Healthcare (Commonwealth Union) – For a long time, it was believed that mindfulness meditation, a practice used for pain relief in many cultures for centuries, worked through the placebo effect. However, recent research has disproven this idea.
A new study appearing in Biological Psychiatry has shown that mindfulness meditation utilizes different brain pathways than those involved in the placebo effect to alleviate pain. Researchers from the University of California San Diego School of Medicine employed advanced brain imaging to examine the pain-reducing effects of mindfulness meditation, a placebo cream, and a “sham” mindfulness meditation on healthy participants.
The findings revealed that mindfulness meditation significantly decreased both pain intensity and discomfort, while also dampening brain activity linked to pain and negative emotions. In comparison, the placebo cream only affected brain activity related to the placebo response, without altering the actual perception of pain.
“The mind is extremely powerful, and we’re still working to understand how it can be harnessed for pain management,” explained Fadel Zeidan, PhD, professor of anesthesiology and Endowed Professor in Empathy and Compassion Research at UC San Diego Sanford Institute for Empathy and Compassion. “By separating pain from the self and relinquishing evaluative judgment, mindfulness meditation is able to directly modify how we experience pain in a way that uses no drugs, costs nothing and can be practiced anywhere.”
The research saw the participation of 115 participants across two clinical trials, all of whom were healthy individuals randomly assigned to one of four groups. Each group received a different intervention: guided mindfulness meditation, a sham-mindfulness meditation that involved only deep breathing, a placebo cream (petroleum jelly) which participants were led to believe could reduce pain, and, as a control, a group that listened to an audiobook. Researchers then applied a painful yet harmless heat stimulus to the back of each participant’s leg and conducted brain scans before and after the interventions.
To assess brain activity patterns, the researchers used a cutting-edge technique called multivariate pattern analysis (MVPA). This method employs machine learning to untangle the complex neural mechanisms that contribute to pain perception, including those triggered by the heat stimulus, negative emotions, and placebo-driven pain responses. By doing this, the researchers were able to determine whether mindfulness meditation and placebo treatments activate similar or distinct brain processes.
Although both the placebo cream and sham-mindfulness meditation helped reduce pain, the study revealed that mindfulness meditation was significantly more effective in alleviating pain compared to the other interventions and the control group.
The researchers also discovered that mindfulness-based pain relief disrupted the synchronization between brain regions associated with introspection, self-awareness, and emotional regulation. These areas form part of the neural pain signal (NPS), a recognized brain activity pattern linked to pain across various individuals and types of pain. On the other hand, the placebo cream and sham-mindfulness meditation showed no significant impact on the NPS compared to the control group, instead activating different brain mechanisms with minimal 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,” explained 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.”
Researchers of the study indicated that in contemporary medicine, therapies are typically considered effective and reliable if they surpass the effects of a placebo. Since this study found that mindfulness meditation is more effective than a placebo and operates through different neurobiological pathways, these results hold significant promise for advancing treatments for chronic pain. However, further research is needed to confirm these findings in individuals who suffer from chronic pain rather than in healthy participants.
Looking ahead, the researchers aim to gain a deeper understanding of the unique brain mechanisms involved in mindfulness meditation. Their ultimate goal is to develop more effective and widely accessible treatments that utilize mindfulness to alleviate pain in individuals with diverse medical conditions.
