Mindfulness physical therapy, pain management, rehabilitation

MBSR, Psychological Functioning and Inflammatory Markers in Trauma-Exposed Women

Patients with a history of trauma are at an increased risk of developing chronic pain.1 The dysregulation of inflammatory responses due to early life stress may become “programmed” into the immune system, resulting in a shift to pro-inflammatory responses in later life.2,3 For example, when experiencing multiple daily stressors, individuals with a history of childhood abuse have been shown to experience IL-6 levels 2.35 times greater than those with no reported early abuse history.4 This amplified pro-inflammatory tendency may contribute to an exaggerated and prolonged pro-inflammatory response to noxious stimulation in adulthood and increase a patient’s risk for developing chronic pain.2

In a pilot study, Gallegos and colleagues examined the effects of a Mindfulness-Based Stress Reduction program on psychological functioning and inflammatory biomarkers in women with histories of at least one interpersonal trauma before the age 18.5 The program was conducted at a community-based health center. Fifty participants completed several measures of psychological functioning at study entry and 4, 8, and 12 weeks later. Inflammatory biomarkers were assayed from blood collected at each assessment. Participants experienced significant decreases in perceived stress, depression, anxiety, emotional dysregulation, and post-traumatic stress symptoms. Session attendance was associated with significant decreases in interleukin (IL)-6 levels.

This pilot study demonstrates the potential beneficial effects of mindfulness training on psychological functioning and the inflammatory biomarker IL-6 among trauma-exposed women. These findings should be considered in light of study limitations which include the small sample size and the lack of a comparison control group. Mindfulness training helps patients build body awareness and self-regulate the stress reaction. Although additional research is needed, one could hypothesize that as pro-inflammatory dysregulation initiated by early life trauma is a proposed mechanism contributing chronic pain risk, an improved ability to modulate stress physiology as an adult may, in turn, contribute to blunting pro-inflammatory tendencies and temper chronic pain vulnerability.

1Davis DA, Luecken LJ, Zutra AJ. Are reports of childhood abuse related to the experience of chronic pain in adulthood? A meta-analytic review of the literature. Clin J Pain 2005;21(5):398-405.
2Burke NN, Finn DP, McGuire BE, Roche M. Psychological stress in early life as a predisposing factor for the development of chronic pain: Clinical and preclinical evidence and neurobiological mechanisms. J Neurosci Res. 2017;95(6):1256-1270.
3Miller GE, Chen E, Parker KJ. Psychological stress in childhood and susceptibility to the chronic diseases of aging: Moving towards a model of behavioral and psychological mechanisms. Psychol Bull. 2011;137(6):959-997.
4Gouin JP, Glaser R, Malarkey WB, et al. Childhood abuse and inflammatory responses to daily stressors. Ann Behav Med 2012;44:287-292.
5Gallegos AM, Lytle MC, Moynihan JA, Talbot NL. Mindfulness-based stress reduction to enhance psychological functioning and improve inflammatory biomarkers in trauma-exposed women: a pilot study. Psychol Trauma. 2015;7(6):525-32.