Summary: Many health experts reject mindfulness as nothing more than a way to distract the mind from pain. But a new study using fMRI (brain scans that show activity) shows mindfulness works. It works in its own way, and it is stronger than a placebo effect.
Many health experts have long doubted that mindfulness meditation helps chronic pain. One reason is that no one could say how it works. Most experts want hard proof, and that proof has mostly been missing.
Plenty of reports and studies show that mindfulness meditation works, especially for chronic pain. But experts have brushed these off as a placebo or a mere distraction from the pain. So they put little trust in mindfulness or in similar therapies.
Now new studies show that mindfulness works, and it is not just a placebo effect. It appears that mindfulness meditation works in a different way from placebo. Advanced brain scans can show the difference. That gives some solid grounds to use such therapies in the clinic, such as in interventional pain management.
Pain research is hard because pain has many sides. Too many things shape how people feel pain. Even the hope that something might help may ease pain. That is the placebo effect.
People in many cultures have used mindfulness meditation for ages to control the mind and rewire the brain. Until now, most researchers believed it worked like a placebo. A new study shows that is not the case.
The new study ran in Biological Psychiatry. To learn how mindfulness works, researchers enrolled 115 people. They randomized them into four groups. One group practiced mindfulness meditation. One got a placebo treatment. One did sham mindfulness meditation. The fourth group read a book. After each, the researchers applied painful heat and scanned their brains with fMRI.
Mindfulness lit up different brain areas than the placebo did. So mindfulness works in a very different way from placebo. This study adds to the proof that mindfulness works. It also shows it is a mistake to lump it in with placebo.
In fact, mindfulness is a strong tool, especially for chronic pain. It appears that by stepping back from the pain, a person can turn it down. Best of all, mindfulness costs nothing.
Other treatments work too. Placebo also eases pain. But mindfulness tunes the brain areas that control emotion. So its effects are more likely to last.
The researchers also say a placebo works differently from regular pain treatments.
Since mindfulness works differently from a placebo effect, it can be added to other treatments for chronic pain. Chronic pain specialists may find mindfulness most useful for long-term conditions.
The study also found that mindfulness eased pain better than placebo. That matters. In modern medicine, a treatment must beat placebo to count as effective. So mindfulness is a strong tool for chronic pain. It works, and it works differently from placebo.
This matters because millions of people live with chronic pain. Chronic pain is hard to manage. Many people with it hurt for months or even years.
It is good to see science finally study how mindfulness works in the brain. It is one of the oldest practices we have.
Frequently asked questions
Does mindfulness help with chronic pain?
Yes. Mindfulness meditation reduces pain. Brain imaging shows it is not just distraction or a placebo. In the Biological Psychiatry study covered here, mindfulness eased pain better than placebo did. It also acts on brain areas that control emotion. That makes lasting benefit more likely. It is a powerful tool for managing chronic pain, and it costs nothing.
Is mindfulness just a placebo effect?
No. Researchers randomized 115 people into four groups: mindfulness meditation, a placebo treatment, sham mindfulness meditation and book reading. After each, painful heat was applied and their brains were scanned with fMRI. Mindfulness lit up different brain areas than placebo. So it works in its own way. It also beat placebo for pain relief. That is the bar modern medicine uses to call a treatment effective.
How does mindfulness reduce pain in the brain?
By stepping back from the pain, a person practicing mindfulness can turn it down. The fMRI scans showed that mindfulness uses its own set of brain areas. These include areas that control emotion. A placebo shows a different pattern. Mindfulness changes how the brain handles pain, not just the hope of relief. So its effects are more likely to last.
Should mindfulness be used with other pain treatments?
Yes. Mindfulness works differently from a placebo. So it can be added to other treatments for chronic pain. Chronic pain specialists may find it most useful for long-standing conditions. Other treatments work too. Mindfulness adds something they do not. It tunes the brain areas that control emotion, and anyone can do it at no cost.
Source:
Riegner, G., Dean, J., Wager, T. D., & Zeidan, F. (2024). Mindfulness meditation and placebo modulate distinct multivariate neural signatures to reduce pain. Biological Psychiatry, 0(0). https://doi.org/10.1016/j.biopsych.2024.08.023
Dr. Gurpreet Singh Padda, MD, MBA, MHP
