Pain is a complicated, multilayered experience that is influenced by aspects other than physical sensation, such as a person’s psyche and pain expectations.
Expectations can drastically change an individual’s experience. One well-known example is the placebo effect, which is the propensity for a person’s symptoms to improve in response to inactive treatment.
People have believed for a long time that mindful meditation, which many cultures have used for centuries to treat pain, functions by triggering the placebo response. Scientists have now demonstrated that this is untrue.
A recent study that was published in Biological Psychiatry found that, in contrast to the placebo effect, mindfulness meditation uses different brain processes to reduce pain(1✔ ✔Trusted Source
Mindfulness meditation and placebo modulate distinct multivariate neural signatures to reduce pain
Mindfulness Meditation vs The Placebo Effect
The researchers of the University of California San Diego School of Medicine compared the pain-relieving effects of mindfulness meditation, a placebo cream, and a “sham” mindfulness meditation in healthy individuals using precise brain imaging techniques.
The study found that
- Mindfulness meditation produced significant reductions in pain intensity and pain unpleasantness ratings and also reduced brain activity patterns associated with pain and negative emotions
- Placebo cream only reduced the brain activity pattern associated with the placebo effect, without affecting the person’s underlying experience of pain
“The mind is extremely powerful, and we’re still working to understand how it can be harnessed for pain management,” said Fadel Zeidan, PhD.
“By separating pain from the self and relinquishing evaluative judgment, mindfulness meditation can directly modify how we experience pain in a way that uses no drugs, costs nothing, and can be practiced anywhere.”
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The study included 115 participants, which consisted of two separate clinical trials in healthy participants, who were randomly placed into groups to be given four interventions:
- Guided mindfulness meditation group
- Sham mindfulness meditation group that only consisted of deep breathing
- Placebo cream group (petroleum jelly) that participants were trained to believe reduces pain
- one group listened to an audiobook (control group)
The researchers applied a very painful but harmless heat stimulus to the back of the leg and scanned the participants’ brains both before and after the interventions.
The researchers used a novel technique called multivariate pattern analysis (MVPA), leveraging machine learning to unravel the complex neural mechanisms behind pain, including responses to heat, negative emotions, and the placebo effect.
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How Mindfulness Meditation Reduces Pain
The researchers were then able to identify if mindfulness meditation and placebo engage similar and/or separate brain processes.
Although placebo cream and sham-mindfulness meditation lowered pain, the researchers found that mindfulness meditation was significantly more effective at reducing pain when compared to placebo cream, sham-mindfulness meditation, and the controls.
They also found that mindfulness-based pain relief reduced synchronization between brain areas involved in introspection, self-awareness, and emotional regulation.
These parts of the brain together comprise the neural pain signal (NPS), a documented pattern of brain activity thought to be common to pain across different individuals and different types of pain.
In contrast, the placebo cream and sham mindfulness meditation did not show a significant change in the NPS when compared to controls. Instead, these other interventions engaged entirely separate brain mechanisms with little overlap.
“It has long been assumed that the placebo effect overlaps with brain mechanisms triggered by active treatments, but these results suggest that when it comes to pain, this may not be the case,” said Zeidan.
“Instead, these two brain responses are completely distinct, which supports the use of mindfulness meditation as a direct intervention for chronic pain rather than as a way to engage the placebo effect.”
In modern medicine, new therapies are generally deemed effective and reliable if they outperform placebo.
As the present study found that mindfulness meditation is more powerful than placebo and does not engage the same neurobiological processes as placebo, the findings have important implications for the development of new treatments for chronic pain.
However, it will take more research to demonstrate these effects in people living with chronic pain as opposed to healthy participants.
In the long term, the researchers hope that by understanding the distinct brain mechanisms underlying mindfulness meditation, they can design more effective and accessible interventions that harness the power of mindfulness to reduce pain in people with various health conditions.
“Millions of people are living with chronic pain every day, and there may be more these people can do to reduce their pain and improve their quality of life than we previously understood,” said Zeidan. “We are excited to continue exploring the neurobiology of mindfulness and how we can leverage this ancient practice in the clinic.”
Reference:
- Mindfulness meditation and placebo modulate distinct multivariate neural signatures to reduce pain- (https:www.biologicalpsychiatryjournal.com/article/S0006-3223(24)01556-7/abstract)
Source-Eurekalert
