Healthy Mind, Healthy Body: Mindfulness Practice Used to Treat Migraines
Written by Ariana Pirzadeh, B.S.
Edited by Sarah Banducci, Ph.D. and Rachel Haake, Ph.D.
Why Mindfulness for Migraines?
Mindfulness practices have gained attention in recent years for their ability to promote mental health and wellbeing. New research from Wake Forest shows mindfulness is effective for improving physical health too. In a study conducted by Dr. Rebecca Wells and colleagues at Wake Forest University, the efficacy of mindfulness-based stress reduction (MBSR) for treating migraine was compared to that of headache education. MBSR focuses on the mind-body connection and helps patients develop an awareness of the migraine while reducing judgment of sensory input, and headache education involves educational classes which provide information about migraines and how to manage them.
Dr. Wells hypothesized that MBSR would be more effective than headache education at improving migraine frequency, disability (such as number of missed school or workdays/3 months), quality of life, and affective/cognitive processes. Affective and cognitive processes include self-efficacy (the individual’s belief in themselves to accomplish their goals), pain catastrophizing (the tendency to over-estimate the level of threat posed by a painful stimulus), and depression. Wells’ hypothesis was formed based on previous research showing that MBSR is associated with improvements in chronic pain conditions in part because it diminishes emotional responses to stress, a common migraine trigger, and because individuals learn to alter their perception of sensory input such as migraine pain.
Putting Mindfulness to the Test
Eighty-nine subjects were divided into two groups, one receiving MBSR and the other receiving headache education. Each of these individuals experienced 4-20 migraine days per month and had been experiencing migraines for at least 1 year. Once the individuals were divided into their respective groups, they met for 2 hours per week for 8 weeks total. Primary and secondary outcomes were measured for each group following treatment. The primary outcomes included the duration, intensity, symptoms, and medication use related to experienced migraines. The secondary outcomes included participants’ quality of life and well-being assessed by a Patient Health Questionnaire and headache-related disability measured by the Migraine Disability Assessment (MIDAS).
Both treatments decreased the frequency of experienced migraines (# migraine days/month) from baseline, but the effect of MBSR and headache education on migraine frequency did not significantly differ. These results suggest both treatments are effective for decreasing migraine frequency. Remarkably, MBSR participants also experienced significant improvements in disability, quality of life, self-efficacy, pain catastrophizing and depression scores from baseline, compared to headache education. These findings were somewhat consistent with Dr. Wells’ hypothesis, as MBSR was more effective than headache education at improving disability, quality of life, and affective/cognitive processes, but not migraine frequency. The researchers concluded that the benefits of MBSR treatment may be due to the fact that mindfulness strengthens an individual’s ability to access sensory input (like pain) and learn skills to decrease the intensity of pain perceived, thus, allowing for a greater quality of life, improved cognitive processes and other long-term benefits.
Implications and Future Directions
This important work suggests that both MBSR and headache education decrease migraine frequency, and MBSR goes even further in treatment efficacy by improving disability, quality of life, pain catastrophizing, and depression. This means that MBSR is supported in its positive impact on individuals with migraines. Future work should look into other potential benefits of this treatment, for example, for other types of chronic pain and illness. Additionally, other treatment regimens including stress management strategies and self-regulation skills may be effective for chronic pain conditions as well. Finding non-drug options for treating chronic pain conditions such as migraine is important because they may reduce the risk of opioid use disorder and overdose.