Pain Relief with Mindfulness Meditation

Researchers report that mindfulness meditation—unlike other cognitive-based approaches to reduce pain, such as hypnosis, acupuncture, distraction, and even the placebo effect—does not appear to utilize the endogenous opioid system to reduce pain.

Study findings published in the Journal of Neuroscience provide “novel evidence demonstrating that mindfulness meditation produces greater pain relief and employs distinct neural mechanisms than placebo cream and sham mindfulness meditation,” according to the authors.

Led by Fadel Zeidan, PhD, assistant professor of neurobiology and anatomy at Wake Forest Baptist Medical Center, the study team found that mindfulness meditation—unlike other cognitive-based approaches to reduce pain, such as hypnosis, acupuncture, distraction, and even the placebo effect—does not appear to utilize the endogenous opioid system to reduce pain.

“Our finding was surprising and could be important for the millions of chronic pain sufferers who are seeking a fast-acting, non-opiate-based therapy to alleviate their pain,” said Zeidan. The finding is all the more important considering that the approximately 100 million Americans who suffer from chronic pain—according to estimates from the Institute of Medicine—spend more than $600 billion annually on treatment. The finding could also provide much-needed relief to the increasing problem of opioid addiction from prescription medications to heroin, which the CDC has labeled an epidemic.

Although mindfulness meditation had been shown in previous research to reduce pain in experimental and clinical settings, whether it engaged pain-relieving mechanisms other than those associated with the placebo effect (eg, conditioning, psychological context, beliefs) had yet to be defined.

To determine if the analgesic mechanisms of mindfulness meditation are different from placebo or use the body’s opioids, the researchers injected participants with naloxone to block the pain-reducing effects of opioids and then randomly assigned 75 healthy volunteers to 4 days (20 minutes per day) of the following:

  • Mindfulness meditation plus naloxone
  • Non-meditation control plus naloxone
  • Meditation plus saline placebo
  • Non-meditation control plus saline placebo

The study teamed used a thermal probe to heat a small area of participants’ skin to 120.2 degrees, a heat most people find very painful. Participants rated their pain on a sliding scale. Patients in the meditation plus naloxone group experienced a 24% reduction from baseline in pain ratings.

According to Zeidan, this finding shows that even when opioid receptors are chemically blocked, meditation appears to be able to significantly reduce pain by using a different pathway. The mediation plus placebo-saline injection group also experienced a reduction in paint ratings, down 21% from baseline. However, participants in both non-meditation control groups—either with naloxone or placebo-saline injection—actually reported increases in pain.

“Our team has demonstrated across four separate studies that meditation, after a short training period, can reduce experimentally induced pain,” said Zeidan. “And now this study shows that meditation doesn't work through the body's opioid system. This study adds to the growing body of evidence that something unique is happening with how meditation reduces pain. These findings are especially significant to those who have built up a tolerance to opiate-based drugs and are looking for a non-addictive way to reduce their pain.”

In a follow-up study, the investigators hope to determine if and how mindfulness meditation can affect a number of various chronic pain conditions.

“At the very least, we believe that meditation could be used in conjunction with other traditional drug therapies to enhance pain relief without it producing the addictive side effects and other consequences that may arise from opiate drugs,” said Zeidan.