Mindfulness Meditation and Chronic Pain

Dear Pain Matters blog readers,

Recently, I bought a book that discussed the possibility of being pain-free through mindfulness meditation (Penman and Burch, 2013).

Science shows that mindfulness meditation may lead to reductions in:

(1) Pain;

as well as

(2) Emotional reactions toward pain (i.e. suffering due to pain and its unpleasantness).

A study involving healthy people showed that meditation reduced pain-related activation of the contralateral primary somatosensory cortex.  These meditation-induced decreases in pain levels also led to increased activity in the anterior cingulate cortex and anterior insula.  Finally, meditation led to reduced ‘pain unpleasantness’ ratings (and activation of the orbitofrontal cortex) (Zeidan et al, 2011).

Okay, so what??  (you may ask…) 

In a nutshell, what this means is that mindfulness meditation can actually lead to real and identifiable changes in the brain, depending on a person’s dedication, devotion and commitment toward this ancient practice.

Furthermore, not only can mindfulness meditation lead to actual changes in the brain (as supported by studies), but it may also lead to brain-induced bodywide changes including improved immune function (more later).

Importantly, from a chronic pain patient’s perspective, regular mindfulness meditation may lead to reductions in pain intensity and/or suffering due to pain.

A Mindfulness Meditation Exercise:

(Please note:   I am not a mindfulness meditation expert….there are plenty of great books and papers on this topic….)

While deep breathing (comfortably),

(Try to) be in the (pain-free) moment.

Then repeat being in this (pain-free) moment.

Try to be in another (pain-free) moment,

And another (pain-free) moment,

And yet another (pain-free) moment….

And so on….

And continue to breathe deeply (and comfortably).

Do not allow yourself to be discouraged by any painful moments…..as these painful moments may also appear today….and even tomorrow….and even the day after tomorrow.  However, daily mindfulness meditation should result in fewer and fewer painful moments over time.

Remember that mindfulness meditation is about ‘being in the (pain-free) moment‘.

Admittedly, a (pain-free) moment is not a very long time….but a million (pain-free) moments can sure add up….and this will inevitably lead to positive changes in the brain as well as throughout the body….that may translate into less pain and suffering.

Ultimately, mindfulness meditation is about ‘living in the (pain-free) moment‘.

 

Practising mindfulness meditation can be done anywhere and anytime.  It can be done with the help of guided imagery, visual aids (e.g. see YouTube below), and relaxing music, or alternatively, with nothing at all except your own state of deep relaxation.

Please do not try this unless you are an accomplished freediver!

A Word of Caution:

Please note that practicing mindfulness meditation is not a replacement for conventional pain management strategies.

On a positive note, with proper medical supervision, practicing mindfulness meditation may lead to reduced reliance on conventional pain medication (and its adverse effects).

In Summary:

The aim of daily mindfulness meditation is to increase the number of pain-free moments, while decreasing pain and suffering altogether including reduced painful moments, lower pain intensity and duration.

Penman and Burch recommend that mindfulness meditation be done daily (10-20 minutes each time) for 8 weeks straight.  Thereafter, one may experience overall reductions in pain and suffering.

So what have you got to lose by following their advice? (other than pain?)

Stay posted…..I will write more on mindfulness meditation once I finish reading this excellent book by Penman and Burch (that I can recommend).

Sabina Walker

REFERENCES

(1A) Danny Penman and Vidyamala Burch (2013)

Mindfulness for Health: A Practical Guide to Relieving Pain, Reducing Stress and Restoring Wellbeing

(1B) For German blog readers:

Danny Penman and Vidyamala Burch (translated into German in 2015)

Schmerzfrei durch Achtsamkeit: Die Effektive Methode zur Befreiung von Krankheit und Stress

(Paperback book, 299 pages)

(2) Zeidan et al; Brain Mechanisms Supporting the Modulation of Pain by Mindfulness Meditation; The Journal of Neuroscience (6 April 2011), 31(14):5540 –5548.

Click to access 5540.full.pdf

(3) Rachel Berl (15 October 2015); Washington Post

A New School of Thoughtfulness

http://news.nationalpost.com/life/a-new-school-of-thoughtfulness

Traditional Chinese Medicine (TCM) For Chronic Pain? Let’s Talk About Corydalis, A Traditional Chinese Herbal Remedy For Chronic Pain

Source of Featured Image:

Courtesy of Shutterstock

and

http://www.medicaldaily.com/chinese-poppy-plant-corydalis-works-chronic-pain-266215

Dear Pain Matters blog readers,

Is traditional chinese medicine (TCM) a treasure box that needs to be opened more fully??

In other words, should more research be done to scientifically explore the hidden treasures of TCM?  If we did this, would we find additional effective pain treatment options not yet offered by conventional medicine?

Consider this ancient, nonaddictive, Chinese herbal remedy for chronic nerve pain that may, at times, offer longer lasting pain relief than opiates:

The roots of a flowering poppy plant called Corydalis yanhusuo (C. yanhusuo; Corydalis) has been used for centuries as a Chinese remedy for chronic pain.  Corydalis is grown in China, Japan and Siberia.  The underground tubers from the Corydalis plant must be harvested, dried, ground, and boiled in hot vinegar before they can be used as a remedy for pain including headaches, back pain, menstrual cramps, chest pain and abdominal pain.

Source of photo showing Corydalis yanhusuo:  

http://www.nature.com/nature/journal/v535/n7611_supp/full/535S18a.html

In collaboration with Chinese scientists, University of California researchers have recently identified and isolated a key pain-relieving compound called dehydrocorybulbine (DHCB) in the roots of Corydalis.  Specifically, basic research showed that DHCB (extracted from the Corydalis tubers) reduced acute pain, inflammatory pain as well as injury-induced nerve pain.  The compound, DHCB, blocks dopamine D2 receptors.

More importantly, the DHCB does not interact with the morphine receptor.  As such, the effectiveness of DHCB will not weaken over time, nor will tolerance, addiction and drug dependence become issues (as often occurs with conventional opiate medicine including codeine and morphine).

Researchers felt that DHCB could offer some relief for low-level chronic pain without the risk of addiction or tolerance following repeated use (Zhang et al, 2014; Ingram, 2014).

Patient experiences with Corydalis yanhusuo extracts:

While not scientifically verifiable, the following (partially copied) user comments are interesting to read:

Refer:

User Reviews & Rating – CORYDALIS

http://www.webmd.com/vitamins-supplements/ingredientreview-415-CORYDALIS.aspx?drugid=415&drugname=CORYDALIS

Quoting comments from a disappointed pain patient:

Patient –

“I took my first capsule this morning and have felt tired, dragged out, strangely a little depressed and above all light-headed–dizzy enough to stumble and fall. If anything, my painful back, hips and knees hurt more today. Obviously I won’t take it again.“

Quoting positive comments from people with chronic pain who use Corydalis:

Patient –

“…both knees replaced at the same time, and also suffer from frequent headaches.  I began using this product after my surgery and it has provided me with great relief!  ….easier on my GI system….Love Corydalis!  Been a lifesaver for me!“

Patient –

“I have been taking 1-2 capsules a day.  It helps my joint pain considerably which I’ve had for 20 years….”

Patient –

“I have had severe knee pain for several years due to old sports injuries and have began using the Cordyalis 10:1 pills recently. The first day my pain was so subtle that I hardly noticed it at all. Stairs were a nightmare for me, but they are much, much easier to handle. I know that nothing can completely remove the pain I suffer from, but this is positively changing my quality of life!!“

Patient –

“I have degenerative disc disease and get spinal headaches from intermittent neck pain. I was instructed by a Taiwanese doctor to take 20g boiled in water from 500cc down to 250cc (about 25 minutes on electric stove med-hi), straining out and discarding the root at the end. I found 20g was too much (I experienced worse spasms), tried 5g, and ended up using 10g per serving, up to twice a day. I found that taking it daily was less effective than taking as needed (was hoping to keep the pain away by taking daily.) When I first used it, it made me “high” like cough syrup. After a few servings, I no longer feel that. It’s probably the most effective thing I’ve taken for the pain (I will not take opioids, which tend to make me sick anyway.) …. The tea from root tastes horrible….”

Patient –

“I have had constant shoulder and neck pain for 2 yrs which also cause headaches and migraines. Muscle relaxers and fiorcet are my daily regimine but still constant pain that made me so tired and energy draining. Since using corydalis i have energy and no shoulder pain.“

Patient –

“Has eased my intractable nerve pain.”

Patient –

“Female, 66 – for sciatica. I take the powder: premixed, in hot water – drink it fast so as to obscure the taste. Worked in 30 min. the first time taken. I take it 1/2 hr before eating dinner. I’ve learned to put Stevia in it – helps with the taste.”

Patient –

“This stuff works, however, I have only taken it in the powdered form. It tastes terrible … Its hard to figure out dosages. I take two teaspoons per day on most days to augment my pain medication, hydrocodone. It dramatically extends the time the hydrocodone works and seems to add some additional relief. I am concerned about possible harmful effects and standardization of strengths of the herb……”

[Blogger’s comments:

Based on above, is it possible that the effectiveness of certain conventional pain medication (in this case, hydrocodone) may be increased, and/or prolonged, through the use of Corydalis?  Further research is warranted.]   

Patient –

“I have experience chronic low back pain for about 2 years. The pain is 24/7 and worsens with inactivity or excessive physical fitness. I purchased capsules. The serving size is 8 capsules and I only took 3 and felt amazing relief. I lifted weights today for my legs and shoulders then did 15 minutes of interval sprints and my back feels PHENOMENAL! For $15.99 it is worth the try!….”

Patient –

“I have a bulging disk and pain 24/7, at times it feels like to torture. Corydalis has helped the pain a little so my pain level is 4 instead of 7 or 8.“

Patient –

“I have had fibromyalgia for 25 years and now suffer spinal stenosis after car wreck 10 years ago. I have found acupuncture and this herb to help the pain and neurological problems.….”

A huge word of caution:

While DHCB is currently not available, TCM practitioners can offer Chinese herbal remedies/extracts that specifically include Corydalis yanhusuo extracts or roots/tubers (as they have already done for many centuries).  Corydalis extracts are also available in Chinese specialist stores and on-line.

However, in Dr Civelli’s words, “DHCB is present in low quantities, but it’s there” (Chia, 2014).

Thus, traditional Chinese remedies that include Corydalis yanhusuo extracts or tubers are certainly worth trying (after discussing with your GP first).  

Please discuss with your GP before deciding to undergo any TCM treatments and/or other alternative/complementary medical treatments (as well as post-TCM treatment, if necessary).

Conclusion:

Increased funding and research into TCM including ancient Chinese herbal remedies for pain are warranted.

In particular, we need to expand research into Corydalis, and its key pain-relieving ingredient, DHCB (as well as research into other effective pain-alleviating remedies offered by TCM).

After all, the best approach is a global and unified approach to the global challenge of chronic pain.

Sabina Walker

REFERENCES

(1) Zhang et al; A Novel Analgesic Isolated From a Traditional Chinese Medicine; Current Biology (20 January 2014); 24(2): 117-123.

doi: 10.1016/j.cub.2013.11.039

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3912990/

http://www.ncbi.nlm.nih.gov/pubmed/24388848

(2) Ingram; Pain: Identification of novel analgesics from traditional Chinese medicines; Current Biology (3 February 3 2014); 24(3): R114–R116.

doi: 10.1016/j.cub.2013.12.030

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3980722/

(3A) Plant Used in Chinese Medicine Fights Chronic Pain; Cell Press (2 January 2014).

http://www.eurekalert.org/pub_releases/2014-01/cp-pui122713.php

(3B) Zhang, Wang, et al; Chinese Herbal Compound Relieves Inflammatory and Neuropathic Pain; UCI News (2 January 2014).

http://news.uci.edu/press-releases/chinese-herbal-compound-relieves-inflammatory-and-neuropathic-pain/

(3C) Ericson, John; Chinese Poppy Plant, Corydalis, Works For Chronic Pain; Drugs (2 January 2014).

http://www.medicaldaily.com/chinese-poppy-plant-corydalis-works-chronic-pain-266215

(3D) Chia, Jessica; The Plant That Could Erase Chronic Pain; Prevention (2 January 2014).

http://www.prevention.com/print/health/health-concerns/chinese-remedy-corydalis-pain

(3E) Pain, Stephanie

Painful Progress

Nature (14 July 2016); 535, S18–S19

doi:10.1038/535S18a

http://www.nature.com/nature/journal/v535/n7611_supp/full/535S18a.html

(4) User Reviews & Rating – CORYDALIS

http://www.webmd.com/vitamins-supplements/ingredientreview-415-CORYDALIS.aspx?drugid=415&drugname=CORYDALIS