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A surprising way to ease chronic pain
A new study points to a unique mindfulness therapy as a promising coping strategy for people living with chronic pain.
Chronic pain can sometimes feel all-consuming. It’s a constant physical challenge. On top of that, it can disrupt jobs, relationships, hobbies and overall quality of life. Living with chronic pain also can lead to depression. It even raises the risk of addiction to opioids. And it’s a widespread health issue. One in 5 Americans lives with chronic pain.1
But there is hopeful news. A new study funded by the National Institutes of Health has found that it may be possible to help heal chronic pain with the power of mind.2
The study included a group of 250 chronic pain patients who had been prescribed opioids but were showing signs of misuse. The patients received either a new therapy called Mindfulness-Oriented Recovery Enhancement (MORE) or standard supportive group therapy. With MORE, you don’t fixate on pain. Instead, you learn how to focus on your breathing. You recall good times and how they made you feel. You learn to let go of negative thoughts.3
After nine months, half of the patients had much less pain. And nearly half stopped misusing opioids. This was more than double what standard therapy could do.
The treatment also helped with depression. At the start of the study, nearly 7 out of 10 people had serious depression. By the end, the signs of depression were gone.2
“This therapy reduces addiction and chronic physical pain. And it also reduces depression,” says Eric Garland, PhD. He’s a distinguished professor and associate dean of research at the University of Utah College of Social Work. He’s also the lead author of the study, which was published in JAMA Internal Medicine.
“This study was a real standout,” he says. “To my knowledge, it is one of the most powerful treatment effects that’s really ever been observed for this population.”
Chronic pain is a complex health problem. What’s exciting about this therapy is that it gives you something more to try or add on to your current care plan. Not every remedy works for everyone, including this one. And that’s OK. The goal is to have enough choices to find something that does.
How does Mindfulness-Oriented Recovery Enhancement work?
MORE therapy appears to change the way the brain handles pain. It also helps reduce the habits of addiction and emotional distress. At the same time, you feel happier and find more meaning in life.3 This makes MORE therapy powerful for people with chronic pain.3
Here are the three main techniques Garland’s team used in the study. Feel free to give them a try. But be sure to reach out to your doctor if pain is getting in the way of your daily life.
Practice viewing pain as a sensation
“We taught patients to use mindfulness skills to zoom into pain. We asked them to break it up into sensations such as heat, tightness or tingling,” says Garland. “They also noticed the spaces between those sensations. Those spaces may have no sensation at all or even pleasant sensations right next to the painful ones.”
Why does this work? “Because all pain is in the brain, it’s not in the body,” explains Garland. Nerves tell the brain that there’s physical damage. The brain interprets it as pain. That’s how pain works. Note: This doesn’t mean that the pain isn’t real. It’s very real. Pain just happens in the nerves and the brain.
Through mindfulness, people learned to change how their brains interpreted those signals from the body. Their experience went from anguish to a simple sensation of heat, tightness or tingling. “And in so doing, they learned how to actually change their pain,” says Garland.3
Try it yourself:
- Focus on your breath and notice when your mind wanders to pain.
- Focus on the pain and break it down into pure sensations, like tightness, heat or tingling.
- Notice whether those sensations have a center and whether they have edges.
- When you do notice pain, breathe into the feeling, and think about softening it.
- Pay attention to how the sensation changes and if it fades with time.
- Focus on the space between the sensations of pain. And feel the open, vast freedom of the space between and surrounding those sensations.
Challenge and change negative thoughts
This therapy is about noticing when you’re feeling pain or stress. Then you reframe it to boost resilience. For example, take someone who was experiencing a stressful life event. They were asked to think about the situation in a different way. They thought about questions like, “What’s a more helpful way to think about this?” and “What can I learn from it?”
Garland says this practice can help you gain a more helpful perspective on the challenges in your life. It can also help you find a sense of meaning in the face of adversity.
Try it yourself:
- Notice how you’re reacting to a stressful event. How are you feeling? What are you thinking?
- Focus on your breath to help calm your body and open your mind.
- Ask yourself: Is there a more helpful way to think about this situation?
- Imagine different and more positive ways you could handle this challenge.
- Think about how going through this situation could help you grow as a person.
- Focus your attention on these new, more positive ways of thinking.
Savor positive experiences
The final mindfulness technique helps people think about what’s good instead of what’s painful.
"We taught patients to first focus on a pleasant life event. (Examples: a beautiful sunset, fall colors, connection with others, singing birds or blossoming flowers.) Then we asked them to think about the good feelings or sensations the memory gave them,” says Garland. Over time, the therapy helps change the way the brain processes natural, healthy rewards.
This is especially helpful for treating opioid addiction. That’s because opioid use can interfere with that reward system. It also makes you more responsive to drug-related cues, pain and distress. And that generally just drives more drug use.
This mindfulness strategy helps your brain become sensitive to those healthy rewards again. And Garland notes that it may lessen chronic pain. When you feel pleasure, your brain makes endorphins that act as a natural painkiller.
Try it yourself:
- Pay attention to your breath.
- Think about something pleasant.
- Zoom in on the pleasant details of this person, object or experience: What does it look like? How does it sound? What are the textures and temperatures? How does it smell?
- Notice the positive feelings in your body and mind when you focus on these pleasant details.
- Savor these feelings.
- Refocus on the pleasant thing again. Hold it in your mind.
The patients learned these techniques through eight weeks of group therapy sessions and then practiced them on their own for 15 minutes a day. They also did three minutes of mindfulness before taking opioid medication. And it helped a lot of people curb their use. More than a third of patients could cut their opioid use in half or more.
Many people could skip their opioid medicine after practicing mindfulness for a few minutes, Garland says.
Mindfulness for constant pain shows a lot of promise. To learn how to do it, get help from a trained health professional.
Fortunately, Garland is on a mission to spread these mindfulness techniques taught in MORE. He's already trained 550 doctors and therapists around the country.
Feeling stressed or just need an ear? Optum has digital mental health support tools that can help. You can work with someone one-on-one through AbleTo.
- PAIN. Prevalence of chronic pain among adults in the United States. Published February 2022. Accessed September 9, 2022.
- JAMA Network. Mindfulness-oriented recovery enhancement vs. supportive group therapy for co-occurring opioid misuse and chronic pain in primary care: A randomized clinical trial. Published February 28, 2022. Accessed September 9, 2022.
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