Brain Scans Reveal That Mindfulness Meditation for Pain Is Not a Placebo

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Pain is a complex, multifaceted experience shaped by various factors beyond physical sensation, such as a person’s mindset and their expectations of pain. The placebo effect, the tendency for a person’s symptoms to improve in response to inactive treatment, is a well-known example of how expectations can significantly alter a person’s experience. Mindfulness meditation, which has been used for pain management in various cultures for centuries, has long been thought to work by activating the placebo response. However, scientists have now shown that this is not the case.

A new study, published in Biological Psychiatry, has revealed that mindfulness meditation engages distinct brain mechanisms to reduce pain compared to those of the placebo response. The study, conducted by researchers at University of California San Diego School of Medicine, used advanced brain imaging techniques to compare the pain-reducing effects of mindfulness meditation, a placebo cream and a “sham” mindfulness meditation in healthy participants.

The study found that mindfulness meditation produced significant reductions in pain intensity and pain unpleasantness ratings, and also reduced brain activity patterns associated with pain and negative emotions. In contrast, the placebo cream only reduced the brain activity pattern associated with the placebo effect, without affecting the person’s underlying experience of pain.

“The mind is extremely powerful, and we’re still working to understand how it can be harnessed for pain management,” said Fadel Zeidan, PhD, professor of anesthesiology and Endowed Professor in Empathy and Compassion Research at UC San Diego Sanford Institute for Empathy and Compassion. “By separating pain from the self and relinquishing evaluative judgment, mindfulness meditation is able to directly modify how we experience pain in a way that uses no drugs, costs nothing and can be practiced anywhere.”

The study included 115 participants, which consisted of two separate clinical trials in healthy participants, who were randomly placed into groups to be given four interventions: a guided mindfulness meditation, a sham-mindfulness meditation that only consisted of deep breathing, a placebo cream (petroleum jelly) that participants were trained to believe reduces pain and, as a control, one group listened to an audiobook. The researchers applied a very painful but harmless heat stimulus to the back of the leg and scanned the participants’ brains both before and after the interventions.