Mindfulness for diabetes related nerve pain (neuropathy)
Diabetes-related nerve pain can cause anxiety and depression, and, even when prescribed by pain experts, painkillers often can’t take the pain away. Canadian Diabetes Association-funded researcher and chronic pain specialist Dr. Howard Nathan and team (myself included!) wanted to know if reducing stress with therapies like relaxation, meditation and yoga could help people with diabetes-related nerve pain live a better, healthier life.
Having diabetes for a long time can cause nerve pain (called diabetic peripheral neuropathy), because over time high levels of glucose (a type of sugar) in the blood can cause damage to the nerves that go to the arms, hands, legs and feet. This can cause sharp, shooting pains, burning, tingling, a feeling of being pricked with pins, throbbing, or numbness. The pain often makes it hard to walk, sleep, or go about normal daily life. As you might imagine, not being able to do the activities you would normally enjoy can cause anxiety and depression. Even though people with neuropathy can take pain medications, these drugs rarely make the pain go away entirely.
People with neuropathy must find other ways to cope with the pain to enjoy life.
Our team at the Ottawa Hospital Research Institute, received a Canadian Diabetes Association research grant to take a closer look at the link between mental health, stress, and pain caused by diabetes-related neuropathy. The team was interested in finding out if treating the mind can improve the wellbeing of people with diabetes-related nerve pain, using a treatment called Mindfulness Based Stress Reduction. Mindfulness means being aware (in a calm way) of what is going on not only around us but also inside our own body and mind. This knowledge allows us to take better care of our physical and mental health.
Mindfulness Based Stress Reduction is delivered in a group, once a week for 2.5 hours, for eight weeks and includes relaxation techniques, meditation, gentle yoga, and coping strategies. Results from this study and others suggest that this treatment could not only help improve enjoyment of life but may also improve blood glucose levels. It seems that this kind of therapy makes it easier to make good decisions in daily life leading to better adherence with diet, medications and exercise, all of which affect blood glucose (that is the “mindfulness” part of the program). Further, stress reduction decreases the amount of stress hormones (like cortisol) in the blood. Cortisol is released into the body in times of stress. Cortisol helps with the “fight or flight” response, raising blood glucose levels so that glucose can be used as energy by your muscles and brain to fight or flee. When cortisol levels are high for too long (as in people with chronic pain) it can cause anxiety, depression, digestive problems, heart disease, sleep problems, weight gain, and memory and concentration problems.
A body scan for mindful pain management
If you’re interested in trying mindfulness for pain management, try out the exercise below:
Get to a quiet place and put yourself in a comfortable position. If you think you’ll fall fast asleep, sit instead of lying down.
Close your eyes and concentrate on your breath. You don’t need to do anything differently with your breathing, but pay attention to it.When your mind wanders, as it will, gently redirect your attention to the breath.
Envision your breath coming into your body, expanding your lungs and then leaving your body, deflating your lungs. Scan your body – that is, direct your full awareness to every part of your body, one at a time. You can start with your toes and end at your head or start at your head and end at your toes.
As you do this, just observe and try your best to not engage. What does your body feel like? What about the parts that aren’t in any pain? Does your pain differ in different parts of your body?When you are ready, bring your attention back to your breath. Slowly open your eyes.
Contact me if you are interested in learning more about Mindfulness Based Stress Reduction for pain.