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15 Articles in Volume 19, Issue #3
Analgesics of the Future: The Potential of the Endocannabinoid System
Buprenorphine: A Promising Yet Overlooked Tool
Chronic Pain and the Psychological Stages of Grief
Could a Personalized Approach to Therapy End the War on Pain?
Finally, A Systematic Classification of Pain (the ICD-11)
Hormone Therapy for Chronic Pain
How to Communicate with a Medical Marijuana Dispensary
Letters: Opioid Conversions; Scrambler Therapy for CRPS
MSK Pain: Time for an Enhanced Assessment Model
National Drug Use & Abuse Trends: Prescribed and Illicit
Neuroplasticity and the Potential to Change Pain Response
Should Emergency Naloxone Be in Schools?
Talking to Patients about Medical Cannabis
Utility of Pulsed Radiofrequency Ablation in Xiphodynia
When Opioid Prescriptions Are Denied

Neuroplasticity and the Potential to Change Pain Response

May 3, 2019
A chat with Joseph Wielgosz, PhD

In today’s age of mindfulness, interest is growing in research around the brain’s neuroplasticity and its potential impact on pain response and management. Joseph Wielgosz, PhD, lead author of the recently published review on “Mindfulness Meditation and Psychopathology,” (Ann Clin Psychol) explains it best: “The same brain circuits which shape our emotions also shape the experience of pain, and in chronic pain syndromes, we know there are shifts in the connectivity of emotion-related circuits, which come to play a heightened role in pain experience. Practices which train the mind have the potential to counteract these shifts, reducing the sensitization and distress associated with pain.”

Dr. Wielgosz is a psychiatry fellow at both the VA Palo Alto Care System and Stanford University, and an affiliated researcher at the University of Wisconsin-Madison’s Center for Healthy Minds. The healthcare community now has “a large body of studies that [show] good-quality training in mindfulness practices provide lasting benefit in pain management, and that delivering this training can be very cost-effective for healthcare systems,” he told PPM. “Moreover, we know that these same practices have benefits for problems that often accompany chronic pain – depression, anxiety, and substance use problems, in particular. Mindfulness training is not a cure-all, despite sometimes being marketed or reported that way – but it does provide a lot of bang for the buck.”

But is the practice of mindfulness used enough, or effectively, in pain practice today? “I work as a clinical psychologist in a hospital setting. Unfortunately, one thing I’ve observed is that pain treatment and mental health have historically been siloed into different areas of treatment despite the close relationship we know that they have with each other,” said Dr. Wielgosz, who added, “I’m very glad to see a shift toward integrative pain management programs which center on the patient and bridges these gaps.”

Growing research on brain neuroplasticity shows that meditation practice may help to improve a patient's response to pain. (Source: 123RF)

Another research area he is excited about is the progress being made to pinpoint exactly how and why mindfulness practice changes pain response. “When you meditate, many systems in your mind and body are affected (eg, breathing, body position, mental focus, the way you relate to your thoughts). I have used brain imaging and measures of physiology to sift out how much each of these factors is responsible for changes in pain after mindfulness training. This will help tailor the way we deliver mindfulness training in the future to be more effective.”

But when a skeptical patient turns a sour eye to the suggestion of meditation, what is a clinician to do? First, clarify that you are not suggesting the pain is “all in their head” and that meditation is just one component of a larger treatment plan that may include a number of other therapies. Then, explain that clinicians and researchers know that pain involves complex relationships between the mind, brain, and body, advises Dr. Wielgosz. "When a patient learns meditation practices, they are learning to work with those relationships in ways that may bring relief. Plus, the practice may be done anywhere, anytime.”

Last updated on: May 3, 2019
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