Chronic pain: the role of Mindfulness and Biofeedback in the treatment of persistent pain
Feeling pain is normal and part of our immune system . The body uses pain as an alarm signal, a warning that tells us that something is not right and that for some reason we are in danger. However, this feeling usually goes away as soon as the threat disappears.
What happens when the pain never goes away and becomes part of the individual’s life? Then we are faced with a problem of chronic pain .
What is chronic pain?
If you are not completely sure what chronic pain is, you can start by watching this video on its main features:
Who suffers from chronic pain?
According to a study by Oye Gureje and her collaborators, approximately 23% of people suffer from chronic pain . This rate increases with age, affecting up to a third of the elderly population. In addition, the World Health Organization itself recognizes that it is a highly disabling problem in all its forms: low back pain, arthritis, headache, fibromyalgia, among many others.
The pain that accompanies these problems is not always the same: there will be days when the person who suffers them only feels discomfort -this being a good day- and others when the pain will be so intense that he or she will not be able to move from the chair.
Episodes of pain are impossible to avoid; one must learn to live with them and find ways to manage them as much as possible. The best way to do this is through stress management.
Thanks to a study by Dr. Kimberly T. Sibille, we know that people with chronic pain show higher levels of stress than other people, both biochemically and psychologically. In addition, when we are under stress our perception of pain is increased. Thus, people with pain enter a vicious circle in which they feel more pain when faced with a stressful event, thus generating more stress and escalating their suffering.
The role of the psychologist is to break this cycle so that the patient does not live these episodes in such a painful way and improve his or her quality of life. The key to pain management lies in the control assessment, or the belief that one has the resources to manage the pain.
How can we get someone to learn to manage chronic pain? Both biofeedback and Mindfulness have proved effective in this respect.
Techniques for managing chronic pain: Biofeedback
Broadly speaking, the basic component of training in biofeedback is learning to control various biological functions using the information from those functions.
In chronic pain, an electromyography is performed. A very thin needle electrode is inserted through the skin into the muscle. The electrode on the needle detects the electrical activity released by the muscles. This activity appears on a monitor nearby and can be heard through a speaker. Thus, the patient is able to identify pain signals, control muscle tension to achieve relaxation and thus lessen the experience of pain, etc.
The philosophy of Mindfulness
The philosophy of Mindfulness is based mainly on living the present, on being attentive to what is happening without judging, or interpreting. In other words, it is based on accepting reality as it is. In fact, it is sometimes considered as a technique of other therapies such as acceptance and commitment therapy.
We invite you to discover the psychological benefits of Mindfulness by consulting these articles:
“What is Mindfulness?: The 7 answers to your questions”
“Mindfulness: 8 psychological benefits of full attention”
Its application in patients with chronic pain is based on the idea that it can help them to accept pain and therefore reduce avoidance , and to have more control over their attentional processes so linked to the perception of pain. In fact, when Mindfulness is assessed as a capacity or personality trait it correlates with pain. People who score higher in Mindfulness feel less pain, have a higher quality of life and suffer fewer negative emotions.
There are many other techniques such as relaxation for problems such as headaches or migraines, emotional writing to make sense of the experience, or training the person to fix their attention elsewhere than on their pain during the episodes. Each patient will do well with a different type of intervention depending on their characteristics and their episodes.
This makes it clear that if you suffer from any chronic pain condition, no matter how disabling, it is possible to learn to manage and live with it. To quote Gautama Buddha: “Pain is inevitable but suffering is optional”
- Gureje, O., Simon, G. E. and Von Korff, M. (2001). A cross-national study of the course of persistent pain in primary care. Pain , 92, 195-200. doi:10.1016/S0304-3959(00)00483-8
- McCracken, L. M. and Velleman, S. C. (2010). Psychological flexibility in adults with chronic pain: a study of acceptance, mindfulness, and values-based action in primary care. Pain , 148,141-147.
- Sibille, K. T., Langaee, T., Burkley, B., Gong, Y., Glover, T. L., King, C., … Fillingim, R. B. (2012). Chronic pain, perceived stress, and cellular aging: an exploratory study. Mol Pain , 8:12.
- Van Uum, S. H. M., Sauvé, B., Fraser, L. a, Morley-Forster, P., Paul, T. L. and Koren, G. (2008). Elevated content of cortisol in hair of patients with severe chronic pain: a novel biomarker for stress. Stress (Amsterdam, Netherlands), 11, 483-488. doi:10.1080/10253890801887388