Recently, SA Hand Therapy has had the pleasure of having Daniel, a final-year Master of Occupational Therapy student from Flinders University, Adelaide. He has spent the past eight weeks completing his second clinical placement with us at our Adelaide, Daw Park, and Mawson Lakes clinics, seeing a range of clients with our experienced staff.
Daniel completed a mini project looking at mindfulness as a treatment method for chronic pain, considering how we at SA Hand Therapy can consider the role of mindfulness with some of our clients.
Pain that is ongoing and experienced most days of the week, beyond expected healing timeframes of 3 – 6 months, is usually defined as chronic pain. Chronic pain can result from injury, surgery, musculoskeletal conditions such as arthritis, or in some cases there may be no apparent physical cause.
Within Australia, chronic pain is experienced by 1 in 5 Australians over the age of 45 according to the Australian Institute of Health and Welfare, 2017. With such a high prevalence, it’s common for SA Hand Therapy to see many clients with ongoing chronic pain. This may also be accompanied by further stressors such as fear, anxiety, and depression. The combination of these stressors and pain can have adverse effects on well-being and how we engage and get through day-to-day activity.
Mindfulness is the ‘non-judgemental awareness of the present moment’ (Zeidan & Vago, 2016). The present moment experience can take many forms, including body sensations, emotional reactions, and even mental images. Mindfulness techniques include, meditation, breathing exercises, and focussing on our five senses to help strengthen our mind body connection and feel calm and focused.
What happens inside the brain when practicing mindfulness? Mindfulness enhances the anterior cingulate cortex, the brain area which improves our emotional regulation and decreases stress. Evidence also shows reduced activity in the amygdala, the region used to process fearful and threatening stimuli (Wheeler, Arnkoff, & Glass, 2017).
Evidence shows that with consistent mindfulness practice, we find ourselves better at dealing with stressful stimuli, our fears, our anxieties, and an improvement in our overall wellbeing (Majeed, Ali, & Sudak, 2018 and Zeidan, Gordon, Merchant, & Goolkasian, 2010). This in turn can vastly influence how we experience pain. Research also shows an overall reduction in pain intensity in some circumstances (Reiner, Tibi, & Lipsitz, 2013).
While this is not a quick fix, with no guarantee of immediate pain relief, what mindfulness can help improve is overall wellbeing, helping to manage emotions which may be influencing our pain (Zeidan, Gordon, Merchant, & Goolkasian, 2010).
But what about mindfulness-based apps? Mobile-based mindfulness applications can be a fun and engaging way to help with mindfulness-based exercises. While there are hundreds of applications, two commonly used versions are Headspace and SuperBetter.
Daniel’s interest in this topic has aligned well with SA Hand Therapy’s open-minded approach to client well-being. If you have any questions about mindfulness or would like some guidance in this area in relation to a chronic arm or hand pain, please let our team know and one of our therapists would be more than happy to answer any questions and help you explore many management possibilities.
Majeed, M. H., Ali, A. A., & Sudak, D. M. (2018). Mindfulness-based interventions for chronic pain: Evidence and applications. Asian journal of psychiatry, 32, 79-83. https://doi.org/10.1016/j.ajp.2017.11.025
Reiner, K., Tibi, L., & Lipsitz, J. D. (2013). Do mindfulness-based interventions reduce pain intensity? A critical review of the literature. Pain Medicine, 14(2), 230-242. https://doi.org/10.1111/pme.12006
Wheeler, M. S., Arnkoff, D. B., & Glass, C. R. (2017). The neuroscience of mindfulness: How mindfulness alters the brain and facilitates emotion regulation. Mindfulness, 8(6), 1471-1487. https://doi.org/10.1007/s12671-017-0742-x
Zeidan, F., Gordon, N. S., Merchant, J., & Goolkasian, P. (2010). The effects of brief mindfulness meditation training on experimentally induced pain. The Journal of Pain, 11(3), 199-209. https://doi.org/10.1016/j.jpain.2009.07.015.
Zeidan, F., & Vago, D. R. (2016). Mindfulness meditation–based pain relief: a mechanistic account. Annals of the New York Academy of Sciences, 1373(1), 114-127. https://doi.org/10.1111/nyas.13153