Mindfulness physical therapy, pain management, rehabilitation

Mindfulness and Pain Qualitative Study

A qualitative study by Doran examined how a mindfulness-based therapy impacted perceptions and management of chronic back pain in 16 individuals with a pain duration of 4 to 28 years.1 At 6-month and 1-year post-program interviews, participants reported changes in their attitude toward and experience of pain. These included they:

  • Became familiar with the pattern of pain and habitual reactions to pain
  • Recognized the difference between being tense and being relaxed in relation to pain
  • Identified early warning signs that precede a pain flare-up
  • Stopped the cycle of projecting past experience of pain onto a fear of future pain
  • Changed maladaptive attitudes and approaches to pain
  • Reduced identification with the diagnostic label or story about pain
  • Became more flexible in their attitude toward pain
  • Reduced self-blame and inner conflict
  • Felt less “fragmented” and experienced a greater integration of mind and body

These descriptions of how mindfulness instruction changed study participants’ experience of pain are consistent with the changes I observe in my patients. In the words of one man with a 2-year history of mid-back pain who I saw for 4 visits:

“What made the difference for me was learning to be in the present moment. Before I was always worrying about what would happen. In my job, I do a lot of planning so my mind is geared to think about the future. When I thought about the future of my health, it seemed pretty dismal and nothing was helping. I would only get anxious and fearful and I did not realize how that only made my pain worse. Focusing my mind on the present moment was enormously helpful. I would tell myself, ‘Calm down. Just be here.’ By breathing, relaxing and labeling the pain ‘sensation’, I could take control of how I was reacting. I immediately saw a difference. My pain did not increase out of control. This gave me hope for the first time.”

1 Doran NJ. Experiencing wellness within illness: Exploring a mindfulness-based approach to chronic back pain. Qual Health Res 2014;24(6):749-760.