Tuesday, September 20, 2016

MINDFULNESS AND POST-OPERATIVE PAIN RELIEF

Mindfulness and other forms of meditation can assist in the relief and management of post-operative pain.

In a study at Mount Sinai Hospital in New York City, a neurosurgeon has teamed up with a geriatrician who leads meditation classes to test whether the technique can lessen pain in spine-surgery patients and reduce the need for painkillers. 

The randomized trial trains patients in a simple form of meditation and asks them to practise it starting two weeks before their surgery and for six weeks after, using audiotapes to guide them. Dr David Langer [pictured], chairman of neurosurgery at Lenox Hill Hospital in New York City, says meditation can help reduce anxiety and stress, which can make pain worse. In other words, meditation helps to break the pain-tension cycle.

Meditation has previously been found to benefit patients with a host of medical and psychological issues. The study, published in 2011 in the Journal of Neuroscience, involved 15 people who were subjected to pain using heated probes. The researchers used an MRI to scan the brains of the volunteers and found that pain intensity was 40 per cent less when they practised meditation than when they didn’t. This 2011 study helped inspire the current study at Mount Sinai on postsurgical pain in spine patients. Since the 2011 study there has been more research carried out by the same team of researchers, including a 2015 study that found benefits from mindfulness meditation.

We know that meditation actually changes the way the mind perceives pain so that it becomes more bearable. Mindfulness works by helping the patient to regulate their response to pain; the patient learns to acknowledge and accept the pain as opposed to trying to fight it. It’s the old story: what we resist, persists. It’s all about practising the art of non-resistance.
  

THE PAIN-TENSION CYCLE
Image sourcePhysiopedia

For those suffering from chronic pain -- and not just post-operative pain -- here are some suggestions I and others have found helpful over the years:

ONE. When you first feel a sensation of pain, avoid the temptation to react to it by resisting it or trying to make it go away.
TWO. Observe the pain. Just observe it. Notice it. Acknowledge its existence. Say to yourself, interiorly and slowly, ‘There is pain.’ (Never say, 'I am in pain.' Never attach the 'I' of you -- the person that you are -- to anything.)
THREE. Now turn the focus of your attention to the pain you feel. Visualise the pain. Is it ‘large’, ‘medium’ or ‘small’? What is its ‘length’, ‘width’ and ‘shape’? What is its ‘colour’?
FOUR. Note the intensity of the pain. Is it ‘very hot’, ‘hot’ or just ‘lukewarm’?
FIVE. Having observed and noted the pain, simply let your pain be there. Don't hold on to it or try to push it away. Say to yourself, interiorly and slowly, ‘It is what it is.’ Let it be.
SIX. Then gently bring the focus of your attention to your breathing. Observe your in-breath and out-breath. Take several deep but slow and steady cleansing breaths. Be mindful of your breathing.
SEVEN. Now turn your mind inwards and proceed to let go of thoughts, feelings, images and sensations. Be fully engaged in the present moment, from one moment to the next. Focus your awareness only on your in-breath and out-breath. Let everything else drop away.
EIGHT. Relax.

The Indian spiritual teacher J. Krishnamurti would say, ‘On the acknowledgement of what is there is the cessation of all conflict.’ Yes, it is simply amazing – well, not that amazing, really – how merely acknowledging what is can result in the cessation of conflict, that is, struggle, resistance, conflict and turmoil ... and even the experience of pain itself.

Acceptance is not about giving up or giving in. It’s about acknowledging what is and not fighting or resisting it. When you start practising the art of non-resistance, you begin to break the pain cycle.





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