Mindfulness Meditation - An Adjunct to Rheumatoid Arthritis Treatment

Ancient Technique Helps People With Chronic Pain

Mature woman meditating in garden.
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Mindfulness meditation is an adjunct therapy for rheumatoid arthritis, as well as other chronic conditions (e.g., fibromyalgia, psoriasis). Most people with rheumatoid arthritis are treated with a combination of medications to control pain and slow progression of the disease. It can be an arduous process finding the best combination of drugs because it is not the same for every patient.

Even when a treatment regimen is decided upon, side effects or an inadequate response to treatment may occur.

That's usually when people look to alternative treatments, natural treatments, or adjunctive therapies. An adjunctive therapy is one which is added into your treatment regimen to be used along with your other treatments. There are many adjunctive therapies or treatments. Mindfulness meditation is not new, but it is being explored and is gaining in popularity as people with rheumatoid arthritis learn more about it.

What Is Mindfulness Meditation?

Mindfulness meditation is a mental technique which is used to focus your attention and awareness on the present moment. The term "mindfulness" is derived from the Pali (language of early Buddhist scriptures) word "sati" which means "to remember." In this case, it refers to remembering to reconnect to the present moment, not remembering a past experience.

A Bit of History

Meditation originated over 2,500 years ago as part of ancient religious and spiritual practices.

While it is said to have originated from Buddhist disciplines, mindfulness was integrated into Christianity, Hinduism, Islam, Judaism, and Taoism as well.

It is just within the past few decades, though, that Western researchers started to recognize the benefits of meditation with regard to physical and mental health.

Mind-body techniques are now considered a viable adjunct therapy for chronic pain conditions.

A Western practitioner, Jon Kabat-Zinn, presented the Mindfulness Based Stress Reduction (MBSR) program in his book "Full Catastrophe Living", originally published in 1990. At first, the program was intended for people with extremely severe illnesses, but it later was adapted for use in the clinical setting to help those with rheumatic diseases of all severity levels. Kabat-Zinn defined mindfulness as "paying attention on purpose, in the present moment, and non-judgmentally, to the unfolding of experience moment to moment."

How Does It Help?

In terms of health, the goal of mindfulness meditation is to see beyond your emotions and to focus on coping with pain and other aspects of the disease, in the present moment. Mindfulness meditation need not be regarded as a spiritual practice despite its origins when used to control emotions and focus on coping. Think of it simply as a technique to focus awareness moment by moment.

While people living with chronic pain can take pain medication to dampen down its physical impact, it is necessary to be able to deal with the stress of living with chronic pain and to accept it as a part of your life. In people with rheumatic diseases, mindfulness meditation may help to:

  • lessen psychological distress
  • enhance the belief that you can overcome or manage pain and other symptoms
  • process emotions related to living with chronic pain
  • improve your fatigue level
  • improve your ability to carry out self-care strategies
  • improve overall well-being and quality of life

Also, some patients may find that they are more compliant with medication use when using mindfulness meditation as an adjunct treatment. Some people may even be able to decrease medication use. Interestingly, it has been suggested that mindfulness meditation may have physiologic effects beyond what it can achieve psychologically.

How Is It Done?

Generally, to achieve mindfulness, one usually can focus attention by concentrating on breathing. Various exercises can be included and the focus of attention can be varied to include sensations or sounds or images. Sounds simple, doesn't it? It's actually not simple at all. Without training and discipline, your attention moves away from the present and shifts between the past and the future. That's the point of mindfulness meditation. It is a technique that is intended to help you focus on the present.

Several approaches to mindfulness exist, but the Mindfulness Based Stress Reduction (MBSR) program is the most recognized. Kabat-Zinn developed the program at the University of Massachusetts in the 1970s. MBSR is an 8-week class which consists of weekly sessions lasting 2.5 to 3 hours. People taking the class learn and practice:

  • sitting meditation that focuses on breath
  • contemplative walking
  • mindful movement using gentle yoga postures
  • how to focus attention on various sensations in the body

Towards the end of the 8-week class, the mindfulness practice is applied to daily activities, called informal mindfulness practice. Audio recordings are provided to support the home practice of mindfulness. Those taking the class must do about 45 minutes of formal mindfulness practice 6 days a week during the 8-week period. There is also a retreat towards the end of the 8-week period where participants sit in uninterrupted silence for a designated period of time.

There are about 1,000 certified MBSR instructors that can be found in almost every state, as well as 30 countries. Before you check to see if there is an instructor in your vicinity, you must have a strong personal commitment to the 8-week process, as well as an understanding of its purpose. You can find out more about MBSR at the Center for Mindfulness at the University of Massachusetts Medical School. If you can't get to a class, there is a workbook available for purchase called A Mindfulness-Based Stress Reduction Workbook, by Bob Stahl, Ph.D. and Elisha Goldstein, Ph.D. The forward was written by Jon Kabat-Zinn, Ph.D.

Sources:

Mindfulness Meditation: A Primer for Rheumatologists. Laura A. Young M.D., Ph.D. Rheumatic Disease Clinics North America. 2011 Feb; 37(1): 63–75.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3045754/

Mindfulness May Improve Medical Efficacy in Rheumatology Patients. Kimberly Retzlaff. The Rheumatologist. September 15, 2015.
http://www.the-rheumatologist.org/article/mindfulness-may-improve-medical-efficacy-in-rheumatology-patients/

Practicing Mindfulness Can Help Alter Patients’ Experience with Chronic Rheumatic Diseases. C. Ronald MacKenzie, M.D. April 15, 2016.
http://www.the-rheumatologist.org/article/practicing-mindfulness-can-help-alter-patients-experience-chronic-rheumatic-diseases/2/

Mindfulness in Medicine. David S. Ludwig, M.D., Ph.D.; Jon Kabat-Zinn, Ph.D. JAMA. 2008;300(11):1350-1352.

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