medical speak in english

Chronic pain,  especially low back pain and sciatica, can be a debilitating disease that can be taxing both physically, spiritually, and emotionally.  This section provides alternative treatment methods and techniques that may be used to improve your pain symptoms and regain control of your life.   Each month I will add new articles that will manage your pain symptoms better.

 

Meditation is the redirection of thought that creates an environment of deep reflection and awareness.  There are many types of meditation.  Guided meditation, also called guided imagery, utilizes mental images of places or situations that you find relaxing.  You use as many senses as possible, such as smells, sights, sounds, and textures.  Mantra meditation uses the repetition of a calming word, thought, or phrase to prevent distracting thoughts.  Mindfulness meditation is based on being mindful, or having an increased awareness and acceptance of living in the present moment.  You focus on what you experience during meditation, such as the flow of your breath.  You can observe your thoughts and emotions but let them pass without judgment.  Qigong combines meditation, relaxation, physical movement, and breathing exercises to restore and maintain balance.  Tai Chi utilizes physical activity as you perform a series of postures or movements while practicing deep breathing.  Transcendental meditation refocuses your attention and eliminates all thoughts from your mind by repeating a word, sound or phrase, which achieves a state of perfect stillness and consciousness.  Yoga promotes a more flexible body and calm mind by performing postures and controlled breathing exercises.  In doing these movements, you focus less on your busy day and more on the moment.

Studies have shown that meditation can be beneficial to everyone, especially people in chronic pain.  With sufficient practice in meditation, people with chronic pain can learn to shift their focus when needed and change their perception of the pain, developing an ability to choose how to respond to the pain.  The findings suggest that those who suffer chronic pain—including stress—may benefit from meditation because of an increased ability to "turn down the volume on pain signals."

A 2007 study in Switzerland found that meditation improved chronic pain.  The study involved two groups of women—27 diagnosed with chronic pain from fibromyalgia and 25 healthy women of the same age.  Compared to normal breathing, slow breathing reduced ratings of pain intensity and unpleasantness, as well as negative emotion.  The slow breathing allows patients to dampen activity in the stress system of the brain, leading to a reduction in pain.  The benefit of slow breathing in relieving pain was greatest in the healthy women.  This may be in part because the healthy women had more distraction techniques in their normal everyday lives.  Not all women with fibromyalgia benefited from slow breathing, only those who also
reported having “a steady diet” of positive emotion in their lives and who had the “capacity” to feel positive felt less pain when breathing at half their normal rates.

When a patient is in pain, there are many physiological events that transpire in addition to the pain, including an increased heart rate, which can increase blood pressure and worsen coronary artery disease or angina.  A 1995 study published in Hypertension demonstrated that those who meditated were able to decrease their blood pressure more than double than those who were in the control group and triple to those that simply received information on how to lower blood pressure through diet and exercise.

Pain may also increase the size of the pupils in patients on opiates that tend to have constricted, or small, pupils.  It may also cause changes in the temperature of the skin and body, increase sweating, and increase breathing.  Prolonged pain may also decrease your immune system, which decreases your ability to fight infections.  Meditation, on the other hand, has many
positive physiological effects, including increased blood and decreased heart rate, both of which decrease the oxygen demands on the body.  For people with coronary heart disease and hypertension, this is beneficial.  All of this decreases anxiety levels, which can be seen in a reduction of cortisol levels, and this can improve sleep.  The benefits of improved sleep with meditation was elucidated in a 1985 study published in the Journal of Counseling and Development, which examined a group of people that did not sleep
well due to post-traumatic stress disorder.  After meditating, their sleep improved, while the control group’s insomnia worsened over time.

Physiologically, slower breathing increases parasympathetic tone and decreases pain.  Not only does this help decrease the heart rate, blood pressure, respiration, and anxiety, but it helps temper the fight or flight response.  This may help decrease the possibility of the centralization of pain.

For fibromyalgia patients, like many other chronic pain patients, meditative breathing alone, or any treatment for that matter by itself, is insufficient for decreasing their pain.  Often times, multiple treatments, such as medications, physical therapy, meditation, and injections, are far more effective than any one treatment method by itself.

Meditation can improve your overall health.  This was demonstrated in a 1997 study published in The American Journal of Managed Care.  This study looked at medical utilization and expenditure and came to the conclusion that those that chose to practice meditation on a regular basis spent fewer days in the hospital and decreased their visits overall.

While these studies may not prove the benefits of meditation to everyone, I believe they show that meditation is good for you and, if done daily or several times a week, it can lead to major health advantages over time.

Meditation has many psychological benefits as well, such as increasing self confidence, which may improve depression and anxiety.  In addition, people focus better, which in turn can improve their memory, learning, and ability to concentrate, even when in pain.  A 1977 study published in Scientific Research on a transcendental meditation program demonstrated that
college students, after a 40-day meditation program, improved their memory up to fourfold over the control group, which did not meditate.  Because people can become less aggressive and ignore trivial matters, their personal relationships can improve, which can become strained while dealing with chronic pain.  Many of my patients tell me that their spouses or significant others want them to do more and that they just do not understand the pain; they begin to think the patient is lazy, and this creates resentment.

Anyone living with chronic pain knows the fear that the pain can instill and the feelings of helplessness that can consume someone.  Often, people become afraid of activity for fear of hurting
themselves and they become prisoners in their own body.  Because of this, a downward spiral ensues and patients’ negative feelings perpetuate their pain and vice versa.  Patients may lose control of their lives because the pain begins to run their lives.  They are not able to work because of their pain or work the job they once had, and this causes depression.  Because they no longer work, they have fewer distractions, which worsens their pain.

This is why I try to encourage my patients to continue working because I find that when they stop working, their pain not only worsens but their lives slowly deteriorate.  Because they do not have the distraction of work, they focus on their pain all day long.  When patients are able to distract themselves, they have less pain because they are not focusing on their pain.  Patients are often surprised when I point this out to them, and really don't realize what is happening when this occurs.  Because meditation refocuses their attention and allows a patient to become more aware of their thoughts and feelings, they can focus on the pain itself.  This allows them to become aware of the negative thoughts that are continually present.  It allows the patient to realize that they have a choice—they can decide whether to let the pain dictate their life or not.

At some point in their treatment, most chronic pain sufferers are told they will have to “learn to live with their pain,” and meditation gives them the skills to do just that, but in a more productive way.