Mindfulness-based stress reduction eases pain

Mindfulness training appears to be effective in reducing pain, and such benefit points to different neural pathways depending on extent and context of practice, a study has shown.

One hundred fifteen healthy participants underwent neuroimaging during a thermal acute pain task before and after random assignment to mindfulness-based stress reduction (MBSR) (n=28), an active control condition (health enhancement program [HEP]; n=32), or a waiting list control condition (n=31). Thirty long-term meditators also completed the neuroimaging paradigm.

The researchers then measured pain response through self-reported intensity and unpleasantness, and neurally via two multivoxel machine-learning-derived signatures: the neurologic pain signature (NPS), emphasizing nociceptive pain processing, and the stimulus intensity independent pain signature–1 (SIIPS1), emphasizing stimulus-independent neuromodulatory processes.

Participants in the MBSR group demonstrated a marked reduction in NPS response compared to those in the HEP group (Cohen’s d, ‒0.43) and from pre- to postintervention assessment (d, ‒0.47). They also showed small, marginal decreases in NPS relative to those in the waiting list group (d, ‒0.36), as well as in SIIPS1 compared to both groups (HRP group: d, ‒0.37; waiting list group: d, ‒0.37).

Moreover, the MBSR and HEP groups exhibited modest decreases in subjective unpleasantness relative to the waiting list group (d, ‒0.45 and ‒0.55, respectively).

Pain was significantly lower among long-term meditators than nonmeditators, but neural response did not differ between groups. In addition, cumulative practice during intensive retreat within the long-term meditator group significantly correlated with reduced SIIPS1 (r, ‒0.65), but daily practice did not.

“Use of neural pain signatures in randomized trials offers promise for guiding the application of mindfulness interventions to pain treatment,” the researchers said.