Mindfulness therapy for osteoarthritis pain
Mindfulness-based therapies could be key to reducing chronic pain of arthritis and similar conditions, suggests work published in the European Journal of Neuroscience.
Chronic pain affects up to about 30% of the population at any one time and is often due to arthritis. The extent of the pain, however, can be poorly related to the amount of damage and can spread to nearby regions of the body where there is no evidence of arthritic disease.
“Currently it is not understood why patients with arthritis have such variability in how much pain they experience but, in spite of this, we continue to spend large sums of money using potentially damaging anti-inflammatory drugs,” explains Prof Antony Jones, who was involved in the study.
Prof Jones and his team from the University of Manchester measured brain waves in response to short painful pulses to the skin in people with osteoarthritic or fibromyalgic pain and those with no pain.
The results suggest there are common abnormalities in the way the brain expects pain in those with fibromyalgia and osteoarthritis, which can be considered potential common brain mechanisms for these conditions.
“Increased activity in this brain area (the insula cortex) has been linked to a number of phenomena, including body perception and emotional processing, which might explain the greater pain perception in some patients,” says Dr Christopher Brown who worked on the project. “Interestingly, responses during pain anticipation were reduced in an area at the front of the brain called the dorsolateral prefrontal cortex. These reduced responses corresponded to less ability to develop positive ways of coping with the pain in both groups of patients.
“We think that boosting activity either directly or indirectly in this area of the brain is likely to result in better coping and better control of pain responses in other areas of the brain.”
More research is needed but the study suggests a move towards putting resources into developing new therapies that target these potential brain mechanisms.
“Our previous work has shown that brain responses to pain expectation can be altered by relatively short and inexpensive mindfulness-based talking therapies in patients with different types of chronic pain,” says Prof Wael El-Deredy, who worked on the study. “Our current findings therefore provide both a new target for development of new therapies and some optimism for simple interventions to improve the brain’s control of chronic suffering endured by many patients with chronic pain conditions.”
