Mindfulness physical therapy, pain management, rehabilitation

Stress Levels, Pain Intensity and the Role of Mindfulness Training in Women with Fibromyalgia

Bergenheim and colleagues examined how pain and other health-related measures changed over 10 to 12 years in 126 women with fibromyalgia (FM) or Chronic Widespread Pain (CWP).1 In addition, they examined the role of psychological and physical health parameters in predicting long-term change in pain intensity. A majority of women improved in pain intensity and other symptoms over 10 to 12 years. For the group, the mean improvement in pain intensity was 13% from baseline. Nine percent of the group demonstrated clinically meaningful improvement of 30% – 50% and 16% demonstrated substantial improvement of at least 50%. Lower levels of stress symptoms and higher pain intensity predicted greater chances of substantial improvement in pain intensity 10 – 12 years later.

Authors of this study conclude that stress levels in women with FM and CWP should be assessed and treatment strategies should include stress management.1 There is substantial research demonstrating mindfulness training improves stress management, pain management and decreases physiological markers of stress in a wide range of patient populations.2,3 In a randomized trial, participants diagnosed with FM enrolled in an 8-week mindful awareness training program demonstrated significant improvements over a control group in levels of FMS symptomatology, pain perception, sleep quality, psychological distress, non-attachment, and civic engagement.4 The therapeutic gains attributed to mindful awareness training were maintained and, in some cases, slightly augmented at 6-month follow-up. Average daily time spent in meditation was found to be a significant predictor of changes in all outcome variables.

1 Bergenheim A, Juhlin, Nordeman L, et al. Stress levels predict substantial improvement in pain intensity after 10 to 12 years in women with fibromyalgia and chronic widespread pain: a cohort study.BMC Rheumatol. 2019 Jun 24;3:5.
2Hilton L, Hempel S, Ewing BA, et al. Mindfulness meditation for chronic pain: Systematic review and meta-analysis. Ann Behav Med. 2017;51(2):199-213.
3Pascoe MC, Thompson DR, Jenkins ZM, Ski CF. Mindfulness mediates the physiological markers of stress: Systematic review and meta-analysis. J Psychiatr Res. 2017;95:156-78.
4Van Gordon W, Shonin E, Dunn TJ, et al. Meditation awareness training for the treatment of fibromyalgia syndrome: a randomized controlled trial. Br J Health Psychol. 2017;22(1):186-206.