KORN KURATED RESEARCH

The Brain Effects of Meditation in Chronic Pain Treatment

Mindfulness-based meditation offers a promising, evidence-based approach to managing chronic pain by reshaping how the brain processes pain and emotion. It has been shown to reduce both physical discomfort and emotional distress, making it a powerful yet underutilized integrative care tool.

I was introduced to meditation in 1971, and it has remained a cornerstone of my life ever since. Over the years, it has helped me navigate grief, loss, illness, and pain. Like many holistic practices, meditation has been around for millennia, yet only recently has it begun to find its rightful place within our modern healthcare system.

When I was doing a post-graduate fellowship at Harvard in the mid-1980s, many who practiced and taught Vipassana (mindfulness) often had to remain “in the closet” about it.  We might laugh about that absurdity now, but that's the way of introducing innovative health practices. At the time, it wasn’t widely accepted in academic or clinical settings. Thankfully, much has changed since then.

One of my favorite films is The Dhamma Brothers, a powerful documentary about the introduction of Vipassana into a maximum-security prison in Alabama. If you haven’t seen it, I highly recommend it. I cry every time I watch it—it’s that moving.

Meditation has become a trusted practice in many people’s healing journeys, used to ease both physical pain and the emotional aftermath of trauma. However, like any therapeutic tool, it’s not one-size-fits-all. For those newly facing trauma or living with daily chronic pain, meditation can offer grounding and relief, or it can feel dysregulating, depending on how and when it’s introduced.

At its core, mindfulness means paying attention to your inner experience—your thoughts, body sensations, and emotions—as they arise without trying to change or fix them. Meditation provides a structured approach to practice this awareness. It’s about learning to sit with what’s present, instead of trying to silence the mind. With time, this shift encourages a calm, mindful response to discomfort rather than an automatic reaction. 

Trauma and chronic pain frequently overlap; both alter the nervous system, disrupt our basic sense of safety, and can leave us feeling either disconnected or hypervigilant. Meditation helps us gently re-inhabit the body—it creates space to notice pain without being consumed by it. This doesn’t mean escaping discomfort; it means reshaping our relationship to it.

Research using brain imaging supports these effects. Regular meditation has been shown to strengthen areas like the insula and anterior cingulate cortex—regions linked to body awareness and emotional regulation—while overactivity in areas like the amygdala and medial prefrontal cortex—associated with fear and rumination—tends to decrease. These brain shifts often mirror tangible improvements in how people manage pain and regulate stress in daily life.

Here are six recent studies that show how mindfulness can support people living with chronic pain, from both a neurological and clinical perspective:

The first study reviews the use of mindfulness-based meditation for chronic pain, highlighting its effectiveness in both clinical and experimental settings. It also explores the neural mechanisms that may explain how mindfulness produces both immediate and lasting relief from pain.

The second study looks at mindfulness-based approaches for chronic low back pain. Researchers analyzed 18 different trials and found that these interventions significantly reduced pain levels across the board.

The third study involved 149 patients in a randomized controlled trial. After taking part in an 8-week MBSR (Mindfulness-Based Stress Reduction) program, participants had meaningful and lasting improvements in pain intensity and quality of life—changes that continued over a full year.

The fourth study used brain pattern analysis to compare mindfulness meditation with placebo. It found that mindfulness activated unique brain pathways and produced greater reductions in pain and unpleasantness than placebo or “sham” meditation.

The fifth paper reviewed the overall benefits of meditation for people in pain. Beyond physical symptoms, it highlighted improvements in stress, sleep, emotional stability, and body connection—reminding us that pain is rarely just about the body.

The sixth is a meta-analysis of fMRI studies that examined meditation’s effect on neural responses to pain. It confirmed that multiple brain areas involved in sensory, cognitive, and emotional processing shift in response to meditation, helping to explain how it eases both pain and the emotional experiences that come with it.

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Tags: mindfulness, meditation, chronic pain, neuroplasticity, pain perception, brain imaging, placebo, pain unpleasantness, fMRI, anterior cingulate, insula

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Referenced Research Publications

Neurosurgery clinics of North America
2022, July 25
DOI: 10.1016/j.nec.2022.02.005

Mindfulness Meditation in the Treatment of Chronic Pain

Abstract

Chronic pain is a leading cause of disability in the United States. Limited efficacy associated with pharmacologic management and surgical interventions in refractory patients has led to further exploration of cognitive and behavioral interventions as both an adjunctive and primary therapeutic modality. Mindfulness-based meditation has shown to be effective in reducing pain in randomized studies of chronic pain patients as well as models of experimentally induced pain in healthy participants. These studies have revealed specific neural mechanisms which may explain both short-term and sustained pain relief associated with mindfulness-based interventions.

Keywords: Chronic pain; Functional neuroimaging; Meditation; Mindfulness; Neural network.

Copyright © 2022 Elsevier Inc. All rights reserved.

Reference

Brandel, M. G., Lin, C., Hennel, D., Khazen, O., Pilitsis, J. G., & Ben-Haim, S. (2022). Mindfulness Meditation in the Treatment of Chronic Pain. Neurosurgery clinics of North America, 33(3), 275–279. https://doi.org/10.1016/j.nec.2022.02.005

The Clinical journal of pain
2024, February 01
DOI: 10.1097/AJP.0000000000001173

Mindfulness-based Interventions for Chronic Low Back Pain: A Systematic Review and Meta-analysis

Abstract

Objective: This systematic review aimed to compile existing evidence examining the effects of mindfulness-based interventions (MBIs) for chronic low back pain (CLBP). CLBP leads to millions of disabled individuals in the United States each year. Current pharmacologic treatments are only modestly effective and may present long-term safety issues. MBIs, which have an excellent safety profile, have been shown in prior studies to be effective in treating CLBP yet remained underutilized.

Design: Ovid/Medline, PubMed, Embase, and the Cochrane Library were searched for randomized controlled trials (RCTs), pilot RCTs, and single-arm studies that explored the effectiveness of MBIs in CLBP.

Methods: Separate searches were conducted to identify trials that evaluated MBIs in reducing pain intensity in individuals with CLBP. A meta-analysis was then performed using R v3.2.2, Metafor package v 1.9-7.

Results: Eighteen studies used validated patient-reported pain outcome measures and were therefore included in the meta-analysis. The MBIs included mindfulness meditation, mindfulness-based stress reduction, mindfulness-based cognitive therapy, mindfulness-oriented recovery enhancement, acceptance and commitment therapy, dialectical behavioral therapy, meditation-cognitive behavioral therapy, mindfulness-based care for chronic pain, self-compassion course, and loving-kindness course. Pain intensity scores were reported using a numerical rating scale (0 to 10) or an equivalent scale. The meta-analysis revealed that MBIs have a beneficial effect on pain intensity with a large-sized effect in adults with CLBP.

Conclusions: MBIs seem to be beneficial in reducing pain intensity. Although these results were informative, findings should be carefully interpreted due to the limited data the high variability in study methodologies, small sample sizes, inclusion of studies with high risk of bias, and reliance on pre-post treatment differences with no attention to maintenance of effects. More large-scale RCTs are needed to provide reliable effect size estimates for MBIs in persons with CLBP.

Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

Reference

Paschali, M., Lazaridou, A., Sadora, J., Papianou, L., Garland, E. L., Zgierska, A. E., & Edwards, R. R. (2024). Mindfulness-based Interventions for Chronic Low Back Pain: A Systematic Review and Meta-analysis. The Clinical journal of pain, 40(2), 105–113. https://doi.org/10.1097/AJP.0000000000001173

Pain management nursing : official journal of the American Society of Pain Management Nurses
2025, March 12
DOI: 10.1016/j.pmn.2025.02.010

Effect of Mindfulness-Based Stress Reduction on Patients With Chronic Pain: A Randomized Controlled Trial

Abstract

Background: Chronic pain management includes treatment with the use of opioids, electrical stimulation and acupuncture. However, traditional understanding of chronic pain has recently been challenged in light of evidence supporting a key role of psycho-social factors and central sensitization in this population. Mindfulness-based stress reduction (MBSR), focuses on increasing awareness and acceptance of moment-to-moment experiences including difficult emotions and physical discomfort.

Objective: To examine the effects of a MBSR on chronic pain patients.

Design: A two-arm, blinding randomized controlled clinical trial with repeated-measures design.

Setting: One pain management clinic in a general hospital.

Participants: Chronic pain patients (N = 149 patients).

Methods: The patients were randomly allocated to either psychoeducation (intervention group) or usual care (control group) (N = 75 vs 74 patients per group). The randomization was minimized, taking into account the imbalance between the groups over a number of prognostic clinical and demographic factors. The intervention included an 8-week MBSR program (2 hours per week) in a group format and the MBSR program was performed 2 times (1-2 months after enrollment and 7-8 months after enrollment). Study outcomes included Chronic pain (pain intensity and pain interference) assessed with Brief Pain Inventory (primary outcomes), and other secondary outcomes (i.e., quality of life, adherence to the intervention, mindfulness and self-awareness and drug assumption). We examined the differences at baseline (clinical-demographic data collected at enrollment), at 6 (T1) and 13 months (T2) between the intervention and control groups by means of chi-square and independent samples t tests. Normally distributed measurement data were represented by means and standard deviations.

Results: Participants in the intervention group revealed significantly greater reductions on impact of chronic pain in terms of pain intensity (worst pain in the last 24 hours, p < .001; pain right now, p < .001) and in terms of pain interference (interference with mood, p = .002; interference with normal work, p = .043; interference with relationship with other people, p = .036) at T1, and in terms of pain intensity (worst pain in the last 24 hours, p < .001; pain on average, p =. 013; pain right now, p < .001) and in terms of pain interference (interference with mood, p < .001; Interference with sleep, p < .001) at T2. A significant difference emerged in the perceived quality of life, between two groups at T2 (55.9 vs 58.7, t(133) = - 2.053, p = .044).

Conclusions: Our study added values on the benefits of patients-focused MBSR to treatment of chronic pain. Future research can evaluate its long-term effects for patients of chronic pain with diverse socio-demographic and pain-related characteristics in a greater sample.

Registration: Italian Clinical Trial Registry (NCT05843409). Recruitment: April 2023 to April 2024.

Keywords: Chronic pain; Mindfulness based stress reduction; Psychoeducation.

Copyright © 2025. Published by Elsevier Inc.

Reference

Damico, V., Milani, M., & Murano, L. (2025). Effect of Mindfulness-Based Stress Reduction on Patients With Chronic Pain: A Randomized Controlled Trial. Pain management nursing : official journal of the American Society of Pain Management Nurses, S1524-9042(25)00122-5. Advance online publication. https://doi.org/10.1016/j.pmn.2025.02.010

Biological psychiatry
2025, January 01
DOI: 10.1016/j.biopsych.2024.08.023

Mindfulness Meditation and Placebo Modulate Distinct Multivariate Neural Signatures to Reduce Pain

Abstract

Background: Rather than a passive reflection of nociception, pain is shaped by the interplay between one's experiences, current cognitive-affective states, and expectations. The placebo response, a paradoxical yet reliable phenomenon, is postulated to reduce pain by engaging mechanisms shared with active therapies. It has been assumed that mindfulness meditation, practiced by sustaining nonjudgmental awareness of arising sensory events, merely reflects mechanisms evoked by placebo. Recently, brain-based multivariate pattern analysis has been validated to successfully disentangle nociceptive-specific, negative affective, and placebo-based dimensions of the subjective pain experience.

Methods: To determine whether mindfulness meditation engages distinct brain mechanisms from placebo and sham mindfulness to reduce pain, multivariate pattern analysis pain signatures were applied across 2 randomized clinical trials that employed overlapping psychophysical pain testing procedures (49 °C noxious heat; visual analog pain scales) and distinct functional magnetic resonance imaging techniques (blood oxygen level-dependent; perfusion based). After baseline pain testing, 115 healthy participants were randomized into a 4-session mindfulness meditation (n = 37), placebo-cream conditioning (n = 19), sham mindfulness meditation (n = 20), or book-listening control (n = 39) intervention. After each intervention, noxious heat was administered during functional magnetic resonance imaging and each manipulation.

Results: A double dissociation in the multivariate pattern analysis signatures supporting pain regulation was revealed by mindfulness meditation compared with placebo cream. Mindfulness meditation produced significantly greater reductions in pain intensity and pain unpleasantness ratings and nociceptive-specific and negative affective pain signatures than placebo cream, sham mindfulness meditation, and control interventions. The placebo-cream group significantly lowered the placebo-based signature.

Conclusions:? Mindfulness meditation and placebo engaged distinct and granular neural pain signatures to reduce pain.

Keywords: MVPA; Meditation; Mindfulness; Pain; Placebo; fMRI.

Copyright © 2024 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Reference

Riegner, G., Dean, J., Wager, T. D., & Zeidan, F. (2025). Mindfulness Meditation and Placebo Modulate Distinct Multivariate Neural Signatures to Reduce Pain. Biological psychiatry, 97(1), 81–88. https://doi.org/10.1016/j.biopsych.2024.08.023

Curēus
2023, November 22
DOI: 10.7759/cureus.49244

Meditation: A Promising Approach for Alleviating Chronic Pain

Abstract

Chronic pain is a complex and pervasive health issue that significantly impacts the lives of millions. Various cultures have been practicing meditation for thousands of years, and it has been shown that it has many positive effects on mental and physical health. The impact of meditation on chronic pain is encouraging as it will form the base for future advancements. Meditation can improve the body's natural pain-relieving processes, lower stress levels, and boost body awareness. Patients can select from a variety of meditation techniques and include them in their treatment plans in a way that suits them best. Although it may not be a permanent solution, meditation can give patients a useful tool for managing their pain. In both clinical and experimental contexts, mindfulness meditation has been shown to lessen pain dramatically. Meditation may be used to manage chronic pain, which has several benefits, including pain alleviation, stress reduction, improved sleep, and general health. The research study provides insights into various kinds of meditation practices as well as the scientific basis of the mechanisms that are mentioned in the literature for the management of pain. Meditation practices have been scientifically shown in numerous randomized controlled studies to reduce pain intensity, enhance pain tolerance, and improve quality of life in those with chronic pain. Although more research is necessary to fully understand the mechanisms underlying the practice, the encouraging evidence is currently available.

Keywords: pain management, yoga, meditation, mindfulness, chronic pain

Reference

Dubey, A., & Muley, P. A. (2023). Meditation: A Promising Approach for Alleviating Chronic Pain. Cureus, 15(11), e49244. https://doi.org/10.7759/cureus.49244

Neuroscience and biobehavioral reviews
2024, May 29
DOI: 10.1016/j.neubiorev.2024.105735

Effects of meditation on neural responses to pain: A systematic review and meta-analysis of fMRI studies

Abstract

This systematic review investigates the impact of meditation on neural responses to pain, as measured by functional magnetic resonance imaging (fMRI). Up to March 2024, we conducted searches across four databases for human studies implementing fMRI to assess the efficacy of meditation for pain relief. Eighteen studies met the inclusion criteria. Our systematic review indicates that activation of the insula, anterior cingulate cortex, and orbitofrontal cortex is positively associated with meditation for pain relief, while activity in regions like the amygdala and medial prefrontal cortex is negatively correlated with pain relief. Meta-analyses consistently reveal the involvement of various brain regions, including the insula, putamen, amygdala, anterior cingulate cortex, precentral gyrus, postcentral gyrus, inferior parietal lobule, superior temporal gyrus, inferior frontal gyrus, and caudate nucleus, in meditation-induced alleviation of pain. These findings suggest ccthat meditation acts on specific brain regions related to pain, mood, and cognition, providing insight into the potential mechanisms underlying the pain-alleviating effects of meditation on both pain sensations and emotional experiences.

Keywords: Emotional pain; FMRI; Meditation; Meta-analysis; Somatic Pain; Systematic review.

Copyright © 2024 Elsevier Ltd. All rights reserved.

Reference

Fan, C., Wu, M., Liu, H., Chen, X., Gao, Z., Zhao, X., Zhou, J., & Jiang, Z. (2024). Effects of meditation on neural responses to pain: A systematic review and meta-analysis of fMRI studies. Neuroscience and biobehavioral reviews, 162, 105735. https://doi.org/10.1016/j.neubiorev.2024.105735