May 30, 2000 -- The waves of pain are intense for Regina, the result of an auto accident that left her with neck and jaw injuries. Surgery brought no relief, and pain medications left her drowsy, with virtually no energy. She's had to quit her job as an on-the-rise Atlanta chef. "I didn't like the way they made me feel ... not like myself," the 35-year-old tells WebMD of the pain medication.
Seeking an alternative, she gave meditation a try. Now when the intense pain hits -- which happens at least five times a day -- she calms her thoughts, focuses on her breathing, and meditates it away.
Meditation -- an ancient spiritual tradition -- is for millions of people around the world a 15- or 20-minute daily ritual. While there are several forms of meditation, generally it involves focusing on the breathing, ignoring everyday thoughts, and repeating a word or phrase called a mantra. Relaxation, which is at the heart of meditation, has long been known to quiet a turbulent mind, reduce stress, and, as in Regina's case, provide pain relief.
During the past three decades, a handful of scientists have delved deeper into the mysteries of meditation, trying to understand how the mind affects the body. Studies show that daily meditation can indeed be medication -- creating long-lasting physiological effects that reduce high blood pressure and even help unclog arteries to reverse heart disease.
Harvard researcher Herbert Benson, MD, has studied and written about the physiologic effects of meditation over the past 30 years. Also president of the Mind/Body Institute at Beth Israel Deaconess Medical Center in Boston, Benson co-authored a recently published -- albeit small -- study mapping, for the first time, exactly what happens in the brain during meditation.
Five long-time meditation practitioners were involved in the study. Each had practiced Kundalini, an Eastern form of meditation, for at least four years. While meditating, each was given a brain scan called an MRI.
"There was a striking quietude across the entire brain which was documented through MRI," Benson tells WebMD. "The areas of the brain that became active from that quietude were those that control metabolism, heart rate, etc.," says Benson, who is also associate professor of medicine at Harvard Medical School. The results were published recently in the journal Stroke.
"We knew meditation caused a relaxation response, but we couldn't prove it. We knew that if you thought in a certain way, with repetition, that physiologic changes would occur in the body. Here now is proof that mind, in the form of repetition, is affecting the brain, which affects the body," says Benson.
Also studying meditation over the past 12 years are researchers at the College of Maharashi Vedic Medicine in Fairfield, Iowa. Many of the studies, sponsored by the National Institutes of Health, have focused on heart disease and its risk factors.
One study of transcendental meditation, another form of meditation, and its effects on black people with high blood pressure was published earlier this year in Stroke. The study was authored by Amparo Castillo-Richmond, MD, an assistant professor at Maharashi.
In the group that practiced transcendental meditation, there was an reduction in thickness of one of the arteries that supplies blood to the brain, a sign that blood flow is increasing, Castillo-Richmond tells WebMD. In the group that only followed diet and exercise recommendations, "the artery walls were getting thicker."
Another three-month study, published in the journal Hypertension, showed that transcendental meditation had a much greater effect on blood pressure than a widely used approach for relaxation, called progressive muscle relaxation.
"What we found was that conventional education had little or no effect in reducing high blood pressure, which is what doctors find most of the time. We tell our patients to change their diet, lose weight, avoid salt, avoid stress, get more exercise, but they just don't do it. It's hard to change your lifestyle," Robert H. Schneider, MD, director of the Center for Natural Medicine and Prevention at the College of Maharishi Vedic Medicine, tells WebMD.
The group that practiced progressive muscle relaxation showed a small change in blood pressure, which is consistent with other studies, he says.
However, "the transcendental meditation group had twice the change in blood pressure as the relaxation group" and had results similar to drug treatments, Schneider tells WebMD. "This is really critical because transcendental meditation is widely misunderstood. The original hypothesis 25 or 30 years ago was that all meditation approaches had the same effect. However, research in the past decade has disproved this hypothesis clearly."
There are several forms of meditation, including transcendental meditation, and several types of relaxation therapies. Many clinicians believe that relaxation -- however it is achieved -- is the crucial factor.
"There are three basic kinds of meditation: concentrative, awareness, and expressive. Transcendental meditation and Kundalini are concentrative, focusing on a mantra; Vipassani is a mindfulness or awareness meditation, becoming aware of thoughts, feelings, and sensations as they arise; and expressive meditation is dance, twirling, shaking," says James S. Gordon, MD, director of Center for Mind-Body Medicine in Washington, D.C.
"Each may have slightly different physiologic effects, but that doesn't mean that one technique is better than the other. ? Different kinds of meditation are appropriate for different people at different times," Gordon tells WebMD.
Benson agrees. Meditation is but one form of relaxation that leads to a common set of physiologic changes, he tells WebMD. "There's nothing unique about meditation. Physiologically, it is called the relaxation response, and its opposite is the stress response. With the relaxation response there is decreased metabolism, heart rate, blood pressure, rate of breathing, slower brain waves. That's been proven repeatedly in studies."
Benson says yoga, tai chi, Lamaze breathing, and repetitive prayer such as the rosary can do the same. "They all share this common physiology," he says. "Repetition is key to creating the response. ? So it could be a mantra; it could be a prayer; it could be a repetitive muscular activity. The other feature is, when other thoughts come to mind when you do a repetition, simply let them go and come back to the repetition."
The bottom line is that any condition that's caused or exacerbated by stress can be alleviated, says Benson. "So with 60% to 90% of visits to physicians being in the mind-body, stress realm, you can see why this has such legion effects. Anxiety, mild and moderate depression, anger and hostility, hypertension, cardiac irregularities -- all forms of pain are made worse by stress. And that's why the relaxation response is useful."
Regina's doctor, Stan Chapman, PhD, tells WebMD because all relaxation methods involve internal focus and putting distracting thoughts aside, "they can be effective in reducing pain." Chapman is a pain therapy specialist, psychologist, and professor at Emory University School of Medicine in Atlanta. "There's a lot of evidence in the research literature that pain tends to be worse when people are anxious, or when their muscles are tight."
Relaxation methods also help with sleep, a major issue for people with pain. "Many medications people use for sleep have untoward side effects, like carryover drowsiness during the day which affects their ability to function, remember, or drive, which is very critical to people," Chapman tells WebMD.
But in a busy world, if pain relief is not at stake, are people making time to meditate?
Schneider says that because meditation is a very natural activity, people easily adopt it as a routine. He reports that in his blood pressure study, 80% to 90% of people continued doing their daily meditation several months after the study.
"The jury is in on this; it's not even a question that it works," says cardiologist Paul Robinson, MD, of Emory University School of Medicine. But he has met some resistance.
Meditation has helped some of his patients, he says, but "they have to be agreeable to the technique and willing to go through what it takes to do meditation properly. That's one of the drawbacks, because in this country, many people don't understand it and don't want to take time to do it."
Gordon tells WebMD that aside from the health benefits, meditation changes the way you look at the world, the way you live your life, and "that's quite important."
"If you live in the moment and are not preoccupied by the past or worrying about the future, you've made a profound change," he says. "It is true that meditation has important physiologic effects in terms of lowering blood pressure, decreasing heart rate, or decreasing levels of pain, and that's also important. ? Running may have similar effects, but it doesn?t necessarily change your life in profound ways. Meditation has the capacity to do both."
- Meditation can be an effective way to manage pain, relieve stress, lower blood pressure, and lower heart rate.
- The three basic types of meditation are concentrative, awareness, and expressive, and they all induce a relaxation response, which is the opposite of the stress response.
- For meditation to be effective, people must be agreeable to the technique and make the effort to do it properly.