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Meditation for Pain Relief Doesn’t Use the Body’s Natural Opioids

meditation for pain reliefResearch has fairly well established that meditation for pain relief can be a powerful tool, but HOW it helps remains a mystery. One hypothesis is that meditation employs the body’s naturally occurring opioids to control pain. This is what happens when you stub your toe—it hurts at first then it stops hurting when your body produces opioids to block the pain. This opioid theory is incorrect, according to a study published today in the Journal of Neuroscience.

The drug naloxone, which blocks the pain-reduction opioids can provide, was a key part of the study. Researchers divided 78 healthy, pain-free participants into four groups: naloxone plus meditation, naloxone without meditation, saline placebo plus meditation, and saline placebo without meditation. Pain was induced by using a thermal probe to heat a portion of participants’ skin to 120.2 degrees Fahrenheit. Participants used a sliding scale to rate their pain. Each participant established a baseline pain rating before receiving any treatment. The pain ratings after the treatment were 24% lower than baseline in the group that meditated and received naloxone. The ratings were 21% lower than baseline in the meditation group that received the saline placebo. Pain levels were higher than baseline in the groups that did not meditate, whether or not they receive naloxone.

These pain reduction levels are significant because they show that meditation reduced pain even in people whose opioid receptors were chemically blocked. Thus indicating that non-opioid pathways are responsible for pain relief in meditation. Further research is required to determine which pathways might be at work. It will be interesting to see if those pathways (whatever they are) have already been identified as having a role in pain relief.

Although the study included healthy participants who experienced fleeting pain, the lead researcher says the findings could be particularly helpful for people who want to avoid opioids or have built up a tolerance to them—the latter of which implies people with chronic pain. He did not condemn other treatments, but said that meditation can be used to enhance the benefits of other treatments.

Whenever I share anything about pain, I feel the need to clarify that most headache disorders are not just pain. Migraine, cluster headache, and even new daily persistent headache have symptoms that extend beyond pain. Focusing only on the pain diminishes the non-pain symptoms that can be just as, or even more, disabling than the pain. It can also lead to ineffective or even harmful treatment. I’m not worried about that with meditation, but it’s still good to remember that pain isn’t the only symptom for most headache disorders (though I doubt most of you could forget that!). In addition to it’s potential to reduce physical pain, meditation is a great tool for managing the emotional distress that comes with headache disorders. And, as Alicia pointed out in the discussion on acceptance, “the psychological aspect of having migraines can be just as devastating as the physical aspect.”

 

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Readers Speak: Reflections on Acceptance

Thank you for your thoughtful responses on acceptance! I’ve loved seeing your thoughts on a topic so close to my heart.

Only three of you balked at the idea of acceptance. For a couple of you, it was seen as as giving up the search for effective treatment.

Debbie: “I’m not there yet after 35 years. I can’t accept this is going to be the rest of my life! I search regularly and often for answers.”

Rowena: “I’m also going on 30 years with chronic migraine and I refuse to accept that this is how my life will always be.”

The third dissension also defined acceptance as resignation, but believes that her anger about migraine is what motivated her to find relief.

Bibi: “Not accepting my migraines—being innerly infuriated about how much good time was stolen from me made me motivated to change my lifestyle, diet and how I arrange my work life. It can be hard to accept once in a while, that I have to maintain this healthy lifestyle to stay free of the migraines for longer stretches. Like a diabetic I have to avoid things, else my body gets totally out of balance. This was hard to accept in the start, because I felt sorry for myself not being able to eat chocolate and a lot of other foods or to binge on computer watching at night. I try to treat myself with different ‘goodies’ now, when I want to have a good time now. Perhaps saints can accept the crippling, depressing attacks—I couldn’t.”

While our motivators may be different, I don’t think those of us who accept migraine are saints, nor do I believe we are complacent about the “crippling, depressing attacks.” In fact, everyone who wrote about embracing acceptance also said the continue to try to find relief, either by trying new treatments or managing triggers.

Newfoundlander: “I, too, have found that acceptance has been very important to my life quality. It has allowed me to grieve deeply about the life I don’t have. Unloading that heavy grief has lightened my emotional load, so life is better, even if the daily migraines are not. Simultaneously, I keep one foot in the door of hope. Hope for medical advancements, hope for new insights, hope for miracles for us all. That keeps me researching new possibilities. This balance of acceptance and hope is the best approach for me so far.”

Natali: “My most recent and potentially final liberation from the torment of migraines is exactly the same statement of acceptance. That doesn’t mean that I don’t (still!) try new medications or new treatments, it doesn’t mean that I have lost hope and have totally surrendered to a life of doom and gloom…. Acceptance of some short shifts the power back to the individual, you are no longer at the mercy of migraines…. [it] is not about defeat, pessimism or giving up. It is the start of rising from the ashes like a phoenix. It is a very spiritual and pragmatic means of reclaiming one’s own inner strength. I only wish, I had embraced the idea of ‘just accept it’ earlier in my life, to save myself endless days and nights of hellish desperation and pain.”

Lisa: “I think acceptance can easily live next to still being open to what may help…. Well maybe not easily. It takes work, but it’s possible.”

Dawn: “Yes. This has been the biggest help in my life. I still keep my ears open for ideas, but my life isn’t about the search anymore.”

Trish: “I agree that it is a healthy place for me to be when I can accept that I will always have migraines…. If there comes a day that a cure is found or something else works for me, hallelujah!!! Until then, I do have them, I just need to get on with this thing I call life.

Alicia gives a great example to differentiate acceptance from resignation:

“Eckhart Tolle in The Power of Now makes an important distinction between acceptance and resignation. Acceptance is where you are right now in the present moment. He gives an example of being stuck in the mud. If you’re stuck in the mud, you don’t necessarily have to like it or resign yourself to being stuck in the mud. But until you acknowledge that you’re stuck in the mud, you really can’t take necessary steps to get out of the mud. I think that I can accept that migraines are a part of my life. But I don’t necessarily resign myself to them. In the present moment, even if I have a migraine, I try to accept it and then do the necessary things I can do to abort it or prevent one in the future. Acceptance means not adding extra suffering to the physical pain of the migraine, such as resisting it with phrases such as “I wish this weren’t part of my life”,” this will be my life forever,”” I hate this pain, etc.” Changing the way I think about it has given me a lot of relief—after all the psychological aspect of having migraines can be just as devastating as the physical aspect.”

This response is in a similar vein to Acceptance, Not Resignation, a Migraine.com article I wrote, which several readers mentioned in their responses. I still agree with what I wrote several years ago:

I will never be migraine-free.

You may read that sentence as resignation or giving up on trying to improve my health. For me, it represents acceptance and it feels a world away from resignation.

I haven’t given up on finding an effective treatment—I’m always trying new options and constantly tweaking my regimen—but I have given up on the idea that my life can only be good if I’m migraine-free. And by accepting that I will always have migraine, I have lessened its control over me.

The reader who asked the question about Larissa’s comment emailed me after reading some of your responses. He said he thought that maybe the difference was semantic, so I pointed him to the Migraine.com article. After read it, he agreed that we were using different words to describe the same approach.

This is only a sampling of the responses. You can read more in the responses to On Accepting Migraine: Your Thoughts? and in the Facebook discussion.

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Migraine Moments Short Film Contest

Do you want to share your perspective on migraine with health care providers (including headache specialists), research scientists, and patient advocates? Migraine Moments, the American Migraine Foundation’s short film competition, is your chance to do just that. According to AMF’s website, the goal of the films is to “convey many powerful and complex ideas about migraine and people with migraine—the pain and burden of course, but also the struggles and triumphs in finding relief and help from treatments and doctors, family and friends.”

Entries, which are due by April 1, can be any sort of original video you’d like to create: documentary, music video, animation, simulations, visualizations, fiction, performance art, interpretive dance… whatever feels like the best way for you to convey your experience with migraine. Be as creative as you like, as long as the video is a finished work of your own creation that’s no longer than five minutes. Entries will be judged by members of the American Headache Society’s electronic media committee and board of directors.

The first place winner will receive $2,500 and a trip to San Diego to present their work at the American Headache Society’s meeting on Friday, June 10, 2016. The second place winner will receive $1,000 and the third place prize is $500. Winning entries will also be promoted on social media and AMF’s website.

Check AMF’s website for the Migraine Moments official contest rules and entry form.

Don’t fret if you don’t have time to get your entry together by this year’s deadline. AMF plans to turn this into an annual event.

(Wondering why the winners will be presenting at the American Headache Association’s meeting when the contest is sponsored by the American Migraine Foundation? The two groups are part of the same organization. The American Migraine Foundation is the fundraising branch of the American Headache Society. AMF is the force behind the 36 Million Migraine campaign.)

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On Accepting Migraine: Your Thoughts?

“The most important thing I’ve done to deal with migraines emotionally is to accept that I have them and will for the rest of my life.”

That’s an excerpt from Larissa’s story of life with chronic migraine, which I shared last week. It registered with me as healthy statement of acceptance, but it didn’t sit right with a longtime reader. This reader’s unique insights and questions give me a different perspective and help me clarify my own thoughts, so his comments always catch my attention. He wrote:

Would be very interested what the readers thought of one statement of Larissa’s story: “The most important thing I’ve done to deal with migraines emotionally is to accept that I have them and will for the rest of my life.”

Why accept she may have them rest of her life? She is around 30 years old—she will probably live another 60 years or so. With new medical advances and because she is so young—is that a helpful perspective moving further? (No offense to Larissa in my query.)

What I love about this reader is that he hasn’t discounted Larissa’s perspective even though it doesn’t sit right with him. He’s genuinely curious to know about her point of view and what other people think of it. So I’m passing his question on to you.

What do you think of the statement: “The most important thing I’ve done to deal with migraines emotionally is to accept that I have them and will for the rest of my life”? Do you think it is a helpful perspective or not? Do you agree with it and operate under the same principle or do you disagree?

Please leave a comment with your response. I’m looking forward to hearing what you think. I don’t want my thoughts to influence anyone’s response, so I’ll share my response a little later.

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Migraine Stories: Chronic Migraine Hasn’t Eclipsed Larissa’s Spirit

At 30 years old, Larissa has never been able to work full time due to chronic migraine. She still works when she can with an “extremely part-time job” that takes six hours a week and sells her beautiful knit goods on her Etsy shop, Purl Knitting. Larissa is also studying arts and cultural management in a part-time distance learning program. Her determined, hopeful spirit shines through her responses. 

chronic migraine spiritHow frequent are your migraine attacks? What’s your pain like? What are your other most bothersome symptoms?

I have migraine symptoms mixed with tension type headache every day that includes muscle pain and tension, moderate head pain, light sensitivity and nausea. About twice a week it will worsen into a more severe attack. My migraines go in cycles of severity as well, so I will sometimes have a very severe migraine for 2-3 weeks. My pain can be either one sided or all over my face and head, and is usually around a 4-6 out of 10 on daily basis. I would say my most bothersome symptoms are widespread constant muscle pain and tension throughout my face, neck and shoulders, nausea and lack of energy.

What are some of things you find most frustrating about having chronic migraine?

My lack of ability to plan anything or know if I will be able to do anything, and the limitations that it places on my day to day life. I have to constantly pace myself and reign in my activities and energy output to be able to make it through the day.

How has your career been affected by chronic migraine?

I have never been able to work full time because of chronic migraine, and I am now only able to work limited hours from home as an arts administrator. I have had to leave jobs because of it and I’ve had to be on employment insurance because of it. I trained to be a dancer and would like to dance in some way now, but migraines are really holding me back. I feel that although I have the skills and experience needed to do the jobs that I want to do, I don’t fit most job descriptions because I can’t be there in person all the time or work in a traditional way.

However, I consider myself very lucky to be able to work a little bit and also run my Etsy shop, Purl Knitting. Knitting is something I can do 98% percent of the time even if I am quite sick, so it is amazing to have something like that in my life. I am also completing a certificate in Arts and Cultural Management online from Grant MacEwan University that I have been working on for a few years now.

How do you manage work and school with chronic migraine? Can you share any coping or planning strategies that you find useful?

To balance work and school I first do a lot of upfront communication with my employer and with my school professors and staff to make sure they understand my condition and how it can affect me. I am registered with the Disability Accommodations office at the University. Then, I am a very careful planner and make sure that I stay well on top of my work and school so that I always have a buffer if I need to take a few days off being sick. I do plan in a way that no day will have too much work in it but also will allow me to get ahead of schedule. As I said, I do both work and school from home so I can work in small chunks and then rest, eat, walk and nap in between.

What coping strategies do you use to deal with chronic migraine?

The most important thing I’ve done to deal with migraines emotionally is to accept that I have them and will for the rest of my life. When someone first suggested that I needed to do this, I was incredibly angry because it seemed so wrong to accept something like this into my life. Doing so has allowed me to move forward and focus on what I can do. I see a psychotherapist once a week to work on coping strategies which has been extremely useful and made me much more resilient. I have generalized anxiety disorder and have had depressive episodes so I keep a close eye on myself and have my husband and doctors do this as well to notice any flare ups. I find it very important to catch them before they get too bad because if I get into bad mental state my migraines will spiral out of control.

What do you wish people knew about migraine?

I wish people knew that migraine is more than just a bad headache, that it is a neurological disorder that causes you to experience widespread symptoms and severe disability.

What else would you like to share?

For people with migraine: You are enough, and you do enough.


Readers, we’d love to read your story! You can submit it (and upload pictures) at: What’s YOUR Story?