Brief observation
Mindfulness Meditation Modulates Pain Through Endogenous Opioids

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Abstract

Background

Recent evidence supports the beneficial effects of mindfulness meditation on pain. However, the neural mechanisms underlying this effect remain poorly understood. We used an opioid blocker to examine whether mindfulness meditation-induced analgesia involves endogenous opioids.

Methods

Fifteen healthy experienced mindfulness meditation practitioners participated in a double-blind, randomized, placebo-controlled, crossover study. Participants rated the pain and unpleasantness of a cold stimulus prior to and after a mindfulness meditation session. Participants were then randomized to receive either intravenous naloxone or saline, after which they meditated again, and rated the same stimulus.

Results

A (3) × (2) repeated-measurements analysis of variance revealed a significant time effect for pain and unpleasantness scores (both P <.001) as well as a significant condition effect for pain and unpleasantness (both P <.2). Post hoc comparisons revealed that pain and unpleasantness scores were significantly reduced after natural mindfulness meditation and after placebo, but not after naloxone. Furthermore, there was a positive correlation between the pain scores following naloxone vs placebo and participants' mindfulness meditation experience.

Conclusions

These findings show, for the first time, that meditation involves endogenous opioid pathways, mediating its analgesic effect and growing resilient with increasing practice to external suggestion. This finding could hold promising therapeutic implications and further elucidate the fine mechanisms involved in human pain modulation.

Section snippets

Methods

Fifteen healthy mindfulness-meditation practitioners participated in 30 sessions of a double-blind, randomized, placebo-controlled, crossover study. All participants were recruited from the same meditation practice center in Tel Aviv and had over a year's experience of at least one hour of practice a day at least 3 times a week. All practiced sitting mindfulness meditation and referred to the type of practice that they perform as Shamatha or Vipassana meditation.5 All participants had no

Results

A (3) × (2) repeated-measurements analysis of variance was performed separately for both pain and unpleasantness scores for the within-subjects factors of time (prior to/after meditation) and condition (no treatment, naloxone or placebo injection). Both analyses revealed a significant time effect [F(1, 13) = 19.01 for pain ratings; F(1, 13) = 22.85 for unpleasantness, both P <.001], as well as a significant condition effect [F(2, 26) = 4.62 for pain ratings; F(2, 26) = 9.01 for unpleasantness,

Conclusions

In line with previous reports, we found that mindfulness meditation induces a significant analgesic effect. However, we found that this effect was reversed by the administration of an opioid antagonist, indicating the recruitment of the endogenous opioid system during meditation.

Interestingly, in this study there was a significant correlation between the differential response to naloxone vs saline and participants' meditation experience, with saline being more likely to reverse the mindfulness

Acknowledgment

The authors wish to thank Mr. Avy Lugassy for his support.

References (10)

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Funding: This research was supported by the I-CORE Program of the Planning and Budgeting Committee and The Israel Science Foundation (grant no. 51/11) and by Adopt a researcher-TASMC excellence program for physician researchers.

Conflict of Interest: None.

Authorship: All authors had access to the data and participated in writing the manuscript.

1

These authors contributed equally to this work.

2

These authors contributed equally to this work.

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