Mindfulness Meditation for Fibromyalgia: Mechanistic and Clinical Considerations
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Purpose of Review
Fibromyalgia is a disorder characterized by widespread pain and a spectrum of psychological comorbidities, rendering treatment difficult and often a financial burden. Fibromyalgia is a complicated chronic pain condition that requires a multimodal therapeutic approach to optimize treatment efficacy. Thus, it has been postulated that mind-body techniques may prove fruitful in treating fibromyalgia. Mindfulness meditation, a behavioral technique premised on non-reactive sensory awareness, attenuates pain and improves mental health outcomes. However, the impact of mindfulness meditation on fibromyalgia-related outcomes has not been comprehensively characterized. The present review delineates the existing evidence supporting the effectiveness and hypothesized mechanisms of mindfulness meditation in treating fibromyalgia-related outcomes.
Mindfulness-based interventions premised on cultivating acceptance, non-attachment, and social engagement may be most effective in decreasing fibromyalgia-related pain and psychological symptoms. Mindfulness-based therapies may alleviate fibromyalgia-related outcomes through multiple neural, psychological, and physiological processes.
Mindfulness meditation may provide an effective complementary treatment approach for fibromyalgia patients, especially when combined with other reliable techniques (exercise; cognitive behavioral therapy). However, characterizing the specific analgesic mechanisms supporting mindfulness meditation is a critical step to fostering the clinical validity of this technique. Identification of the specific analgesic mechanisms supporting mindfulness-based pain relief could be utilized to better design behavioral interventions to specifically target fibromyalgia-related outcomes.
KeywordsPain Fibromyalgia Mindfulness Meditation fMRI Inflammation
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no competing interests.
Human and Animal Rights and Informed Consent
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
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- 9.Beck JS. Cognitive behavior therapy: basics and beyond. 2nd ed. New York: The Guilford Press; 2011.Google Scholar
- 19.• Lopez-Sola M, Woo CW, Pujol J, et al. Towards a neurophysiological signature for fibromyalgia. Pain. 2017;158(1):34–47. doi: 10.1097/j.pain.0000000000000707. Well-controlled experimental trial using machine learning techniques to identify a fibromyalgia-associated neural signature that characterizes patients based upon pain-related changes in brain activation. PubMedCrossRefGoogle Scholar
- 56.Cherkin DC, Sherman KJ, Balderson BH, et al. Effect of mindfulness-based stress reduction vs cognitive behavioral therapy or usual care on back pain and functional limitations in adults with chronic low back pain: a randomized clinical trial. JAMA. 2016;315(12):1240–9. doi: 10.1001/jama.2016.2323.PubMedPubMedCentralCrossRefGoogle Scholar
- 60.Goldin P, Ziv M, Jazaieri H, et al. Randomized controlled trial of mindfulness-based stress reduction versus aerobic exercise: effects on the self-referential brain network in social anxiety disorder. Front Hum Neurosci. 2012;6:295. doi: 10.3389/fnhum.2012.00295.PubMedPubMedCentralCrossRefGoogle Scholar
- 72.Anheyer D, Haller H, Barth J et al. Mindfulness-based stress reduction for treating low back pain: a systematic review and meta-analysis. Ann Intern Med. 2017:1–9. doi: 10.7326/M16-1997.
- 74.Goldenberg D, Kaplan KH, Nadeau MG, Brodeur C, Smith S, Schmid CH. A controlled study of a stress-reduction, cognitive-behavioral treatment program in fibromyalgia. J Musculoskelet Pain. 1994;2(2).Google Scholar
- 75.Cash E, Salmon P, Weissbecker I, et al. Mindfulness meditation alleviates fibromyalgia symptoms in women: results of a randomized clinical trial. Annals of behavioral medicine : a publication of the Society of Behavioral Medicine. 2015;49(3):319–30. doi: 10.1007/s12160-014-9665-0.CrossRefGoogle Scholar
- 79.Davis MC, Zautra AJ. An online mindfulness intervention targeting socioemotional regulation in fibromyalgia: results of a randomized controlled trial. Annals of behavioral medicine : a publication of the Society of Behavioral Medicine. 2013;46(3):273–84. doi: 10.1007/s12160-013-9513-7.CrossRefGoogle Scholar
- 81.• Van Gordon W, Shonin E, Dunn TJ, et al. Meditation awareness training for the treatment of fibromyalgia syndrome: a randomized controlled trial. Br J Health Psychol. 2017;22(1):186–206. doi: 10.1111/bjhp.12224. Well-controlled clinical trial demonstrating that civic engagement and non-attachment may mediate meditation-associated improvements in fibromyalgia patients. PubMedCrossRefGoogle Scholar
- 85.• Zeidan F, Emerson NM, Farris SR, et al. Mindfulness meditation-based pain relief employs different neural mechanisms than placebo and sham mindfulness meditation-induced analgesia. The Journal of neuroscience : the official journal of the Society for Neuroscience. 2015;35(46):15307–25. doi: 10.1523/JNEUROSCI.2542-15.2015. Mechanistic study in healthy participants demonstrating that mindfulness meditation may alleviate pain through engaging cognitive reappraisal mechanisms that in turn modulate the transmission of nociceptive information throughout the cortex in a context dependent manner. CrossRefGoogle Scholar
- 98.Creswell JD, Irwin MR, Burklund LJ, et al. Mindfulness-based stress reduction training reduces loneliness and pro-inflammatory gene expression in older adults: a small randomized controlled trial. Brain Behav Immun. 2012;26(7):1095–101. doi: 10.1016/j.bbi.2012.07.006.PubMedPubMedCentralCrossRefGoogle Scholar
- 99.Kabat-Zinn J, Wheeler E, Light T, et al. Influence of a mindfulness meditation-based stress reduction intervention on rates of skin clearing in patients with moderate to severe psoriasis undergoing phototherapy (UVB) and photochemotherapy (PUVA). Psychosom Med. 1998;60(5):625–32.PubMedCrossRefGoogle Scholar
- 105.Michalsen A, Grossman P, Acil A, et al. Rapid stress reduction and anxiolysis among distressed women as a consequence of a three-month intensive yoga program. Medical science monitor : international medical journal of experimental and clinical research. 2005;11(12):CR555–61.Google Scholar
- 106.Zucker TL, Samuelson KW, Muench F, et al. The effects of respiratory sinus arrhythmia biofeedback on heart rate variability and posttraumatic stress disorder symptoms: a pilot study. Applied psychophysiology and biofeedback. 2009;34(2):135–43. doi: 10.1007/s10484-009-9085-2.PubMedCrossRefGoogle Scholar