Ease Rheumatoid Arthritis Pain with Meditation
When you have rheumatoid arthritis pain, meditation may be the last thing on your mind. But studies show that mindfulness exercises can help reduce stress and ease symptoms of rheumatoid arthritis.
Anyone who suffers from symptoms of rheumatoid arthritis knows that sometimes it’s hard to think about anything else. But learning to focus your mind with mindfulness training can help you deal with rheumatoid arthritis pain, new research has found.
“Mindfulness is the practice of bringing one’s full attention to the present moment,” says Steven Rosenzweig, M.D., clinical associate professor and director of the Medical Humanities Program at Drexel University College of Medicine in Philadelphia.
“People in pain often react automatically to [what’s going on],” he says. “You think I feel pain, and then the body tightens and you have a flurry of other thoughts like Pain is ruining my life.
Mindfulness allows you to notice this distress as it happens and to intentionally step back, shifting awareness to the body and adjusting it in a way that can bring ease.”
When Norwegian volunteers practiced mindfulness exercises, their stress and fatigue levels were significantly reduced, according to a 2011 study published in Annals of Rheumatic Diseases. The 73 patients, who had rheumatoid arthritis or other joint diseases, participated in 10 group mindfulness sessions over 15 weeks.
Other research has found mindfulness to be helpful against pain. In a 2009 study, Dr. Rosenzweig and colleagues at Drexel University taught mindfulness-based stress reduction exercises to 133 people with chronic pain conditions for eight weeks. The participants, especially those with arthritis, reported considerable improvement in pain and physical function. It was most effective when they also practiced the mindfulness exercises at home.In a 2008 study, 144 people with symptoms of rheumatoid arthritis were treated with mindfulness meditation, cognitive behavioral therapy (psychotherapy that addresses negative thoughts and behaviors), or wellness education. Although the therapy most effectively reduced pain, mindfulness meditation improved participants’ depression and joint tenderness levels. This was especially important, the researchers said, because depression and chronic stress are linked to inflammatory activity.
“One of the things we found was an increasing energy in people who are mindful,” says lead author Alex Zautra, Ph.D., Foundation Professor of Psychology at Arizona State University in Tempe. “Their zest for life was much greater, and they had more ability to put illness in its place and move forward. They stopped spending all their energy fighting the sensation of [rheumatoid arthritis pain].”
Mindfulness also reduced levels of cytokines, inflammatory molecules that increase pain in those with symptoms of rheumatoid arthritis.
“That suggests that mindfulness has a biological consequence,” Zautra says.
Women tend to be more receptive to mindfulness than men, he says, in part because men tend to think of it – inaccurately – as a passive process.
“Even though you’re [physically] still, you’re busy at the work of awareness,” he says.
Learning Mindfulness
The most effective way to learn mindfulness exercises is with group training, Zautra says.
He suggests finding classes through a local university or hospital – a growing number are offering mindfulness programs for people with chronic conditions such as rheumatoid arthritis pain.You can also learn mindfulness meditations with CDs that offer guided instruction, says Carolyn McManus, P.T., staff physician therapist and coordinator of the Mindfulness-Based Stress Reduction Program at the Swedish Medical Center in Seattle. One choice is Guided Mindfulness Meditation by Jon Kabat-Zinn, founding director of the Center for Mindfulness at the University of Massachusetts Medical School.
The Mindful Awareness Research Center at UCLA also offers free audio instructions and meditations online.
You can also try the following whenever you’re feeling stress or pain.
Just remember that regular practice is essential – Dr. Rosenzweig recommends spending 20-40 minutes per day on these exercises.
Exercise for rheumatoid arthritis pain #1: Breath awareness meditation
Focusing on the breath is an easy way to bring your mind to the present moment and interrupt the stress response, Dr. Rosenzweig says. It’s the first and most basic step of any mindfulness practice.
Do this meditation seated in a quiet place for 10 minutes or more. It’s also helpful on an informal basis any time you feel anxious.
When you’re sitting comfortably, simply close your eyes and become aware of your breathing. Experience each breath as it goes in and out. If you notice your mind wandering, gently push those thoughts away and return to your breathing awareness.
Let your stomach rise as you inhale and fall as you exhale, McManus says. “Breathe deeply. That calms the nervous system.”
People under stress – like those living with a chronic illness such as rheumatoid arthritis – tend to breathe shallowly, rapidly, or hold their breath, she explains.
Exercise for rheumatoid arthritis pain #2: Body-scan meditation
This is usually done lying down, Dr. Rosenzweig says. But you can also do it sitting up, especially if it tends to put you to sleep.
“Bring your attention to one part of your body at a time,” Dr. Rosenzweig says. “Begin with your left toes, and move in sequence to the top of your head.”
For each body part, “notice any sensation arising in the moment, like tingling, vibration, temperature, heaviness, lightness,” he says.
“By bringing more attention to your body from moment to moment, you can be more in touch with its needs,” he explains.
You’ll also learn to relax parts of the body, relieving muscle tension and calming the nervous system, Dr. Rosenzweig says – all of which may help reduce rheumatoid arthritis pain.
Exercise for rheumatoid arthritis pain #3: Emotional clarity practice
For this exercise, sit for 10 minutes and try to accept whatever emotions cross your mind.
“People are taught to cope with feelings by evading or denying them,” Zautra says. “Allow yourself to feel, even if it’s painful. Painful feelings only last when you fight them.”This exercise can help people with symptoms of rheumatoid arthritis by reducing the time and energy they spend fighting the condition, Zautra says.
“By stopping the fight, you increase your capacity for awareness of the rest of life.”
You won’t be at the mercy of pain if you learn to accept it as one of many feelings, not the sole feeling, he adds.
“By gaining emotional awareness – and pain is an emotion – you also learn emotional regulation.”
Exercise for rheumatoid arthritis pain #4: Mindful hand-washing
It may sound odd, but any activity can be an opportunity to practice being mindful – even washing your hands, McManus says.
“Let your mind rest in the present moment, with the feeling of warm water on your hands,” she says. “As you wash, notice your breathing and deliberately try to calm yourself.”
Like the others, this exercise allows you to calm your nervous system and relax from stressful tasks or worrying thoughts, she says. And that can reduce the inflammation that leads to rheumatoid arthritis pain.
“After a calming moment, you can go forward [with the rest of your day] more calmly,” McManus says.
Exercise for rheumatoid arthritis pain #5: Mindful walking
This has the benefit of combining mindfulness with low-impact exercise, both of which can help reduce symptoms of rheumatoid arthritis.
As you walk, focus on the experience, Dr. Rosenzweig says.
“Walk slowly, with full attention on the sensations of the body as they change step by step.”
Staying in touch with your body as you move triggers a healing response, Dr. Rosenzweig says. It can reduce inflammation and calm physical stress reactions such as rapid heart rate and elevated blood pressure.
Exercise for rheumatoid arthritis pain #6: Your healing story
Try this the next time someone upsets you, McManus suggests.
“Notice your breathing and reaction [to the situation],” she says. “Begin to breathe more deeply to calm the nervous system. See the situation as a ‘story,’ not necessarily a reality. Then reassess what a healing story would be.”
For example, you might say to yourself, “I’m doing the best I can and aspiring for happiness, and so is that other person. We’re just different.”
“By doing that, you access a different perspective – another way of talking to yourself – to tone down the distress,” McManus says.
Exercise for rheumatoid arthritis pain #7: Emotional openness
Part of mindfulness is becoming more open to a range of emotions, so you experience more than your symptoms of rheumatoid arthritis, Zautra says.
“The aim is to be able to say, ‘Regardless of how much pain I’m in, I can feel full [of emotion],’” he explains.
Zautra suggests thinking back to a positive experience, even one in childhood: “Let your mind settle on an occasion when you felt really good,” he says. “Give that moment time and attention. Remind yourself how you felt.”
When you focus on good feelings, bad ones are more tolerable, Zautra says.
Exercise for rheumatoid arthritis pain #8: Mindful listening
For 10 or more minutes, simply listen to the sounds around you – without trying to describe them.
“With formal mindful practices [like this one], you build the capacity to bring mindful awareness into your day from moment to moment,” Dr. Rosenzweig says. “You’re better able to shift your attention to your body and breath, to notice automatic thoughts, to relax parts of the body, adjust posture, deepen breath and then move into the next moment.”
When you experience symptoms of rheumatoid arthritis, this sense of calm perspective will help you deal with them, he says.
Exercise for rheumatoid arthritis pain #9: Thoughtful driving
Many people are “white-knuckled” drivers. And if you have symptoms of rheumatoid arthritis, road stress can exacerbate tight muscles and pain.
“When muscles contract, they create lactic acid, which irritates nerve endings,” McManus says.
She suggests taking a quick body survey as you drive: Are you holding your breath? Are your shoulders tight?
“Simply notice your reaction with kindness and curiosity,” she says. “Look how much suffering the tension is causing.”
Then, take a deep breath, let your shoulders relax and put on calm music instead of talk radio.
“Ask yourself, ‘Can I [drive] with ease and safety?’” McManus says. “Remind yourself that we’re all just trying to get home.”
Exercise for rheumatoid arthritis pain #10: Schedule fun stuff
This simple exercise will help you focus on pulling pleasant events into your life, rather than being overwhelmed by rheumatoid arthritis pain.
“Make a list of things you’d like to do, and pick 1-2 things to do each day or each week,” Zautra says. “Start small and work up to more. Life is more fulfilling if you direct your attention to what satisfies you.”
By Dorothy Foltz-Gray