Mindfulness and chronic pain

April 20, 2016 Gordon A. Irving, MD


If you are one of the millions of Americans who suffer from chronic pain, mindfulness may provide some relief. Mindfulness in the broadest sense is the practice of focusing on the present moment as a way to reduce stress and pain. Sounds simple, right? For most people, mindfulness actually takes practice. But the benefits can be significant, especially for people with debilitating pain.

What is mindfulness?

At the heart of mindfulness is acceptance: We pay attention to our thoughts and feelings without judging them—without believing, for instance, that there's a right or wrong way to think or feel in a given moment.

What mindfulness and pain do to the brain

Your brain can change, for the better and for the worse. This is called neuroplasticity. Chronic pain can cause changes in certain areas of the brain, including the hypothalamus, which can shrink under the stress of constant pain. Mindfulness meditation and similar behaviors have been shown to increase the volume of the hypothalamus.

Why do we care about the hypothalamus? Because it controls the release of critical hormones that help regulate our body temperature, appetite, sleep cycles, emotional responses and more.

How do you practice mindfulness?

There are many ways to practice mindfulness. One is through meditation. Sit or lie in a quiet place and concentrate on breathing deeply from your belly. As you do this, let all thoughts and feelings pass by. Don’t hold onto them or evaluate them! Do this for 10 to 15 minutes a day, at least five days a week.

Being mindful sounds a lot easier than it is, so persevere—there is a payoff: When this technique was tested on people in their 60s who hadn’t meditated before, their mental functions improved in eight weeks.

A decrease in chronic pain

For people with chronic pain, there is another payoff. A review of 133 studies of mindfulness-based interventions (MBI) found 16 studies that met the stringent criteria for scientific research papers. The majority of these studies showed a sustained decrease in pain. Patients with fibromyalgia seemed to do especially well.

Despite such promising results, not everyone embraces mindfulness. One reason is that many people find the solitude of meditation depressing. And being left alone with our thoughts can be very uncomfortable at times. In experiments, some people have even resorted to giving themselves a painful electrical shock to get out of thinking quietly.

Mindfulness – there’s an app for that

There are many smart phone apps that offer guided meditation. Look at Sattva, a free app that is one of the most comprehensive and advanced meditation apps. It offers a wide variety of guided meditations by experts in the field, and includes:

  • A meditation timer
  • A heart rate monitor
  • A mood tracker
  • Challenges and trophies to help you keep track of your goals
  • An “insights engine” so you can track meditation’s impact on your well-being

Tips for mindfulness

Mindfulness requires you to change your inner narrative and be good to yourself. You can do this by:

  • Creating healing stories for your mind and focusing on them. Recognize that your thoughts are just that—ideas and information that come and go and aren’t necessarily true.
  • Stepping back from an inner story line that stokes stress. In many situations, it’s possible to drop a narrative playing in your mind or to change it to ease anxiety. Turn horror stories into healing stories.
  • Being on your side, not on your case. Deflate your inner critic and give energy to your inner cheering squad and your kind adviser. Cultivate unconditional friendliness toward yourself. Talk to yourself as you would a good friend if he or she were in your shoes.
  • Living more in the present. Spend less time and mental energy ruminating on the past. Plan for the future but don’t worry about it or live there. Focus your mind on the here and now.

For more about easing pain, use Swedish’s Pain Management Guide. There, you can also learn how to schedule a consultation at one of our convenient locations.

Here are some resources to learn more about mindfulness:


Clinical mindfulness expert Jon Kabat-Zinn defines mindfulness
Sara Lazar on how meditation can change your brain
An introduction to guided mindfulness meditation
Mindfulness-based stress reduction as a strategy in reducing pain


Do Mindfulness-based Interventions Reduce Pain Intensity? A Critical Review of the Literature,” Authors Reiner K et al, Pain Medicine 2013, pp 230-242.


Previous Article
What is the Palliative Care and Symptom Management Clinic?

Palliative care is a service that helps people define their goals for their care with a focus on improving ...

Next Article
What is celiac disease?

Celiac disease is an autoimmune disorder that damages the small intestine and prevents the absorption of nu...