Chronic pain: the role of Mindfulness and Biofeedback in the treatment of persistent pain.

Two powerful allies to combat chronic pain.

Feeling pain is normal and part of our immune system.. The body uses pain as an alarm signal, a warning that tells us that something is wrong and that for some reason we are in danger. Normally, however, this sensation goes away as soon as the threat disappears.

What happens when the pain never goes away and is part of the individual's life? Then we are faced with a problem of chronic pain.

What is chronic pain?

If you are completely unaware of what chronic pain is, you can start by watching this video about its main characteristics:

Who suffers from chronic pain?

According to a study by Oye Gureje and his collaborators, approximately 23% of people suffer from chronic pain. This rate increases with age, affecting up to one third of the elderly population. Moreover, the World Health Organization itself recognizes that it is a highly disabling problem in all its forms: low back pain, arthritis, headache, fibromyalgia, among many others.

The pain that accompanies these problems is not always the same: there will be days when the sufferer only feels discomfort -this being a good day- and others when the pain will be so intense that he/she will not be able to move from the chair.

Episodes of pain are impossible to avoid; one must learn to live with them. learn to live with them and find ways to manage them as much as possible. The best way to do this is through stress management.

Regaining control

Thanks to a study by Kimberly T., M.D., Ph. Sibille, we know that people with chronic pain show higher levels of stress than other people, both biochemically and psychologically. Moreover, when we are under stress our perception of pain is increased. Thus, people with pain enter a vicious circle in which they feel more pain in the face of a stressful event, thus generating more stress and escalating their suffering.

The role of the psychologist is to break this circle so that the patient does not experience these episodes in such a painful way and improve their quality of life. The key to pain management lies in the appraisal of control, or the belief that one has the resources to manage pain.

How can we get someone to learn to control chronic pain? In this regard, both biofeedback and biofeedback and Mindfulness.

Techniques to control chronic pain: Biofeedback

Broadly speaking, the basic component of biofeedback training is the biofeedback training is learning to control various Biological functions using information from those functions.

In chronic pain, an electromyography. A very thin needle electrode is inserted through the skin into the muscle. The electrode in the needle detects the electrical activity released by the muscles. This activity is displayed on a nearby monitor and can be heard through a loudspeaker. Thus, the patient is able to identify pain signals, control muscle tension to achieve relaxation and thus lessen the pain experience, etc.

The philosophy of Mindfulness

The philosophy of Mindfulness is mainly based on living in the present, being attentive to what is happening without judging or interpreting. In other words, it is based on accepting reality as it is. In fact, it is sometimes considered as a technique of other therapies such as acceptance and commitment therapy.

We invite you to discover the psychological benefits of Mindfulness by consulting these articles:

"What is Mindfulness: the 7 answers to your questions".

"Mindfulness: 8 psychological benefits of mindfulness".

Its application in patients with chronic pain is based on the idea that it can help them to accept pain and therefore reduce avoidanceand to have more control over their attentional processes so closely linked to the perception of pain. In fact, when Mindfulness is assessed as an ability or personality trait it correlates with pain. People who score higher in Mindfulness feel less pain, have a higher quality of life and suffer fewer negative emotions.

There are many other techniques such as relaxation for problems such as headaches or migraines, emotional writing to make sense of the experience, or training the person to focus their attention on something other than their pain during episodes. Each patient will do well with a different type of intervention depending on their characteristics and that of their episodes.

This shows that if you suffer from chronic pain, however incapacitating it may be, it is possible to learn to manage it and live with it. To quote Gautama Buddha: "Pain is inevitable but suffering is optional."

Bibliographical references:

• Gureje, O., Simon, G. E. and Von Korff, M. (2001). A cross-national study of the course of persistent pain in primary care. Pain92, 195-200. doi:10.1016/S0304-3959(00)00483-8.
• McCracken, L. M., & Velleman, S. C. (2010). Psychological flexibility in adults with chronic pain: a study of acceptance, mindfulness, and values-based action in primary care. Pain, 148,141-147.
• Sibille, K. T., Langaee, T., Burkley, B., Gong, Y., Glover, T. L., King, C., … Fillingim, R. B. (2012). Chronic pain, perceived stress, and cellular aging: an exploratory study. Mol Pain, 8:12.
• Van Uum, S. H. M., Sauvé, B., Fraser, L. a, Morley-Forster, P., Paul, T. L. y Koren, G. (2008). Elevated content of cortisol in hair of patients with severe chronic pain: a novel biomarker for stress. Stress (Amsterdam, Netherlands), 11, 483–488. doi:10.1080/10253890801887388