Mindfulness-based Pain Management
Mindfulness-based Pain Management
Mindfulness meditation has been known in the West since the 1980s and has been used successfully for various medical conditions. Based on the widespread MBSR course developed by Jon-Kabat Zinn1, many variations for specific life situations have emerged in recent years. Mindfulness-based pain management (MBPM) is one such variation of MBSR specifically for people with chronic pain. MBPM was developed by Vidyamala Burch from England, who herself suffers from severe chronic pain and was able to use a combination of mindfulness, compassion and pacing to turn her approach to illness and pain in a positive direction in order to lead a fulfilling life despite the pain.
You’re probably wondering how meditation can help you with FQAD? What I notice in counseling is that many sufferers, understandably, spend a lot of energy searching for a solution to FQAD. Unfortunately, however, there is still no well-researched therapy for FQAD. In general, chronic diseases, especially chronic pain, are difficult to treat. It is therefore worthwhile for everyone, in addition to the medical optimization of the therapy, to deal with their own life situation at an early stage. I would now like to give you the answer to the question of how meditation can help me deal with FQAD
Impact on the nervous system
Meditation has a direct influence on the nervous system and therefore on the processing and perception of pain. Pain is perceived in the brain and not, as many believe, at the site of the pain. When processing back pain, for example, various areas of the brain have a strengthening or weakening influence on the intensity that we ultimately perceive. I am not suggesting that your pain is “psychosomatic” or “only in your head”. However, if you look at current knowledge on pain processing and perception, it quickly becomes clear that pain – even acute pain in the event of an accident – is only perceived in the brain. Our leg or back does not have the ability to “perceive (awareness)”. Meditation simultaneously strengthens those areas of the brain that attenuate pain and reduces the activity of areas of the brain that increase pain.2 This effect increases with practice and time invested and can have a significant effect on your quality of life when dealing with pain.
Meditation has a direct influence on the nervous system and therefore on the processing and perception of pain. Pain is perceived in the brain and not, as many believe, at the site of the pain. When processing back pain, for example, various areas of the brain have a strengthening or weakening influence on the intensity that we ultimately perceive. I am not suggesting that your pain is “psychosomatic” or “only in your head”. However, if you look at current knowledge on pain processing and perception, it quickly becomes clear that pain – even acute pain in the event of an accident – is only perceived in the brain. Our leg or back does not have the ability to “perceive (awareness)”. Meditation simultaneously strengthens those areas of the brain that attenuate pain and reduces the activity of areas of the brain that increase pain.2 This effect increases with practice and time invested and can have a significant effect on your quality of life when dealing with pain.
Focus
Mindfulness meditation has the additional effect of training the ability to concentrate on certain things in particular. Our brain only has the ability to focus our attention on one thing. Although we can do different things at the same time, such as eating and listening to music, our attention is either focused on one or the other – or switches back and forth quickly. The area of the brain that is responsible for actual attention (“awareness”) can only perceive one thing at a time. If you train your ability to concentrate on something, you have more opportunities to focus on something other than pain in certain situations.2 Here is an example: You are in a café with a friend and are in pain at the same time. However, you want to talk to your friend, take part in the conversation and have as good a time as possible. Mindfulness practice helps you to focus on the conversation at this moment instead of dwelling on the pain and worrying about whether it will ever go away or why it hurts so much again. Of course, this depends on the extent of the pain, but in many cases this change of focus is possible and brings a better quality of life.
Compassion (Metta)
Another aspect, especially when it comes to chronic illness, is self-compassion. Meditation with a focus on compassion, also known as metta, is particularly helpful for people in pain. Compassion can reduce the suffering caused by resistance to a situation that cannot be changed and lead to a better quality of life.
Pacing
Another important reason why MBPM helps many FQAD patients is pacing. In our experience, pacing or “paced training” is the central component of fluoroquinolone-associated symptoms, especially pain. It is about finding a conscious balance in activities that are neither unnecessarily stressful for the body nor so stressful that they cause more pain and symptoms. A very slow increase in strenuous movement after finding this balance makes sense in order to accustom the body to more mobility. Pacing is often difficult to implement. A great deal of mindfulness is required. If you frequently go beyond your own limits, a so-called “boom and bust” cycle develops, whereby activity is often stopped completely in phases of increased pain, which leads to a loss of fitness and muscle mass and is often very stressful psychologically. A fear of movement develops more and more. As soon as the pain subsides, those affected often start to be too active again, which again leads to irritation of the tissue. A vicious circle develops, which is illustrated in the following picture:
Pacing is one of the most important measures for achieving long-term improvement in FQAD. The prerequisite for successful pacing is mindfulness and controlled implementation. The detailed chapter in Vidyamala Burch’s book “Schmerzfrei durch Achtsamkeit” (English: Mindfulness for Health)3 can be used as an aid here. It is also worth finding out about events and courses at Breathworks-Mindfulness. However, these are only available in English.
As an accredited MBPM teacher, I offer individual sessions in German on this aspect of the treatment of FQAD. You can book these directly below in Calendly if you are interested. The following aspects are covered:
- Learning a mindfulness practice
- Dealing with difficult symptoms, feelings and limitations in order to reduce suffering as much as possible. The focus is on (self-)compassion
- Learning to focus on the mostly forgotten, pleasant sensations
- Learning how to implement pacing correctly in order to get out of the boom and bust cycle and positively influence your own prognosis.
In future there will also be an 8-week MBPM course in German, which has been specifically customised for FQAD patients. If you are interested, you are welcome to contact us at ferdinand.dirsch@fqad-support.com
Sincerely,
Marco Karrer
Sources
- Mindfulness-based stress reduction: a non-pharmacological approach for chronic illnesses; Asfandyar Khan Niazi 2011
- The Brain and Pain; Richard Ambron
- Mindfulness for Health; Vidyamala Burch