decrease pain, and you take control over your experience of pain.

The following SMaRT mindfulness strategies are especially valuable for dealing with the physical experience of pain:

• Body awareness: Techniques like the body scan will relax individual body parts from the tension of fighting pain and also remind you of those parts of your body that may be pain-free. Yoga, Tai Chi, and Qigong encourage movement that aids your mobility and gives you a sense of control over your body.
• Meditation: The act of meditating removes your attention from the pain, encourages you to feel empowered and in control, and helps you to subdue catastrophizing and fear. Some studies have shown that mindful meditation more than halves the intensity of chronic pain.