Psychological factors are important contributors to the intensity of pain and to the disability associated with chronic pain. Pain and stress are intimately related. There may be a continuous cycle in which pain causes stress, and stress, in turn, causes more pain. Mind/body approaches provide a variety of benefits, including a greater sense of control, improved coping skills, decreased pain intensity and distress, changes in the way pain is perceived and understood, and increased sense of well-being and relaxation.
Mind-Body focuses on the interactions among the brain, the rest of the body, the mind, and behavior. The ways in which emotional, mental, social, spiritual, experiential, and behavioral factors can directly affect health.
There are several mind-body interventions including relaxation, meditation, imagery, biofeedback, and hypnosis.
- Meditation is one of the most widely used forms of complementary therapy, particularly as a palliative for chronic illness. Available meditation research is generally of low-to-modest quality, but tends to support this intervention for the reduction of stress and pain, and improving quality of life in a variety of medical conditions.
- Hypnosis is a state of deep relaxation, which involves selective focusing, receptive concentration, and minimal motor functioning. A National Institutes of Health Technology Panel found strong support for the use of hypnosis for the reduction of pain. Individuals can be taught to use hypnosis themselves (self-hypnosis), and the use of self-hypnosis can provide pain relief for up to several hours at a time.
- Relaxation and biofeedback are directed toward helping persons with chronic pain become aware of their ability to exert some control over physiologic processes of which they are not normally aware (e.g., muscle tension, heart rate, skin temperature, and respiration).
- Relaxation, self-hypnosis, and meditation techniques are a form of physiologic self-management. They assist individuals with muscle relaxation and distraction away from pain perception.
- Biofeedback uses feedback from a device or computer to give information about a person’s progress. This can be particularly useful in headaches and chronic pain in which pain tends to tense muscles, which often causes increased pain due to muscle fatigue.
There are a variety of meditative practices, with the most studied one for chronic pain being mindfulness-based stress reduction (MBSR). Mindfulness is a way of learning to relate directly to whatever is happening in your life, a way of taking charge of your life, a way of doing something for yourself that no one else can do for you — consciously and systematically working with your own stress, pain, illness, and the challenges and demands of everyday life. Mindfulness-based stress reduction is intended to ignite this inner capacity and infuse your life with awareness. MBSR is another form of meditation that has been applied to stress reduction.
Recent results from NIH-funded studies on CAM mind-body therapies include:
- Pain sufferers often seek relief though CAM therapies, including mind-body modalities. A review of the evidence on various mind-body therapies to help treat certain neurological diseases involving pain found some evidence for positive effects from some therapies–including biofeedback for migraine headache, yoga for fatigue from multiple sclerosis, and relaxation therapy as a part of comprehensive programs to help control epileptic seizures.
- In a study of 60 breast cancer survivors, women who used hypnosis reduced the number and severity of hot flashes and also reported improvements in mood and sleep.
- A small preliminary trial suggests that Zen meditation may be a strategy to help prevent and/or reduce the cognitive decline of normal aging.
- A study of 63 people with rheumatoid arthritis found that Mindfulness Based Stress Reduction helped to improve quality of life and reduce psychological distress.
- A study of 298 college students found that Transcendental Meditation helped students reduce stress and improve coping strategies.
- In a study of 50 women, regular practice of yoga benefited mood and physiological response to stress.
- People with fibromyalgia may benefit from practicing tai chi according to a study in 66 people. Study participants who practiced tai chi had a significantly greater decrease in total score on the Fibromyalgia Impact Questionnaire. In addition, the tai chi group demonstrated greater improvement in sleep quality, mood, and quality of life.
- Tai chi may also be a safe alternative to conventional exercise for maintaining bone mineral density in postmenopausal women, thus helping to prevent or slow osteoporosis, increase musculoskeletal strength, and improve balance.