A woman meditating outside (Photo by Benjamin Child on Unsplash)
SAN DIEGO — A new study finds that mindfulness meditation is more effective at reducing pain than placebo treatments, challenging the long-held assumption about how these techniques work. The research provides compelling evidence that meditation engages distinct brain mechanisms to alleviate pain rather than simply tapping into the “placebo effect” as previously thought.
For years, scientists have debated whether practices like meditation merely harness the power of suggestion, similar to how placebos work. This new study published in the journal Biological Psychiatry puts that idea to rest, showing that meditation and placebo activate different neural pathways to provide pain relief.
“The mind is extremely powerful, and we’re still working to understand how it can be harnessed for pain management,” explains Fadel Zeidan, PhD, professor of anesthesiology and Endowed Professor in Empathy and Compassion Research at UC San Diego Sanford Institute for Empathy and Compassion, in a media release. “By separating pain from the self and relinquishing evaluative judgment, mindfulness meditation is able to directly modify how we experience pain in a way that uses no drugs, costs nothing and can be practiced anywhere.”
The study, led by researchers at UC San Diego and Dartmouth College, involved 115 healthy volunteers who were randomly assigned to four groups: mindfulness meditation, sham meditation, placebo cream, or a control group. Participants went through four 20-minute training sessions in their respective techniques before undergoing pain testing in an MRI scanner.
During the experiment, researchers applied painful heat to participants’ legs while their brains were scanned. The mindfulness meditation group was instructed to focus on their breath and observe sensations without judgment. The sham meditation group went through similar motions but without actual mindfulness instruction. The placebo group received a cream they were told would reduce pain, while the control group simply rested.
Mindfulness meditation not only outperformed placebo and sham treatments in reducing participants’ pain ratings, but it also showed unique effects in the brain. Using advanced analysis techniques, the researchers identified distinct “neural signatures” associated with different aspects of pain processing. Mindfulness meditation was the only intervention that significantly reduced activity in brain regions linked to both the physical sensation of pain and its emotional impact.
In contrast, the placebo cream only affected brain patterns associated with pain expectations and beliefs. Sham meditation, designed to mimic the ritual of meditation without its key components, showed minimal effects.
“It has long been assumed that the placebo effect overlaps with brain mechanisms triggered by active treatments, but these results suggest that when it comes to pain, this may not be the case,” Zeidan says. “Instead, these two brain responses are completely distinct, which supports the use of mindfulness meditation as a direct intervention for chronic pain rather than as a way to engage the placebo effect.”
These findings suggest that mindfulness meditation doesn’t just work by convincing people they’re in less pain – it actually changes how the brain processes painful stimuli at a fundamental level. This could have major implications for chronic pain treatment, offering a drug-free alternative that targets multiple dimensions of the pain experience.
As chronic pain affects millions worldwide and opioid addiction remains a pressing concern, this research opens up new avenues for non-pharmacological pain management.
“Millions of people are living with chronic pain every day, and there may be more these people can do to reduce their pain and improve their quality of life than we previously understood.” Zeidan concludes. “We are excited to continue exploring the neurobiology of mindfulness and how we can leverage this ancient practice in the clinic.”
Paper Summary
Methodology
The study combined data from two separate experiments using different brain imaging techniques. Participants were randomly assigned to groups and underwent four training sessions. During the final brain scanning session, they received painful heat stimuli to their leg while practicing their assigned technique (meditation, sham meditation, or placebo cream application). The control group simply rested. Pain ratings were collected, and brain activity was analyzed using advanced machine learning methods to identify specific patterns associated with different aspects of pain processing.
Key Results
Mindfulness meditation significantly reduced both pain intensity and unpleasantness ratings compared to all other groups. It also decreased activity in brain regions associated with physical pain sensation (the “neurologic pain signature”) and emotional pain processing (the “negative affective pain signature”). Placebo cream only affected brain patterns linked to pain expectations. Sham meditation had minimal effects on pain or brain activity.
Study Limitations
The study was conducted on healthy volunteers experiencing acute pain, so the results may not directly translate to chronic pain conditions. The sample size, while respectable, could be larger to increase confidence in the findings. Additionally, the study didn’t collect brain imaging data before the interventions, making it difficult to determine if changes were solely due to the treatments or partially influenced by pre-existing differences between participants.
Discussion & Takeaways
This research challenges the notion that meditation is “just a placebo” for pain relief. By showing that mindfulness engages distinct brain mechanisms, it suggests that meditation could offer more comprehensive pain management than placebo-based treatments. The study also validates the use of advanced brain imaging techniques to disentangle different aspects of pain processing. These findings could inform the development of more targeted and effective non-pharmacological pain treatments.
Funding & Disclosures
The study was funded by the National Center for Complementary and Integrative Health. The authors reported no conflicts of interest related to this research.
The placebo effect is a function of the mind and its expectations. This study uses the mind to control pain, and tries to differentiate mindfulness as an effective treatment versus as a placebo effect. It is assumed that the placebo effects is something like faith in the treatment, and that faith and belief in the treatment causes the brain and body to react positively, due to this expectation. However, this may be too narrow a view of the placebo effect. Mindful meditation could also be considered a placebo effect, since it is also a function of one’s mind. There could be multiple ways to elicit positive reactions from mental expectations, or multiple placebos that work. Placebos can be used to treat disease. Mindful meditation can be one of these placebo techniques for stimulating self-healing. In fact, that is a better definition of a placebo: a substance or process that activates the brain to self-heal the body. This would make mindful meditation a placebo process, which is fine since the goal is healing.