"Meditation better than morphine for pain relief"?

[Orphia Nay]

Meditation produces powerful pain-relieving effects in the brain, according to new research published in the April 6 edition of the Journal of Neuroscience.

“This is the first study to show that only a little over an hour of meditation training can dramatically reduce both the experience of pain and pain-related brain activation,” said Fadel Zeidan, Ph.D., lead author of the study and post-doctoral research fellow at Wake Forest Baptist Medical Center.

“We found a big effect – about a 40 percent reduction in pain intensity and a 57 percent reduction in pain unpleasantness. Meditation produced a greater reduction in pain than even morphine or other pain-relieving drugs, which typically reduce pain ratings by about 25 percent.”

For the study, 15 healthy volunteers who had never meditated attended four, 20-minute classes to learn a meditation technique known as focused attention. Focused attention is a form of mindfulness meditation where people are taught to attend to the breath and let go of distracting thoughts and emotions.

Both before and after meditation training, study participants’ brain activity was examined using a special type of imaging -- arterial spin labeling magnetic resonance imaging (ASL MRI) -- that captures longer duration brain processes, such as meditation, better than a standard MRI scan of brain function. During these scans, a pain-inducing heat device was placed on the participants’ right legs. This device heated a small area of their skin to 120° Fahrenheit, a temperature that most people find painful, over a 5-minute period.

The scans taken after meditation training showed that every participant’s pain ratings were reduced, with decreases ranging from 11 to 93 percent, Zeidan said.

http://www.wakehealth.edu/News-Rele...g_Illustrates_How_Meditation_Reduces_Pain.htm

A sample size of 15?

"Funding for the study was provided by the Mind and Life Institute in Boulder, Colo., and the Center for Biomolecular Imaging at Wake Forest Baptist"?

Were some people not given the heat pad till after the meditation? (Maybe the test shows that people can become used to pain very quickly without any treatment whatsoever.)

 

[andyandy]

A sample size of 15?

You can get significant results even from small samples.....

"Funding for the study was provided by the Mind and Life Institute in Boulder, Colo., and the Center for Biomolecular Imaging at Wake Forest Baptist"?

?

Here is the abstract:

J Neurosci. 2011 Apr 6;31(14):5540-8.
Brain mechanisms supporting the modulation of pain by mindfulness meditation.

Zeidan F, Martucci KT, Kraft RA, Gordon NS, McHaffie JG, Coghill RC.

Departments of Neurobiology and Anatomy and Biomedical Engineering, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157, and Psychology Department, Marquette University, Milwaukee, Wisconsin 53233.
Abstract

The subjective experience of one's environment is constructed by interactions among sensory, cognitive, and affective processes. For centuries, meditation has been thought to influence such processes by enabling a nonevaluative representation of sensory events. To better understand how meditation influences the sensory experience, we used arterial spin labeling functional magnetic resonance imaging to assess the neural mechanisms by which mindfulness meditation influences pain in healthy human participants. After 4 d of mindfulness meditation training, meditating in the presence of noxious stimulation significantly reduced pain unpleasantness by 57% and pain intensity ratings by 40% when compared to rest. A two-factor repeated-measures ANOVA was used to identify interactions between meditation and pain-related brain activation. Meditation reduced pain-related activation of the contralateral primary somatosensory cortex. Multiple regression analysis was used to identify brain regions associated with individual differences in the magnitude of meditation-related pain reductions. Meditation-induced reductions in pain intensity ratings were associated with increased activity in the anterior cingulate cortex and anterior insula, areas involved in the cognitive regulation of nociceptive processing. Reductions in pain unpleasantness ratings were associated with orbitofrontal cortex activation, an area implicated in reframing the contextual evaluation of sensory events. Moreover, reductions in pain unpleasantness also were associated with thalamic deactivation, which may reflect a limbic gating mechanism involved in modifying interactions between afferent input and executive-order brain areas. Together, these data indicate that meditation engages multiple brain mechanisms that alter the construction of the subjectively available pain experience from afferent information.

http://www.ncbi.nlm.nih.gov/pubmed/21471390

Were some people not given the heat pad till after the meditation? (Maybe the test shows that people can become used to pain very quickly without any treatment whatsoever.)

"After 4 d of mindfulness meditation training, meditating in the presence of noxious stimulation significantly reduced pain unpleasantness by 57% and pain intensity ratings by 40% when compared to rest."

There's already loads of peer reviewed studies which attest to the efficacy of meditation in pain relief - but for whatever reason all this evidence has to work 10 times as hard to convince people as if it was a pill with the same evidence. People simply seem naturally resistant to the idea that mind-related activities can reduce pain, I'm not sure why.

 

[Emet]

Here's a blog article from NPR about the study:

http://www.npr.org/blogs/health/2011/04/08/135146672/even-beginners-can-curb-pain-with-meditation

 

[Fnord]

I want my ...
I want my ...
I want my morphine, please ...

 

[slow lurker]

Do I understand correctly?

A small group is subjected to a moderately painful procedure.
They get training in meditation.
They are subjected to the same moderately painful procedure as before.
They apparently feel less pain.

The conclusion we are supposed to draw is that the difference is the meditation training.

Nothing to do with familiarity with the painful procedure and how long it will last, etc.

I am not buying it based on just this study.

 

[Orphia Nay]

Do I understand correctly?

A small group is subjected to a moderately painful procedure.
They get training in meditation.
They are subjected to the same moderately painful procedure as before.
They apparently feel less pain.

The conclusion we are supposed to draw is that the difference is the meditation training.

Nothing to do with familiarity with the painful procedure and how long it will last, etc.

I am not buying it based on just this study.

Thankyou. That sums up my thoughts better than I phrased them myself.

 

[andyandy]

Do I understand correctly?

A small group is subjected to a moderately painful procedure.
They get training in meditation.
They are subjected to the same moderately painful procedure as before.
They apparently feel less pain.

The conclusion we are supposed to draw is that the difference is the meditation training.

Nothing to do with familiarity with the painful procedure and how long it will last, etc.

I am not buying it based on just this study.

Familiarity with the process was controlled for. The linked article about the study gives more details on this.

In this study, subjects who paid attention to their breathing to mimic meditation saw no significant change in pain. And, in a previous study, subjects given fake training failed to see meditation's effects, even though they believed they were actually performing mindfulness meditation.

Every part of the body is mapped to a specific part of the brain called the primary somatosensory cortex. "If I touch you on your left hand right above your left knuckle, there is an area in the brain that corresponds to that specific area in your hand that will be activated," Zeidan explains. "When you are in pain it is much more activated — more intense and more widespread."

This activation shows up on MRI brain scans. When subjects experienced the heat stimulus under normal conditions, the "right calf" part of the primary somatosensory cortex lit up. But after the subjects were trained in meditation, the activity in this region was not even detectable.

Brain images also show that meditation increased activation in areas of the brain related to cognitive control and emotion — areas where the experience of pain is built. What's more, better meditators (those who scored higher on a standard scale of mindfulness) tended to have more activation in these areas and a lower experience of pain.

http://www.npr.org/blogs/health/2011/04/08/135146672/even-beginners-can-curb-pain-with-meditation

They compared pain scores with people who had just had rest and with people who had just done breathing exercises. They also looked at MRI scans and saw significant changes here too. This was published in the Journal of Neuroscience, peer reviewed articles normally understand what controls are!

If there was a pill (MedX) that had exactly the same peer reviewed evidence of efficacy in reducing pain, and exactly the same cost (basically free - after perhaps needing an initial training session) and exactly the same side effects (basically none - certainly when compared to other pain relief medication it would be much much safer) it would be being prescribed in every doctor's surgery in the country. The only reasons meditation is not:

1) many people are still locked into a mind body dualism which separates the mind and body as distinct entities. It should be no surprise that the mind affects the body and the body affects the mind. They are after all just part of the same system.

2) There is not the massive marketing and PR self-interests lobbying for it as would be for a pill that can make Pharma A lots of money (and associated with this, no-one willing to fund expensive large scale trials).

3) It takes the "sphere of responsibility" away from the doctor (ie - you give me a pill and make me better), and towards the patient (ie - i have to do something to make me better....). This runs contrary to our expectations and so many people reject it....

 

[Pup]

This seems intuitively right to me, since I find pain to be very variable, and controllable to some extent by mental action alone. Even though I've never been able to get any benefit from meditation or even figure out what people are talking about when they try to tell me how to do it, I can get the benefits that people claim for meditation with other mental exercises.

To me, the question is what use is this? In other words, if you meditate for X minutes, will you get pain relief for X hours (great for chronic pain, as useful as morphine), or does it only last a few minutes after the meditation, so chronic pain sufferers would need to spend most of their day meditating to get any relief (not really practical)? Does it work for intense, acute pain (getting a tooth filled) or nagging, chronic pain (a sore back) or both? Do you need to meditate before the pain starts to prevent it, or will it work after the pain has started also to make it go away? Can the pain be so great that it prevents the person from meditating and thus makes the benefits impossible to achieve?

To me, those are the more important questions when considering what current painkillers it could replace.

 

[Squeegee Beckenheim]

To me, the question is what use is this? In other words, if you meditate for X minutes, will you get pain relief for X hours (great for chronic pain, as useful as morphine), or does it only last a few minutes after the meditation, so chronic pain sufferers would need to spend most of their day meditating to get any relief (not really practical)? Does it work for intense, acute pain (getting a tooth filled) or nagging, chronic pain (a sore back) or both? Do you need to meditate before the pain starts to prevent it, or will it work after the pain has started also to make it go away? Can the pain be so great that it prevents the person from meditating and thus makes the benefits impossible to achieve?

Purely anecdotal but on anther message board I frequent a poster claims that they used to suffer from debilitating pain which he had to take so many drugs for that he couldn't function on a day-to-day basis. He tried meditation and managed to get it under control with a couple of hours meditation. He now claims that he is so practised at it that he can meditate for 5 minutes at the beginning of the day and then go about his business without ever noticing his pain.

If that's true, then it would be a very useful tool, albeit one which takes a long time to become truly effective.

I remain sceptical, though, as he is a believer in various forms of woo. One of those types who likes to think of themselves as having a rational approach, but then jumping on to ideas like the stone tape "theory" for ghosts, and who then become defensive and angry when you point out that there's no possible mechanism for that and that it, in and of itself, would require as much of a re-writing of the laws of physics as ghosts would.

 

[marplots]

Here's the part I have a beef with: "Meditation produced a greater reduction in pain than even morphine or other pain-relieving drugs, which typically reduce pain ratings by about 25 percent."

Morphine for pain relief is a dose-dependent phenomena. "Typically" is the weasel word in the quote. I can give you more morphine and you will get greater pain relief. I can give you enough morphine that you won't even respond to getting your leg cut off. Can you take more meditation if you don't get the necessary level of relief?

Having pain reducing chemicals in the brain isn't a shocker, but wouldn't you expect them to become depleted? One solution would be to give biologically active chemicals from outside the brain that mimic the effects... maybe morphine?

 

[Alan]

Pain is very subjective.

 

[andyandy]

Here's the part I have a beef with: "Meditation produced a greater reduction in pain than even morphine or other pain-relieving drugs, which typically reduce pain ratings by about 25 percent."

Morphine for pain relief is a dose-dependent phenomena. "Typically" is the weasel word in the quote. I can give you more morphine and you will get greater pain relief. I can give you enough morphine that you won't even respond to getting your leg cut off. Can you take more meditation if you don't get the necessary level of relief?

Having pain reducing chemicals in the brain isn't a shocker, but wouldn't you expect them to become depleted? One solution would be to give biologically active chemicals from outside the brain that mimic the effects... maybe morphine?

Well, it depends whether your brain develops a "tolerance" to meditation - ie you need more and more to achieve the same results. I don't know - but i don't see why you would expect that. If anything i would expect the reverse - that changing the way the brain processes pain would be a long term phenomenon that could be maintained after meditation had finished.

Certainly when comparing to (say) morphine - well, tolerance here definitely does build up - as does very significant addiction.

 

[andyandy]

Looking at long-term changes in brain structure, which seems to increase with longer meditative practise :

Previous research indicates that long-term meditation practice is associated with altered resting electroencephalogram patterns, suggestive of long lasting changes in brain activity. We hypothesized that meditation practice might also be associated with changes in the brain’s physical structure. Magnetic resonance imaging was used to assess cortical thickness in 20 participants with extensive Insight meditation experience, which involves focused attention to internal experiences. Brain regions associated with attention, interoception and sensory processing were thicker in meditation participants than matched controls, including the prefrontal cortex and right anterior insula. Between-group differences in prefrontal cortical thickness were most pronounced in older participants, suggesting that meditation might offset age-related cortical thinning. Finally, the thickness of two regions correlated with meditation experience. These data provide the first structural evidence for experience-dependent cortical plasticity associated with meditation practice.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1361002/

 

[Skwinty]

Although my opinion is anecdotal, I call BS on this.

When I was lying in ICU with 5 fractured ribs, collapsed lung and massive internal trauma, meditation did nothing, but the morphine sure helped.

The pethidine was of great benefit as well.

 

[andyandy]

Although my opinion is anecdotal, I call BS on this.

When I was lying in ICU with 5 fractured ribs, collapsed lung and massive internal trauma, meditation did nothing, but the morphine sure helped.

The pethidine was of great benefit as well.

It's clear that the sentence taken from the lead author in an interview is referring to the study in question - ie pain from a heat press. It's not referring to being in intensive care.

 

[Andrew Wiggin]

My own personal anecdote; waking up from surgery and asking the nurse to hold off with the morphine so I could see if I could get the pain under control myself. About ten minutes later I was waving my hand in the air, saying 'I think I'll take that shot now'.

 

[Dancing David]

http://www.wakehealth.edu/News-Rele...g_Illustrates_How_Meditation_Reduces_Pain.htm

A sample size of 15?

"Funding for the study was provided by the Mind and Life Institute in Boulder, Colo., and the Center for Biomolecular Imaging at Wake Forest Baptist"?

Were some people not given the heat pad till after the meditation? (Maybe the test shows that people can become used to pain very quickly without any treatment whatsoever.)

The main problem is that they did not use morphine in the trail. People's tolerance for the heat would be much higher with morphine. They made a bogus association and did not measure tehe effect of teh use of actual morphine. In fact given enough morphine people would tolerate damage and burns.

 

[Dancing David]

It's clear that the sentence taken from the lead author in an interview is referring to the study in question - ie pain from a heat press. It's not referring to being in intensive care.

But they did not measure the effect of morphine, they just plugged in an number from somewhere. That is called error. Morphine can just mask minor pain therefore the 25% figure is specious.

 

[Dancing David]

http://www.ncbi.nlm.nih.gov/pubmed/21471390

His statement in the article is not is the study.

So it is NOT more effective than morphine. That is just an aside they made with out testing, I bet you give the subject the standard dose of morphine and they would tolerate the pain until the dose wore off. I would be willing to bet this was not what meditating subjects would do in terms of time.

 

[fls]

Familiarity with the process was controlled for. The linked article about the study gives more details on this.

http://www.npr.org/blogs/health/2011/04/08/135146672/even-beginners-can-curb-pain-with-meditation

They compared pain scores with people who had just had rest and with people who had just done breathing exercises. They also looked at MRI scans and saw significant changes here too. This was published in the Journal of Neuroscience, peer reviewed articles normally understand what controls are!

If there was a pill (MedX) that had exactly the same peer reviewed evidence of efficacy in reducing pain, and exactly the same cost (basically free - after perhaps needing an initial training session) and exactly the same side effects (basically none - certainly when compared to other pain relief medication it would be much much safer) it would be being prescribed in every doctor's surgery in the country.

This is incorrect. A drug with scant level B evidence would not substitute for drugs or other treatments with solid level A evidence for efficacy which are already usually cheap and safe. I'm also not sure how often we would encounter these circumstances - three days warning for a short-lived encounter with mild to moderate pain - so I'm not sure how it could have any clinical impact based on the highly artificial results of this study.

Linda