For thousands of years, people around the world have used meditation as part of their spiritual practices. These days, many people from religious leaders to celebrities tout its benefits. But can meditation help patients with chronic illnesses manage pain and stress? Researchers at the University of Maryland Center for Integrative Medicine are now studying whether Mindfulness-Based Stress Reduction (MBSR) can help relieve the physical and emotional symptoms of rheumatoid arthritis.
"Many people with rheumatoid arthritis live with pain everyday," says Brian Berman, M.D., founder and director of the Center for Integrative Medicine and professor of family medicine at the University of Maryland School of Medicine. "We want to see if this meditation technique can help patients manage the pain and stress that are part of living with a chronic illness."
During the study, called Mindfulness Intervention for Rheumatoid Arthritis, researchers will follow participants for six months. All study participants will be under their doctor's supervision and continue to take their prescribed medications. Participants will take an eight-week course to learn about the meditation techniques.
"The MBSR program was developed 25 years ago by Jon Kabat-Zinn at the University of Massachusetts," explains Trish Magyari, the MBSR program director at the University of Maryland Center for Integrative Medicine. "As part of the program, students receive guided instruction in mindfulness meditation practices, including breathing exercises, gentle stretching or yoga, and applying mindfulness to the challenges of their lives. Participants receive workbooks and CDs so they can practice at home. There are even exercises in mindful eating."
"The goal of mindfulness is to have people be calmly aware of what's happening moment-to-moment," says Lisa Pradhan, co-investigator for the study. "Many people with chronic pain have a lot of anxiety. We want to see if the MBSR class will help these patients relax and focus on each moment."
One-half of the 80 participants will go through the MBSR class. The other half will serve as the control group. All participants will receive physical and psychological evaluations to track any changes."We will be working with rheumatologists to measure the level of inflammation in the patient's joints," Dr. Berman says. "Blood samples can help us measure this along with a physical exam to check for tender or swollen joints."
Researchers will use a mindful attention awareness scale to measure changes in mindfulness. "This is a very new field, where we look at a state of mind that has not been well-characterized up until now, and try to quantify it," Pradhan explains. The scale is developed through a series of questions such as, "I am aware of doing things while I'm doing them" or "I have accidents because I am not paying attention."
"A recent study of MBSR has shown that these practices activate the parts of our brain associated with well-being," says Magyari. "Many people with chronic illnesses get into a cycle of pain and depression. We want to see if the mindfulness training can help them step out of that cycle for a short time, and maybe then it can help break the cycle altogether."
During the eight-week MBSR course, classes meet once a week for two-and-a-half hours. Participants will do relaxation and meditation exercises at home. They will also attend a full-day retreat toward the end of the classes. Following the course, there will be three monthly refresher sessions. Study participants and those in the control group will have three assessments: one at the beginning, one after eight weeks and a final one at the end of 24 weeks. Once the study is finished, the 40 people in the control group can choose to take the MBSR class.
"We have had some rheumatoid arthritis patients who've already been through the program. They report feeling a tremendous benefit from MBSR. Now we want to see if we can show this improvement in a scientific way," Pradhan says.
Rheumatoid arthritis is an autoimmune disease that produces inflammation in the joints, typically in the hands and feet. In the majority of cases, when a joint on one side of the body is affected, the corresponding joint on the other side of the body is affected as well. This inflammation causes pain and stiffness and can lead to permanent joint damage. In severe cases, the disease can cause damage to other organs such as lungs and kidneys. Rheumatoid arthritis affects twice as many women as men.
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