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Mindfulness Chronic Pain

Joshua A Grant, Fadel Zeidan
Consciousness, defined here as the quality of awareness of self and the corresponding sensory environment, is considered to be one of most enigmatic and contentious areas of scholarly dissection and investigation. The subjective experience of pain is constructed and modulated by a myriad of sensory, cognitive and affective dimensions. Thus, the study of pain can provide many inroads to a concept like consciousness that the traditional sense modalities do not. Mindfulness defined here as non-reactive awareness of the present moment, can uniquely control and/or modulate particular substrates of conscious experience...
January 9, 2019: Current Opinion in Psychology
Sanjay Kalra, Gagan Priya, Emmy Grewal, Than Than Aye, B K Waraich, Tint SweLatt, Touch Khun, Menh Phanvarine, Sun Sutta, Uditha Kaush, Manilka, Sundeep Ruder, Bharti Kalra
Buddhist philosophy is a way of life that transcends the borders of religion and focuses on the alleviation of suffering. The core teaching of Buddha was the Four Noble Truths: there is suffering, suffering is caused by clinging and ignorance, there is a way out of suffering and that way is the Noble Eightfold Path. The medical analogy in diabetes care would include identification of diabetes, understanding its etiopathogenesis, and how prognosis can be improved with appropriate care and management of this chronic disorder...
November 2018: Indian Journal of Endocrinology and Metabolism
Eric L Garland, Barbara L Fredrickson
The Mindfulness-to-Meaning Theory (MMT) is a temporally dynamic process model of mindful positive emotion regulation that elucidates downstream cognitive-affective mechanisms by which mindfulness promotes health and resilience. Here we review and extend the MMT to explicate how mindfulness fosters self-transcendence by evoking upward spirals of decentering, attentional broadening, reappraisal, and savoring. Savoring is highlighted as a key, potential means of inducing absorptive experiences of oneness between subject and object, amplifying the salience of the object while imbuing the sensory-perceptual field with affective meaning...
January 14, 2019: Current Opinion in Psychology
Ariana Thompson-Lastad, Paula Gardiner, Maria T Chao
Purpose: Integrative group medical visits (IGMVs) aim to increase access to complementary and integrative health care, which is particularly relevant for low-income people. We sought to describe IGMV programs in US safety-net clinics through a survey of providers. Methods: An online and paper survey was conducted to collect data on the use of complementary health approaches and characteristics of IGMV programs. We recruited a purposive sample of safety-net clinicians via national meetings and listservs. Results: Fifty-seven clinicians reported on group medical visits...
2019: Health Equity
Eve-Ling Khoo, Rebecca Small, Wei Cheng, Taylor Hatchard, Brittany Glynn, Danielle B Rice, Becky Skidmore, Samantha Kenny, Brian Hutton, Patricia A Poulin
QUESTION: This review compares mindfulness-based stress reduction (MBSR) to cognitive-behavioural therapy (CBT) in its ability to improve physical functioning and reduce pain intensity and distress in patients with chronic pain (CP), when evaluated against control conditions. STUDY SELECTION AND ANALYSIS: Ovid MEDLINE, EmbaseClassic+Embase, PsycINFO and the Cochrane Library were searched to identify randomised controlled trials. The primary outcome measure was physical functioning...
February 2019: Evidence-based Mental Health
Richard B Lipton, Stephen Silberstein
Migraine is associated with considerable pain and disability. Accurate diagnosis that differentiates migraine from other primary and secondary headache disorders is needed, and clinicians should assess the patient's risk of progressing to chronic migraine. Many patients will benefit from preventive treatment. Clinicians must know how to identify these patients and be familiar with the numerous preventive treatments. Finally, clinicians must select the safest, most effective treatment while keeping in mind individual characteristics such as coexisting conditions and patient preferences...
December 27, 2018: Primary Care Companion to CNS Disorders
Jessica M Brooks, Kanako Iwanaga, Brandi Parker Cotton, Jon Deiches, John Blake, Chungyi Chiu, Blaise Morrison, Fong Chan
The study purpose was to evaluate pain catastrophizing and psychological distress as mediators for the relationship between perceived mindfulness and depressive symptoms in people with chronic pain. We conducted an online cross-sectional survey with 211 adults with chronic musculoskeletal pain recruited from U.S. clinics and community networks. A serial multiple mediation analysis was performed using ordinary least-squares regressions and a bootstrap testing approach. Pain catastrophizing and psychological distress, independently and jointly, mediated the relationship between mindfulness and depressive symptoms...
April 2018: Journal of Rehabilitation
Eric L Garland, Myranda A Bryan, Sarah E Priddy, Michael R Riquino, Brett Froeliger, Matthew O Howard
Background: Among opioid-treated chronic pain patients, deficient response inhibition in the context of emotional distress may contribute to maladaptive pain coping and prescription opioid misuse. Interventions that aim to bolster cognitive control and reduce emotional reactivity (e.g., mindfulness) may remediate response inhibition deficits, with consequent clinical benefits. Purpose: To test the hypothesis that a mindfulness-based intervention, Mindfulness-Oriented Recovery Enhancement (MORE), can reduce the impact of clinically relevant, negative affective interference on response inhibition function in an opioid-treated chronic pain sample...
January 22, 2019: Annals of Behavioral Medicine: a Publication of the Society of Behavioral Medicine
Alexandre Gouveia, Olivier Pasche, Silva Auer, Robin Chenal, Lionel De Alencastro, Yvonne Fierz, Rebecca Gray, Lionel Koehli, Christophe Monney, Kevin Selby, Patrick Bodenmann
Mindfulness meditation and cognitive-behavioral therapy are more cost-effective than conventional management of chronic low back pain. Women with iron deficiency can be treated with oral iron substitution every other day to improve tolerance. Smokers who smoke four or less cigarettes per day have a disproportionately high risk of cardiovascular and cerebrovascular events. All antidepressants are effective in cases of severe depression. Cannabis derivatives have no analgesic effect and do not improve the quality of life of people with neuropathic pain...
January 17, 2019: Revue Médicale Suisse
William Jackson, Emily L Zale, Stanley J Berman, Alberto Malacarne, Amy Lapidow, Michael E Schatman, Ronald Kulich, Ana-Maria Vranceanu
Purpose: The importance of improved physical function as a primary outcome in the treatment of chronic pain is widely accepted. There have been limited attempts to assess the effects mindfulness skills training (MST) has on objective outcomes in chronic pain care. Methods: This systematic review evaluated published reports of original randomized controlled trials that described physical function outcomes after MST in the chronic pain population and met methodological quality according to a list of predefined criteria...
2019: Journal of Pain Research
Shintaro Irie, Takatoshi Anno, Fumiko Kawasaki, Ryo Shigemoto, Hideaki Kaneto, Kohei Kaku, Niro Okimoto
BACKGROUND: Osteomyelitis is an infection in a bone. Acute osteomyelitis is observed mainly in the long leg bones of children and is usually treated with antibiotics. On the other hand, in adults, subacute or chronic osteomyelitis is more common. Antibiotics therapy is not necessarily effective for chronic osteomyelitis, and sometimes a surgical operation is performed for its remission. Furthermore, in classification of osteomyelitis by cause, type 2 diabetes mellitus is one of most common conditions associated with osteomyelitis...
January 7, 2019: Journal of Medical Case Reports
Dominika Lipowska James, Maryam Jowza
Inappropriate and excessive opioid prescribing practices for treatment of chronic nonmalignant pain contributed to rising rates of opioid related mortality. Effective and widely available opioid addiction treatment resources are needed to ensure successful resolution of the "opioid epidemic". This chapter outlines the basic pathophysiology of addiction as well as principles of opioid addiction management focusing on the pharmacological and nonpharmacological aspects of care. Pharmacological treatment focuses on opioid substitution therapy, with aim at prevention of opioid cravings and opioid withdrawal symptoms...
March 2019: Clinical Obstetrics and Gynecology
Melissa A Day, L Charles Ward, Dawn M Ehde, Beverly E Thorn, John Burns, Amanda Barnier, Jason B Mattingley, Mark P Jensen
Objective: This pilot trial compared the feasibility, tolerability, acceptability, and effects of group-delivered mindfulness meditation (MM), cognitive therapy (CT), and mindfulness-based cognitive therapy (MBCT) for chronic low back pain (CLBP). Setting: University of Queensland Psychology Clinic. Subjects: Participants were N = 69 (intent-to-treat [ITT] sample) adults with CLBP. Design: A pilot, assessor-blinded randomized controlled trial...
January 3, 2019: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Luisa Meyerholz, Julia Irzinger, Michael Witthöft, Alexander L Gerlach, Anna Pohl
BACKGROUND AND OBJECTIVES: Deviations in interoception might contribute to the development and maintenance of mental disorders. The improvement of interoceptive accuracy (IA) is desirable but assessment and training methods remain controversial. For instance, it was assumed that performance increases in heartbeat counting paradigms after cardiac feedback were due to an improvement of knowledge with regard to heart rate rather than due to an actual improvement in IA. METHODS: Here, we examined effects of contingent cardiac feedback training, non-contingent cardiac feedback, mindfulness practice, and a waiting period with external attentional focus on IA...
December 4, 2018: Journal of Behavior Therapy and Experimental Psychiatry
Panna Gajdos, Adrien Rigó
Irritable bowel syndrome is a chronic functional gastrointestinal disorder with a prevalence of 7-21%. It has a negative impact on health-related quality of life and work productivity and it is associated with increased psychological distress and mental comorbidity, like major depression disorder and generalised anxiety disorder. Due to biopsychosocial factors and the brain-gut axis playing a key role in the aetiology of the disease, the use of psychological treatments has great importance in the therapy of irritable bowel syndrome...
December 2018: Orvosi Hetilap
Joseph Wielgosz, Simon B Goldberg, Tammi R A Kral, John D Dunne, Richard J Davidson
Mindfulness meditation is increasingly incorporated into mental health interventions, and theoretical concepts associated with it have influenced basic research on psychopathology. Here, we review the current understanding of mindfulness meditation through the lens of clinical neuroscience, outlining the core capacities targeted by mindfulness meditation and mapping them onto cognitive and affective constructs of the Research Domain Criteria matrix proposed by the National Institute of Mental Health. We review efficacious applications of mindufulness meditation to specific domains of psychopathology including depression, anxiety, chronic pain, and substance abuse, as well as emerging efforts related to attention disorders, traumatic stress, dysregulated eating, and serious mental illness...
December 10, 2018: Annual Review of Clinical Psychology
Andrew S McClintock, Shannon M McCarrick, Eric L Garland, Fadel Zeidan, Aleksandra E Zgierska
OBJECTIVES: Nonpharmacologic approaches have been characterized as the preferred means to treat chronic noncancer pain by the Centers for Disease Control and Prevention. There is evidence that mindfulness-based interventions (MBIs) are effective for pain management, yet the typical MBI may not be feasible across many clinical settings due to resource and time constraints. Brief MBIs (BMBIs) could prove to be more feasible and pragmatic for safe treatment of pain. The aim of the present article is to systematically review evidence of BMBI's effects on acute and chronic pain outcomes in humans...
December 5, 2018: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
Adina C Rusu, Hannah Gajsar, Michael-Christian Schlüter, Yara-Inken Bremer
OBJECTIVES: Information processing biases such as attentional biases, interpretation biases and memory biases are supposed to play a role in the exacerbation and maintenance of chronic pain. Current research in the area of cognitive biases shows that all these biases seem to have an influence on attention to, interpretation of and recall of pain and can lead to maladaptive strategies and the exacerbation of pain. METHODS: We conducted a narrative literature review, considering evidence extracted from various databases including PubMed, MEDLINE, Science Direct and ProQuest...
November 28, 2018: Clinical Journal of Pain
Nuha Alammar, Ellen Stein
Irritable bowel syndrome (IBS) is present in patients with symptoms of chronic abdominal pain and altered bowel habits but no identifiable organic etiology. Rome IV classification groups patients based on predominant stool pattern. Low-FODMAP diets have been helpful in providing symptom relief, as have cognitive behavioral and mind-body techniques that help patients manage symptoms. Targeted symptomatic relief for the patient's predominant symptoms provides relief in addition to effective older medications that are inexpensive and reliable...
January 2019: Medical Clinics of North America
Mark A Lumley, Howard Schubiner
OBJECTIVE: Chronic pain is a significant health problem that is increasing in prevalence, and advances in treatment are needed. METHODS: We briefly review the leading evidence-based psychological therapies for chronic pain-cognitive-behavioral and acceptance / mindfulness-based therapies-and examine several limitations and missing perspectives of these approaches. We review six lesser-known interventions that address these limitations, and we describe our integrative model for psychological assessment and treatment of centralized pain...
November 19, 2018: Psychosomatic Medicine
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