Meditation and Mindfulness for Chronic Neuropathic Pain

A few weeks ago, Elizabeth Wilcox found herself practicing yoga and mindfulness during a long and aggravating call with her internet provider’s customer service department. Paul Fleming used a box breathing technique to reset after dealing with morning rush hour traffic. 

Both Elizabeth and Paul learned some of these practices through their participation in a clinical trials pilot study at Shepherd Center. The study, funded by the Samsky Spine and Pain Research Fund, aimed to explore the feasibility and acceptability of a mindfulness meditation training program and to determine whether it could lead to improved ability to cope with pain and increased health-related quality of life outcomes. Having the tools to help manage frustrating calls and heavy traffic was a bonus.

Since breaking three vertebrae and sustaining other injuries in a fall about eight years ago, Elizabeth has experienced chronic pain. Her doctor’s warning to be careful, coupled with a fear of falling again, led her to stop many of her activities, which, in turn, led to isolation and depression at the loss of her socially and physically active life. She began coming to The Dean Stroud Spine and Pain Institute about a year ago, participating in physical therapy and adaptive yoga with great results. When she heard about the Mindfulness-Meditation Study, she knew she’d like to give it a try. 

“Because I want to get better. It's mindfulness and yoga, and I thought, ‘There's something here,’” she recalls. “I knew how much the yoga had helped, so I thought, ‘Well, more ways to look at something, more ways to move.’ It's just been incredible.”

Paul has been a patient at the Andrew C. Carlos Multiple Sclerosis Institute for about 20 years and has participated in research at Shepherd in the past. He was already curious about meditation, so when Erica Sutton, MA, CRC, clinical research coordinator at the Virginia Crawford Research Institute at Shepherd Center and principal investigator for the 12-week study, asked if he’d like to participate, he was in. 

“I have been on the fringes of trying to understand meditation and what it does,” says Paul. “Then Erica, out of the blue, called. ‘Hey, Paul, I was thinking about you. You said you always want to participate in things, and I think I have the right choice for you here — it's called mindful meditation.’”

Sutton, who practices meditation herself and holds two clinical meditation certifications, says she wanted to introduce people to its benefits. 

“I built a protocol based around meditation, and for people who are new to meditation and mindfulness, I wanted to show some of the different ways that people can engage in these mindful practices.”

Connecting and Reflecting

Participants in the program attended weekly classes at Shepherd Center and a weekly virtual support group session for eight weeks, followed by four weeks of practicing on their own, during which they could continue to attend virtual sessions. 

During each class, Sutton and her colleague, Alexandra Juarez, EP, RYT 200 HR, introduced participants to a variety of meditation and mindfulness practices, including visual meditation, sound baths, breathing techniques, guided body scans, and mindful eating.

Sutton and Juarez intentionally included time in each session for participants to catch up, share reflections on the tools they’d learned about, and connect with one another — a practice Elizabeth found especially meaningful. 

“Being able to talk to people … sharing how we handle it mentally, emotionally, and physically, even though all our stuff is different, has been a really important part of the mindfulness group,” she says.  

“Part of the benefit of having the study in person is that they get to have a social connection as well, and they really do enjoy that,” says Sutton. “Being able to see people with different diagnoses and to come together collectively with the same goal in mind has been a beautiful process.”

Between classes and during the four weeks of independent practice, participants kept journals documenting the mindful meditation they tried throughout the week and their reflections on the practice. 

“At the end of the study, we will use the diaries to collect those analyses to see if there were any improvements in areas of their overall well-being,” Sutton explains. “We're looking at any changes, primarily in the relationship to pain, so that's something that's important about this study. 

Although we targeted people with chronic neuropathic pain, it was not because we were looking to cure anything, but to build a better relationship with how they navigate and manage life with chronic pain. So, we're looking at their relationship with pain and overall quality of life. Was there any improvement with that? And then of course the safety and efficacy of the study.”

And Sutton hopes that this pilot study of 10 participants will lead to something bigger.

“It's a feasibility study. We're taking this hypothesis, and we're testing it in a small group with the hope that we can conduct more research on a larger scale, and thus translate that into clinical practice.” 

A Variety of Tools

Paul says he has noticed a change in his stress levels and energy.

“I'm like, ‘Am I really noticing that much of a difference that fast?’” he reflects. “My pain levels have gone down from like a six to a two. … I'm sleeping seven hours very easily. I'm in a deeper sleep. … I’m waking up with a lot of energy.”

And he’s even been able to use some of the relaxation techniques he’s learned instead of taking pain medication. 

“Through all the different techniques I've learned, I don't need it. When I feel that pain going across my shoulders or down my spine or my lower back or even on my leg, I'll just do a nervous system reset, and it's been working,” he says.

Elizabeth says learning so many different forms of meditation has been very helpful. 

“I might have known a bit of here and there, but to be very thoughtful, if I'm in pain, let me try this. And finding out which things work for me,” she explains. “Each class was a focus on a different way of meditating. I've known my whole life, ‘Oh, meditation is good,’ and I’d try it, and my mind gets too busy somewhere, and I just haven't been able to meditate. So, learning which ways to meditate has been so important — which ones work for me.”

“It's been very rewarding to hear the feedback and watch what tools they use,” Sutton says. “What we teach is that there's no right or wrong. It's a personal practice, and what's important is that they are making the space to carve out that time for themselves and to use whatever feels best for them in the moment.”

Paul also appreciates having a variety of tools to try. 

“I've used every single technique, and I found it very beneficial. It's a
healing of the soul, in my opinion,” Paul says. “I feel like when you're doing these things, you find yourself, you really get in touch with yourself, with your body, and it's been refreshing.”

Elizabeth says her daughter has noticed how she’s becoming more of her old self again, getting out, reconnecting with friends and family, and engaging in life.

“It's just progress every day,” Elizabeth says. “It has been life changing.” 

If you’d like to find out more about research at Shepherd Center, visit https://shepherd.org/research/redefining-rehab/find-studies/

Written by Ruth Underwood