The Medicine Cabinet: Ask the Harvard Experts
By Howard LeWine, M.D.
Q: For years, I have needed narcotic medications to control my chronic pain. My doctor is trying to reduce my dose by asking me to practice meditation. Can this really help reduce my pain?
A: Yes, meditation and other avenues to mindfulness can help decrease your use of pain medication. And you may eventually be able to stop narcotics completely.
Mindfulness is an ancient practice, but it has taken modern imaging technology to demonstrate how it may work. An imaging test called functional MRI [fMRI] shows the brain as it is working. It has allowed us to see things in humans we couldn’t before.
What’s most interesting is that people with chronic pain still show significant activity in pain centers while practicing mindfulness meditation. But despite the brain’s pain centers firing on fMRI, the meditators report feeling less pain compared to non-meditators. The likely reason: The mindfulness practitioners have less activity in regions involved in emotion and memory.
Such images indicate that mindfulness practitioners may still feel the pain but not the unpleasantness of the sensation. Instead of blocking the sensation itself, they avoid making associations that identified it as “painful.”
Mindfulness involves focusing your mind on the present and letting go of concerns about the past and the future. Here are the basics of a mindfulness meditation practice:
In a quiet and comfortable place, sit on a cushion on the floor with your legs crossed, or sit in a chair with your feet flat on the floor. Sit up straight but not stiff. Let your hands rest on the tops of your thighs.
Start by bringing your attention to the sensations of your body (sight, sound, taste, touch, scent).
Next, bring your awareness to your breathing as you inhale and exhale. Pay particular attention to breathing out.
When you become distracted by thoughts and feelings — for example, an appointment you must keep or anger at someone — silently and gently label these as thoughts, let them go, and return your focus to your breath.
If you’d like to practice mindfulness meditation, start by setting aside some time each day and begin gradually, meditating for five to 10 minutes once or twice a day. You can gradually build up to 20 minutes or even an hour.
(Howard LeWine, M.D. is an internist at Brigham and Women’s Hospital in Boston and assistant professor at Harvard Medical School. For additional consumer health information, please visit www.health.harvard.edu.)