Drugs to relieve pain for people with chronic diseases are expensive and can have harmful side effects. But there are alternatives that promise benefits exceeding pain relief.
Mindfulness meditation – in particular, mindfulness-based stress reduction programs – can help people with a range of chronic illnesses.
Chronic pain often accompanies chronic disease, leading to suffering for individuals and families, and generating extensive costs to our communities and health system.
It is not surprising, then, that people suffering from chronic diseases have a higher level of psychological distress than the general population.
Mindfulness-based stress reduction programs
A mindfulness-based stress reduction (MBSR) program was developed in the late 1970s by Jon Kabat-Zinn at the University of Massachusetts Medical Center. It is an eight-week course designed to complement medical treatment.
Originally used for managing chronic pain and stress-related disorders, it has since helped people with cancer, chronic pain, stress, anxiety, depression, fibromyalgia, psoriasis, disordered eating and other conditions.
Kabat-Zinn described mindfulness as “the awareness that emerges through paying attention on purpose, in the present moment, and non-judgmentally to the unfolding of experience moment by moment.”
Program participants reported improvements in mood, sleep quality, fatigue, psychological distress, overall quality of life and reduced stress levels.
Amounts of the hormone cortisol, which is excreted by the adrenal gland in response to stress, were found to decrease following participation in the MBSR program.
Participation in an MBSR program can also increase left-sided prefrontal activity. This has been associated with positive feelings and immune function in relation to influenza.
Mindfulness meditation has its origins in Buddhism, but the mindfulness practices taught in the MBSR program are of a secular nature. They do not require any religious beliefs or lifestyle changes.
Mindfulness can be cultivated in any situation and incorporated into daily activities like cooking, eating or cleaning.
The MBSR program is delivered in a group with weekly sessions of one-and-a-half to two-and-a-half hours. One full day (six to eight hours) of silent retreat is held in the sixth week.
The sessions consist of instruction in and practice of mindfulness meditation, and discussion of the experience of meditation.
Meditation exercises cover mindful body scanning, sitting meditation, walking meditation and basic Hatha Yoga postures.
Participants are encouraged to practice mindfulness meditation daily for between 20 and 45 minutes and to incorporate mindfulness into everyday situations.
Often, guided meditation recordings and a workbook support homework. A health professional trained in MBSR runs the sessions.
The benefits of mindfulness-based stress reduction programs
A recent literature review published in the Australian Journal of Primary Health reported on research into the effects of MBSR programs for people with chronic diseases.
The review examined 15 studies involving a total of about 700 people. All the studies found the MBSR program to be a supportive therapy with positive effects.
The studies involved adults with chronic conditions such as fibromyalgia, chronic pain, rheumatoid arthritis, type 2 diabetes, chronic fatigue syndrome, multiple chemical sensitivity and cardiovascular conditions.
Participants practicing mindfulness meditation showed improvements of symptoms compared to a control group which did not participate in the MBSR training.
Benefits for practitioners were also found when comparing groups before and after participation in the MBSR program.
Participants’ mental health (in particular anxiety and depression), physical health, quality of life and well-being improved. MBSR also improved coping skills and attention.
Circulatory complaints, arthritis, headaches, chronic back and neck pain, skin complaints, fatigue, sleeping problems, blood sugar levels in people with diabetes and blood pressure all responded positively to the MBSR program.
Sympathetic nervous system (SNS) activation in women with fibromyalgia decreased. SNS activation is an indicator for acute stress.
Overall, study participants were enthusiastic about the program and adhered to the daily homework. Many continued mindfulness practice after completion of the MBSR program.
MBSR programs complement primary care services
People with chronic diseases face many difficulties and MBSR can help them to reduce stress and improve quality of life.
There are no known negative side effects to MBSR and it can be practised anywhere and at any time. This makes it suitable for wide use in the primary care system in Australia to ease the burden of chronic diseases.
As the demands placed on health care providers increase, MBSR programs can also benefit staff working in the primary care system.
MBSR programs might not reverse underlying chronic disease, but they can make it easier to cope with symptoms, improve overall well-being and quality of life and improve health outcomes.
As an addition to standard care, this program has potential for much wider application in Australian primary care settings.