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Mindfulness training helps reduce the pain experience

Mindfulness training and hypnotic suggestion significantly reduced acute pain, experienced by hospital patients, similar to what one might expect from an opioid painkiller. After participating in a single, 15-minute session of one of these mind-body therapies, a study found that patients reported an immediate decrease in pain levels similar to what one might expect from an opioid painkiller. This study is the first to compare the effects of mindfulness and hypnosis on acute pain in the hospital setting.

The yearlong study's 244 participants were patients at the University of Utah Hospital in Salt Lake City who reported experiencing unmanageable pain as the result of illness, disease or surgical procedures. Willing patients were randomly assigned to receive a brief, scripted session in one of three interventions: mindfulness, hypnotic suggestion or pain coping education. Hospital social workers who completed basic training in each scripted method provided the interventions to patients.

While all three types of intervention reduced patients' anxiety and increased their feelings of relaxation, patients who participated in the hypnotic suggestion intervention experienced a 29% reduction in pain, and patients who participated in the mindfulness intervention experienced a 23% reduction in pain. By comparison, those who participated in the pain coping intervention experienced a 9% reduction. Patients receiving the two mind-body therapies also reported a significant decrease in their perceived need for opioid medication.

"About a third of the study participants receiving one of the two mind-body therapies achieved close to a 30% reduction in pain intensity," said Eric Garland, lead author of the study and director of the U's Centre on Mindfulness and Integrative Health Intervention Development. "This clinically significant level of pain relief is roughly equivalent to the pain relief produced by 5 milligrams of oxycodone."

Garland's previous research has indicated that multi-week mindfulness training programmes can be an effective way to reduce chronic pain symptoms and decrease prescription opioid misuse. This new study added a novel dimension to Garland's work by revealing the promise of brief mind-body therapies for people suffering from acute pain.

"It was really exciting and quite amazing to see such dramatic results from a single mind-body session," said Garland. "Given our nation's current opioid epidemic, the implications of this study are potentially huge. These brief mind-body therapies could be cost-effectively and feasibly integrated into standard medical care as useful adjuncts to pain management."

Garland and his interdisciplinary research team aim to continue studying mind-body therapies as non-opioid means of alleviating pain by conducting a national replication study in a sample of thousands of patients in multiple hospitals around the country.

Abstract
Background: Medical management of acute pain among hospital inpatients may be enhanced by mind-body interventions.
Objective: We hypothesized that a single, scripted session of mindfulness training focused on acceptance of pain or hypnotic suggestion focused on changing pain sensations through imagery would significantly reduce acute pain intensity and unpleasantness compared to a psychoeducation pain coping control. We also hypothesized that mindfulness and suggestion would produce significant improvements in secondary outcomes including relaxation, pleasant body sensations, anxiety, and desire for opioids, compared to the control condition.
Methods: This three-arm, parallel-group randomized controlled trial conducted at a university-based hospital examined the acute effects of 15-min psychosocial interventions (mindfulness, hypnotic suggestion, psychoeducation) on adult inpatients reporting “intolerable pain” or “inadequate pain control.” Participants (N = 244) were assigned to one of three intervention conditions: mindfulness (n = 86), suggestion (n = 73), or psychoeducation (n = 85).
Key Results: Participants in the mind-body interventions reported significantly lower baseline-adjusted pain intensity post-intervention than those assigned to psychoeducation (p < 0.001, percentage pain reduction: mindfulness = 23%, suggestion = 29%, education = 9%), and lower baseline-adjusted pain unpleasantness (p < 0.001). Intervention conditions differed significantly with regard to relaxation (p < 0.001), pleasurable body sensations (p = 0.001), and desire for opioids (p = 0.015), but all three interventions were associated with a significant reduction in anxiety (p < 0.001).
Conclusions: Brief, single-session mind-body interventions delivered by hospital social workers led to clinically significant improvements in pain and related outcomes, suggesting that such interventions may be useful adjuncts to medical pain management.

Authors
Eric L Garland, Anne K Baker, Paula Larsen, Michael R Riquino, Sarah E Priddy, Elizabeth Thomas, Adam W Hanley, Patricia Galbraith, Nathan Wanner, Yoshio Nakamura

[link url="https://unews.utah.edu/mind-body-therapies-immediately-reduce-unmanageable-pain-in-hospital-patients-new-study-finds/"]University of Utah material[/link]
[link url="https://link.springer.com/article/10.1007%2Fs11606-017-4116-9"]Journal of General Internal Medicine abstract[/link]

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