Date Presented 03/27/20
Chronic pain impacts multiple aspects of an individual’s life, including participation in meaningful occupations. Mindfulness techniques such as yoga, meditation, journaling, and variations on mindfulness-based stress-reduction (MBSR) programs have been shown to positively affect the relationship an individual has with chronic pain, thereby increasing opportunities for participation in meaningful occupations.
Primary Author and Speaker: Michelle Jackson
Contributing Authors: Sarbinaz Bekmuratova
PURPOSE: The purpose of this study is to critically appraise treatment approaches for individuals living with chronic pain through asking the question “What is the effectiveness of mindfulness practice on participation in meaningful occupations for individuals with chronic pain?”. Within the scope of occupational therapy (OT), clients that experience chronic pain may experience decreased opportunities to participate in not only basic activities of daily living (ADLs), but also experience difficulties with sleep, leisure activities, and other areas of occupation. With the advent of the opioid epidemic and the number of individuals living with chronic pain, non-invasive, non-pharmaceutical treatment interventions are needed. Mindfulness techniques provide such an intervention.
DESIGN: This study entailed a critically appraised topic (CAT) approach to the research question. Level I quantitative studies were used within the CAT. Inclusion criteria consisted of pain as one of the main outcome measures, Level I research (randomized controlled trials/clinical trials or systematic reviews of randomized controlled trials), applicable to occupational therapy (diagnosis, population, intervention), use of mindfulness techniques as part of the intervention, and the accessibility of study articles.
METHOD: Fifteen articles that met the inclusion criteria were chosen for initial analysis following a literature search. Following the initial analysis, seven articles were chosen for full analysis. An evidence table was created to reflect the study objectives, interventions, outcome measures, results, and the implications for OT.
RESULTS: Overall, the articles reflected that mindfulness techniques were found to decrease disability days, decrease anxiety and depression, increase quality of life, and increase participation in daily activities. Mindfulness was not found to decrease the severity of pain, duration of each pain event, or the long-term chronic nature of pain. Positive impacts were largely attributed to the individual changing their relationship to the pain, thereby providing increased opportunities for participation in meaningful occupation as a result of the mindfulness practice.
CONCLUSION: (Including brief impact statement). Chronic pain impacts multiple areas of daily functioning. Mindfulness can be used as a non-pharmaceutical, non-invasive intervention strategy for individuals with chronic pain. Although the pain itself does not change in duration or severity, the impact of the pain on the individual’s ability to participate in daily activities is changed through mindfulness practices. This increases independence and satisfaction in participating in meaningful occupation.
IMPACT STATEMENT: The use of mindfulness practices as an adjunct to traditional interventions with individuals experiencing chronic pain changes the focus from decreasing the severity and duration of pain events to adapting an individual’s relationship to the pain, which empowers the client to learn to live with chronic pain and participate in the occupations that are meaningful to them.
References
Davis, M. C., Zautra, A. J., Wolf, L. D., Tennen, H., & Yeung, E. W. (2015). Mindfulness and cognitive-behavioral interventions for chronic pain: Differential effects on daily pain reactivity and stress reactivity. Journal of Consulting and Clinical Psychology, 83(1), 24-35. doi: 10.1037/a0038200
Day, M., Thorn, B.E., Ward, L.C., Rubin, N., Hickman, S.D., Scogin, F., & Kilgo, G.R. (2014). Mindfulness-based cognitive therapy for the treatment of headache pain: A pilot study. The Clinical Journal for Pain, 30(2), 152-161. doi: 10.1097.AJP.0b013e18287a1dc.
la Cour, P., & Petersen, M. (2015). Effects of mindfulness meditation on chronic pain: A randomized controlled trial. Pain Medicine, 16(4), 641-652. doi: 10.1111/pme.12605
Seng, E.K., Singer, A.B., Metts, C., Grinberg, A.S., Patel, Z.S., Marzouk, M., Rosenberg, L., Day, M., Minen, M.T., Buse, D.C. (2019). Does mindfulness-based cognitive therapy for migraine reduce migraine-related disability in people with episodic and chronic migraine? A phase 2b pilot randomized clinical trial. Headache. doi: 10.111/head.13657.
