Psychiatric Aspects in Chronic Pain and Utility of Yoga and Mindfulness-Based Cognitive Behavioral Therapy for Pain (Y-MBCT Pain) as a Translational Model

Chapter
First Online:

Abstract

One may agree that under-treated pain is an epidemic and over-treated pain is a nightmare for clinicians. It is a major public health problem. Chronic pain in the United States has a national economic cost of approximately $600 billion per year [57]; pain costs society $2000 per year for every individual living in the United States [113]. Chronic pain involves many complex aspects including persistent pain, anxiety, depression, difficulty moving, muscle weakness due to lack of use, and, of course, reduced quality of life—requiring further healthcare resources [3]. Pain is necessary to handle the danger signal that invoked it; however, due to the unpleasantness of pain, it is something that is consciously avoided: this adds to its complexity. In addition, the fear of pain in these patients more often than not leads to the avoidance of important activities such as exercises and thus creates a vicious cycle of avoidance, disability, depression, and more enduring pain. Prolonged pain, through the various feedback mechanisms, may lead to changes in the structure of the body and functions of the nerves that perpetuate these symptoms even after the tissue has had adequate time to heal [21]. It is not only the cost of health care or disability that is impacted by chronic pain; actually, the type of care that a patient receives and responds to is greatly impacted by chronic pain as well. No wonder that chronic pain is a leading cause for absence from work, reducing labor productivity, patient’s income and insurance coverage, and increasing the need for workers’ disability [71]. Also important to note that although many therapies are available for chronic pain, up to two-thirds of patients are inadequately treated [92].

Keywords

Chronic Pain Pain Experience Mindfulness Meditation Mindfulness Intervention Home Practice 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in to check access.

References

  1. 1.
    Afridi SK, Giffin NJ, Kaube H, Goadsby PJ. A randomized controlled trial of intranasal ketamine in migraine with prolonged aura. Neurology. 2013;80(7):642–7.PubMedCrossRefGoogle Scholar
  2. 2.
    Baer RA. Mindfulness training as a clinical intervention: a conceptual and empirical review. Clin Psychol Sci Pract. 2003;10:125–43.CrossRefGoogle Scholar
  3. 3.
    Bair MJ, Robinson RL, Katon W, Kroenke K. Depression and pain comorbidity: a literature review. Arch Intern Med. 2003;163(20):2433–45.PubMedCrossRefGoogle Scholar
  4. 4.
    Balasubramaniam M, Telles S, Doraiswamy PM. Yoga on our minds: a systematic review of yoga for neuropsychiatric disorders. Front Psychiatry. 2013;3:117. doi: 10.3389/fpsyt.2012.00117.PubMedPubMedCentralCrossRefGoogle Scholar
  5. 5.
    Barbas H, Saha S, Rempel-Clower N, Ghashghaei T. Serial pathways from primate prefrontal cortex to autonomic areas may influence emotional expression. BMC Neurosci. 2003;4:25.PubMedPubMedCentralCrossRefGoogle Scholar
  6. 6.
    Basbaum A, Jessell T. The perception of pain. In: Kandel ER, Schwartz JH, Jessell TM, editors. Principles of neural science. 4th ed. New York: McGraw-Hill, Health Professions Division; 2000.Google Scholar
  7. 7.
    Basbaum AI, Woolf CJ. Pain. Curr Biol. 1999;9:R429–31.PubMedCrossRefGoogle Scholar
  8. 8.
    Belzung C. The genetic basis of the pharmacological effects of anxiolytics: a review based on rodent models. Behav Pharmacol. 2001;12(6–7):451–60.PubMedCrossRefGoogle Scholar
  9. 9.
    Bohlmeijer E, Prenger R, Tall E, Cuijpers P. The effects of mindfulness-based stress reduction therapy on mental health of adults with a chronic medical disease: a meta-analysis. J Psychosom Res. 2010;68:539–44.PubMedCrossRefGoogle Scholar
  10. 10.
    Brown RP, Gerbarg PL. Sudarshan kriya yogic breathing in the treatment of stress, anxiety, and depression: clinical applications and guidelines. J Altern Complement Med. 2005;11(4):711–7.PubMedCrossRefGoogle Scholar
  11. 11.
    Bushnell MC, Ceko M, Low LA. Cognitive and emotional control of pain and its disruption in chronic pain. Nat Rev Neurosci. 2013;14(7):502–11.PubMedPubMedCentralCrossRefGoogle Scholar
  12. 12.
    Campbell JN, Meyer RA. Mechanisms of neuropathic pain. Neuron. 2006;52(1):77–92.PubMedPubMedCentralCrossRefGoogle Scholar
  13. 13.
    Carmel PW. Vegetative dysfunctions of the hypothalamus. Acta Neurochir (Wien). 1985;75(1–4):113–21.CrossRefGoogle Scholar
  14. 14.
    Carmody J, Baer RA. Relationships between mindfulness practice and levels of mindfulness, medical and psychological symptoms and well-being in a mindfulness-based stress reduction program. J Behav Med. 2008;31:23–33.PubMedCrossRefGoogle Scholar
  15. 15.
    Chiechis S, Nicoletti F. Metabotropic glutamate receptors and the control of chronic pain. Curr Opin Pharmacol. 2012;12:28–34.CrossRefGoogle Scholar
  16. 16.
    Chiesa A, Serretti A. Mindfulness-based interventions for chronic pain: a systematic review. J Altern Complement Med. 2011;17:83–93.PubMedCrossRefGoogle Scholar
  17. 17.
    Crombez G, Vlaeyen JWS, Heuts PHTG, Lysens R. Pain-related fear is more disabling than pain itself: evidence on the role of pain-related fear in chronic back pain disability. Pain. 1999;80(1–2):329–39.PubMedCrossRefGoogle Scholar
  18. 18.
    Dalai Lama. The middle way: faith grounded in reason. (Jinpa T, Trans.). Boston: Wisdom Publications; 2009.Google Scholar
  19. 19.
    De La Forge. Treatise on the human mind, International archives of the history of ideas. Boston: Kluwer Academic Publishers; 1997.CrossRefGoogle Scholar
  20. 20.
    Denk F, McMahon SB, Tracey I. Pain vulnerability: a neurobiological perspective. Nat Neurosci. 2014;17(2):192–200.PubMedCrossRefGoogle Scholar
  21. 21.
    Deyo RA, Von Korff M, Duhrkoop D. BMJ. 2015;2015:350. http://dx.doi.org/10.1136/bmj.g6380.Google Scholar
  22. 22.
    Dickenson A. The neurobiology of chronic pain states. Anaesth Intensive Care Med. 2011;14(11):484–7.CrossRefGoogle Scholar
  23. 23.
    D’Mello R, Dickenson AH. Spinal cord mechanisms of pain. Br J Anaesth. 2008;101(1):8–16.PubMedCrossRefGoogle Scholar
  24. 24.
    Dowell D, Haegerich TM, Chou R. CDC guideline for prescribing opioids for chronic pain — United States, 2016. MMWR Recomm Rep. ePub: 15 Mar 2016. doi: http://dx.doi.org/10.15585/mmwr.rr6501e1er.
  25. 25.
    Eccleston C, Williams AC, Morley S. Psychological therapies for the management of chronic pain (excluding headache) in adults. Cochrane Database Syst Rev. 2009;2009(2):CD007407. doi: 10.1002/14651858.CD007407.pub2.Google Scholar
  26. 26.
    Eisendrath SJ. Psychiatric aspects of chronic pain. Neurology. 1995;45(12 Suppl 9):S26–34; discussion S35-6. PMID 8538883.PubMedCrossRefGoogle Scholar
  27. 27.
    Eliade M. Yoga: for immortality and freedom. 2nd ed. Princeton: Princeton University Press; 1969.Google Scholar
  28. 28.
    Everitt BJ, Belin D, Economidou D, et al. Neural mechanisms underlying the vulnerability to develop compulsive drug-seeking habits and addiction. Philos Trans R Soc Lond B Biol Sci. 2008;363(1507):3125–35.PubMedPubMedCentralCrossRefGoogle Scholar
  29. 29.
    Finan PH, Buenaver LF, Coryell VT, Smith MT. Cognitive-behavioral therapy for comorbid insomnia and chronic pain. Sleep Med Clin. 2014;9(2):261–74.PubMedPubMedCentralCrossRefGoogle Scholar
  30. 30.
    Furini C, Myskiw J, Izquierdo I. The learning of fear extinction. Neurosci Biobehav Rev. 2014;47:670–83.PubMedCrossRefGoogle Scholar
  31. 31.
    Gureje O. Psychiatric aspects of pain. Curr Opin Psychiatry. 2007;20(1):42–6.PubMedCrossRefGoogle Scholar
  32. 32.
    Gardner-Nix J. The mindfulness solution to pain: step-by-step techniques for chronic pain management. Oakland: New Harbinger Publications; 2009.Google Scholar
  33. 33.
    Ghashghaei HT, Hilgetag CC, Barbas H. Sequence of information processing for emotions based on the anatomic dialogue between prefrontal cortex and amygdala. Neuroimage. 2007;34(3):905–23.PubMedCrossRefGoogle Scholar
  34. 34.
    Goldman-Rakic PS. Circuitry of the primate prefrontal cortex and the regulation of behavior by representational memory. In: Plum F, editor. Handbook of physiology, the nervous system, higher functions of the brain. Bethesda: American Physiological Society; 1987. p. 373–417.Google Scholar
  35. 35.
    Grant JA, Courtemanche J, Rainville P. A non-elaborative mental stance and decoupling of executive and pain-related cortices predicts low pain sensitivity in Zen meditators. Pain. 2011;152:150–6.PubMedCrossRefGoogle Scholar
  36. 36.
    Grossman P, Niemann L, Schmidt S, Walach H. Mindfulness-based stress reduction and health benefits: a meta-analysis. J Psychosom Res. 2004;57:35–43.PubMedCrossRefGoogle Scholar
  37. 37.
    Guzmán J, Esmail R, Karjalainen K, Malmivaara A, Irvin E, Bombardier C. Multidisciplinary rehabilitation for chronic low back pain: systematic review. BMJ. 2001;322:1511–6.PubMedPubMedCentralCrossRefGoogle Scholar
  38. 38.
    Hayes SC, Strosahl KD, Wilson KG. Acceptance and commitment therapy: an experiential approach to behavior change. New York: The Guilford Press; 1999.Google Scholar
  39. 39.
    Hoffman BM, Papas RK, Chatkoff DK, Kerns RD. Meta-analysis of psychological interventions for chronic low back pain. Health Psychol. 2007;26:1–9. doi: 10.1037/0278-6133.26.1.1.PubMedCrossRefGoogle Scholar
  40. 40.
    Hunt SP, Mantyh PW. The molecular dynamics of pain control. Nat Rev Neurosci. 2001;2(2):83–91.PubMedCrossRefGoogle Scholar
  41. 41.
    Institute of Medicine of the National Academies. Relieving pain in America – a blueprint for transforming prevention, care, education, and research. Pain Res 2011 Rep Br. 2011;2011:4. Available at: www.iom.edu/relievingpain.Google Scholar
  42. 42.
    Jensen MP. Psychosocial approaches to pain management: an organizational framework. Pain. 2011;152:717–25.PubMedCrossRefGoogle Scholar
  43. 43.
    Julius D, Basbaum AI. Molecular mechanisms of nociception. Nature. 2001;413:203–10.PubMedCrossRefGoogle Scholar
  44. 44.
    Kabat-Zinn J. An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: theoretical considerations and preliminary results. Gen Hosp Psychiatry. 1982;4:33–47.PubMedCrossRefGoogle Scholar
  45. 45.
    Kabat-Zinn J, Lipworth L, Burney R. The clinical use of mindfulness meditation for the self-regulation of chronic pain. J Behav Med. 1985;8:163–90.PubMedCrossRefGoogle Scholar
  46. 46.
    Kabat-Zinn J. Full catastrophe living. New York: Delacorte Press; 1990.Google Scholar
  47. 47.
    Kabat-Zinn J, Massion AO, Kristeller J, Peterson LG, Fletcher KE, Pbert L, Lenderking WR, et al. Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders. Am J Psychiatry. 1992;149:936–43.PubMedCrossRefGoogle Scholar
  48. 48.
    Kahl KG, Winter L, Schweiger U. The third wave of cognitive behavioral therapies. Curr Opin Psychiatry. 2012;25(6):522–8.PubMedCrossRefGoogle Scholar
  49. 49.
    Kandel E. A new intellectual framework for psychiatry? Am J Psychiatry. 1998;155:457–69.PubMedCrossRefGoogle Scholar
  50. 50.
    Keng SL, Smoski MJ, Robins CJ. Effects of mindfulness on psychological health: a review of empirical studies. Clin Psychol Rev. 2011;31:1041–56.PubMedPubMedCentralCrossRefGoogle Scholar
  51. 51.
    Kennedy J, Roll JM, Schraudner T, Murphy S, McPherson S. Prevalence of persistent pain in the U.S. adult population: new data from the 2010 national health interview survey. J Pain. 2014;15(10):979–84.PubMedCrossRefGoogle Scholar
  52. 52.
    Latremoliere A, Woolf CJ. Central sensitization: a generator of pain hypersensitivity by central neural plasticity. J Pain. 2009;10:895–926.PubMedPubMedCentralCrossRefGoogle Scholar
  53. 53.
    Lavey R, Sherman T, Mueser KT, Osborne DD, Currier M, Wolfe R. The effects of yoga on mood in psychiatric inpatients. Psychiatr Rehabil J. 2005;28:399–402.PubMedCrossRefGoogle Scholar
  54. 54.
    LeDoux J. Fear and the brain: where have we been and where are we going? Biol Psychiatry. 1998;44(12):1229–38.PubMedCrossRefGoogle Scholar
  55. 55.
    Ledoux JE. Emotion circuits in the brain. Annu Rev Neurosci. 2000;23:155–84. New York.PubMedCrossRefGoogle Scholar
  56. 56.
    Lethem J, Slade PD, Troup JDG, Bentley G. Outline of a fear-avoidance model of exaggerated pain perception-I. Behav Res Ther. 1983;21(4):401–8. doi: 10.1016/0005-7967(83)90009-8.PubMedCrossRefGoogle Scholar
  57. 57.
    Lewis SS, Loram LC, Hutchinson MR, Li CM, Zhang Y, Maier SF, Huang Y, Rice KC, Watkins LR. Naloxone, an opioid-inactive toll-like receptor 4 signaling inhibitor, reverses multiple models of chronic neuropathic pain in rats. J Pain. 2012;13(5):498–506.PubMedPubMedCentralCrossRefGoogle Scholar
  58. 58.
    Linehan MM. Cognitive-behavioral treatment of borderline personality disorder. New York: Guilford Press; 1993.Google Scholar
  59. 59.
    Linton SJ. A review of psychological risk factors in back and neck pain. Spine. 2000;25(9):1148–56.PubMedCrossRefGoogle Scholar
  60. 60.
    Marlowe N. Self-efficacy moderates the impact of stressful events on headache. Headache. 1998;38:662–7.PubMedCrossRefGoogle Scholar
  61. 61.
    Marchand S. The phenomenon of pain. Seattle: IASP Press; 2012.Google Scholar
  62. 62.
    Mayberg HS. Targeted electrode-based modulation of neural circuits for depression. J Clin Invest. 2009;119(4):717–25.PubMedPubMedCentralCrossRefGoogle Scholar
  63. 63.
    McCracken LM, Vowles KE. Acceptance and commitment therapy and mindfulness for chronic pain: model, process, and progress. Am Psychol. 2014;69(2):178–87.PubMedCrossRefGoogle Scholar
  64. 64.
    Melzack R, Katz J. The gate control theory: reaching for the brain. In: Craig KD, Hadjistavropoulos T, editors. Pain: psychological perspectives. Mahwah: Lawrence Erlbaum Associates Publishers; 2004. ISBN 0-8058-4299-3.Google Scholar
  65. 65.
    Melzack R, Wall PD. Pain mechanisms: a new theory. Science. 1965;150(3699):971–9.PubMedCrossRefGoogle Scholar
  66. 66.
    Melzack R. Pain and the neuromatrix in the brain. J Dent Educ. 2001;65(12):1378–82.PubMedGoogle Scholar
  67. 67.
    Miller A. Ingenious pain. London: Scepter; 1997.Google Scholar
  68. 68.
    Morley JS. New perspectives in our use of opioids. Pain Forum. 1999;8(4):200–5.CrossRefGoogle Scholar
  69. 69.
    Morley S, Eccleston C, Williams A. Systematic review and meta-analysis of randomized controlled trials of cognitive behaviour therapy and behaviour therapy for chronic pain in adults, excluding headache. Pain. 1999;80:1–13. doi: 10.1016/S0304-3959(98)00255-3.PubMedCrossRefGoogle Scholar
  70. 70.
    Munro G. Dopamine D(1) and D(2) receptor agonism enhances anti-nociception mediated by the serotonin and noradrenaline reuptake inhibitor duloxetine in the rat formalin test. Eur J Pharmacol. 2007;575(1–3):66–74.PubMedCrossRefGoogle Scholar
  71. 71.
    Natl. Cent. Heal. Stat. 2006. Available at: http://www.cdc.gov/nchs/data/hus/hus06.pdf.
  72. 72.
    National Research Council (US) Committee on Recognition and Alleviation of Pain in Laboratory Animals. Recognition and alleviation of pain in laboratory animals. Washington, DC: National Academies Press; 2009.Google Scholar
  73. 73.
    Neafsey EJ. Prefrontal control of the autonomic nervous system: anatomical and physiological observations. Prog Brain Res. 1990;85:147–65.PubMedCrossRefGoogle Scholar
  74. 74.
    Nyanamoli B. The path of purification (Visuddhimagga). Kandy: Buddhist Publication Society; 1975.Google Scholar
  75. 75.
    Nyanaponika T. The heart of Buddhist meditation. Kandy: Buddhist Publication Society; 1954.Google Scholar
  76. 76.
    Ongür D, Price JL. The organization of networks within the orbital and medial prefrontal cortex of rats, monkeys and humans. Cereb Cortex. 2000;10(3):206–19.PubMedCrossRefGoogle Scholar
  77. 77.
    Opler LA, Opler MGA, Arnsten AFT. Ameliorating treatment-refractory depression with intranasal ketamine: potential NMDA receptor actions in the pain circuitry representing mental anguish. CNS Spectr. 2015;21(1):12–22.PubMedPubMedCentralCrossRefGoogle Scholar
  78. 78.
    Pally R. How the brain actively constructs perceptions. Int J Psychoanal. 1997;78:1021–30.PubMedGoogle Scholar
  79. 79.
    Pally R. Non-conscious prediction and a role for consciousness in correcting prediction errors. Cortex. 2005;41:643–62.PubMedCrossRefGoogle Scholar
  80. 80.
    Perkins FM, Kehlet H. Chronic pain as an outcome of surgery: a review of predictive factors. Anesthesiology. 2000;93(4):1123–33.PubMedCrossRefGoogle Scholar
  81. 81.
    Perlman DM, Salomons TV, Davidson RJ, Lutz A. Differential effects on pain intensity and unpleasantness of two meditation practices. Emotion. 2010;10:65–71.PubMedPubMedCentralCrossRefGoogle Scholar
  82. 82.
    Ploghaus A, Narain C, Beckmann CF, Clare S, Bantick S, Wise R, Matthews PMRawlins JN, Tracey I. Exacerbation of pain by anxiety is associated with activity in a hippocampal network. J Neurosci. 2001;21(24):9896–903.PubMedGoogle Scholar
  83. 83.
    Pradhan BK. Yoga and mindfulness based cognitive therapy: a clinical guide. Cham: Springer; 2014.Google Scholar
  84. 84.
    Pradhan BK, Pumariega AJ, Barnes A. Successful use of mindfulness based graded exposure therapy (M-BET) in adolescents with PTSD: a case series. Presented in the 21st World Congress of the International Association for Child and Adolescent Psychiatry and Allied Professions (IACAPAP), Durban; 2014.Google Scholar
  85. 85.
    Pradhan BK, Gray RM, Parikh T, Akkireddi P, Pumariega A. Trauma Interventions using Mindfulness Based Extinction and Reconsolidation (TIMBER©) as monotherapy for chronic PTSD in adolescents: a pilot study. Adolescent Psychiatry. 2015;5(2):125–31.CrossRefGoogle Scholar
  86. 86.
    Pradhan BK, Parikh T, Makani R, Sahoo M. Ketamine, transcranial magnetic stimulation (TMS) and depression specific Yoga-mindfulness based cognitive therapy (DepS Y-MBCT) in management of treatment resistant depression: Review and some data on efficacy. Depress Res Treat. 2015;2015:842817. doi: 10.1155/2015/842817, Hindawi Publishing Corporation.PubMedPubMedCentralGoogle Scholar
  87. 87.
    Pradhan BK, D’Amico JK, Makani R, Parikh T. Non conventional interventions for chronic post-traumatic stress disorder (PTSD): ketamine, repetitive transcranial magnetic stimulation (rTMS) and alternative approaches. J Trauma Dissociation. 2016;17(1):35–54.PubMedCrossRefGoogle Scholar
  88. 88.
    Pradhan BK, Parikh T, Sahoo M, Pumariega A. Successful use of yoga-mindfulness based cognitive therapy (Y-MBCT) in comorbid panic and generalized anxiety disorders (GAD): a pilot study. Presented in Philadelphia in the annual conference of the Anxiety and Depression Association of America (ADAA); 2016. doi: 10.13140/RG.2.1.2245.4163.
  89. 89.
    Pradhan BK, Sabia M, Jean S, Wainer I, Pumariega AJ. Ketamine and mindfulness based cognitive therapy in refractory PTSD: comparison of efficacy and metabolomics profiles (ongoing study at departments of Psychiatry and Anesthesiology at Cooper University Hospital, NJ and the Bio-analytic and Drug Discovery Division of the National Institute on Aging); 2016 unpublished data.Google Scholar
  90. 90.
    Price DD. Psychological and neural mechanisms of the affective dimension of pain. Science. 2000;288(5472):1769–72.PubMedCrossRefGoogle Scholar
  91. 91.
    Ratcliffe GE, Enns MW, Belik SL, Sareen J. Chronic pain conditions and suicidal ideation and suicide attempts: an epidemiologic perspective. Clin J Pain. 2008;24(3):204–10.PubMedCrossRefGoogle Scholar
  92. 92.
    Reuben DB, Alvanzo AA, Ashikaga T, Bogat GA, Callahan CM, Ruffing V, Steffens DC. National Institutes of Health Pathways to Prevention Workshop: the role of opioids in the treatment of chronic pain. Ann Intern Med. 2015;162(4):295–300.PubMedCrossRefGoogle Scholar
  93. 93.
    Rhudy JL, Meagher MW. The role of emotion in pain modulation. Curr Opin Psychiatry. 2001;14:241–5.CrossRefGoogle Scholar
  94. 94.
    Rosenzweig S, Greeson JM, Reibel DK, Green JS, Jasser SA, Beasley D. Mindfulness-based stress reduction for chronic pain conditions: variations in treatment outcomes and role of home meditation practice. J Psychosom Res. 2010;68:29–36.PubMedCrossRefGoogle Scholar
  95. 95.
    Satchidananda S. The yoga sutras of Patanjali: translations and commentary. Yogaville: Integral Yoga Publications; 1978.Google Scholar
  96. 96.
    Scascighini L, Toma V, Dober-Spielmann S, Sprott H. Multidisciplinary treatment for chronic pain: a systematic review of interventions and outcomes. Rheumatology. 2008;47:670–8.PubMedCrossRefGoogle Scholar
  97. 97.
    Shapiro D, Cook IA, Davydov DM, Ottaviani C, Leuchter AF, Abrams M. Yoga as a complementary treatment of depression: effects of traits and moods on treatment outcome. Evid Based Complement Alternat Med. 2007;4:493–502.PubMedPubMedCentralCrossRefGoogle Scholar
  98. 98.
    Shapiro SL, Carlson LE, Astin JA, Freedman B. Mechanisms of mindfulness. J Clin Psychol. 2006;62:373–86.PubMedCrossRefGoogle Scholar
  99. 99.
    Sivananda S. Kundalini yoga. 10th ed. Himalayas: Divine Life Society Publication; 1994.Google Scholar
  100. 100.
    Treede RD, Meyer RA, Raja SN, Campbell JN. Peripheral and central mechanisms of cutaneous hyperalgesia. Prog Neurobiol. 1992;38(4):397–421.PubMedCrossRefGoogle Scholar
  101. 101.
    Trestman RL, Appelbaum K, Metzner J, editors. Psychiatric aspects of pain management. New York: Oxford University Press; 2015.Google Scholar
  102. 102.
    Turk DC, Meichenbaum D, Genest M. Pain and behavioral medicine: a cognitive-behavioral perspective. New York: Guilford Press; 1983.Google Scholar
  103. 103.
    Urban MO, Gebhart GF. Supraspinal contributions to hyperalgesia. Proc Natl Acad Sci U S A. 1999;96:7687–92.PubMedPubMedCentralCrossRefGoogle Scholar
  104. 104.
    Vallath N. Perspectives on yoga inputs in the management of chronic pain. Indian J Palliat Care. 2010;16(1):1–7.PubMedPubMedCentralCrossRefGoogle Scholar
  105. 105.
    Villemure C, Bushnell MC. Cognitive modulation of pain: how do attention and emotion influence pain processing? Pain. 2002;95:195–9.PubMedCrossRefGoogle Scholar
  106. 106.
    Villemure C, Ceko M, Cotton VA, Bushnell MC. Insular cortex mediates increased pain tolerance in yoga practitioners. Cereb Cortex. 2014;24:2732–40.PubMedCrossRefGoogle Scholar
  107. 107.
    Vogt BA, Sikes RW. The medial pain system, cingulate cortex, and parallel processing of nociceptive information. Prog Brain Res. 2000;22:223–35.CrossRefGoogle Scholar
  108. 108.
    Wells RE, Burch R, Paulsen RH, Wayne PM, Houle TT, Loder E. Meditation for migraines: a pilot randomized controlled trial. Headache. 2014;54:1484–95.PubMedCrossRefGoogle Scholar
  109. 109.
    Willis WD, Westlund KN. Neuroanatomy of the pain system and of the pathways that modulate pain. J Clin Neurophysiol. 1997;14(1):2–31.PubMedCrossRefGoogle Scholar
  110. 110.
    Willis WD, Al-Chaer ED, Quast MJ, Westlund KN. A visceral pain pathway in the dorsal column of the spinal cord. Proc Natl Acad Sci U S A. 1999;96(14):7675–9.PubMedPubMedCentralCrossRefGoogle Scholar
  111. 111.
    Woolery A, Myers H, Sternlieb B, Zeltzer L. A yoga intervention for young adults with elevated symptoms of depression. Altern Ther Health Med. 2004;10:60–3.PubMedGoogle Scholar
  112. 112.
    Wren AA, Wright MA, Carson JW, Keefe FJ. Yoga for persistent pain: new findings and directions for an ancient practice. Pain. 2011;152:477–80.PubMedPubMedCentralCrossRefGoogle Scholar
  113. 113.
    Yang W, Dall TM, Halder P, et al. Economic costs of diabetes in the U.S. in 2012. Diabetes Care. 2013;36(4):1033–46.CrossRefGoogle Scholar
  114. 114.
    Zeidan F, Gordon NS, Merchant J, Goolkasian P. The effects of brief mindfulness meditation training on experimentally induced pain. J Pain. 2010;11:199–209.PubMedCrossRefGoogle Scholar
  115. 115.
    Zeidan F, Grant JA, Brown CA, McHaffie JG, Coghill RC. Mindfulness meditation-related pain relief: evidence for unique brain mechanisms in the regulation of pain. Neurosci Lett. 2012;520(2):165–73.PubMedPubMedCentralCrossRefGoogle Scholar
  116. 116.
    Zeidan F, Adler-Neal AL, Wells RE, et al. Mindfulness-meditation-based pain relief is not mediated by endogenous opioids. J Neurosci. 2016;36(11):3391–7.PubMedPubMedCentralCrossRefGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  1. 1.Department of PsychiatryCooper University Hospital and Cooper Medical School of Rowan UniversityCamdenUSA

Personalised recommendations