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      Mindfulness-Based Meditation Versus Progressive Relaxation Meditation: Impact on Chronic Pain in Older Female Patients With Diabetic Neuropathy

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          Abstract

          Chronic pain, the most common complication of diabetes, is treated with medication often to no avail. Our study aimed to compare the use of mindfulness meditation and progressive relaxation to reduce chronic pain in older females with diabetes. Methods The 105 study participants were divided randomly into 3 groups: Group MM (mindfulness meditation), Group CM (control meditation), and Group PM (progressive relaxation meditation). Assessment of analgesic effectiveness required changes in average daily pain Brief Pain Inventory (BPI) modified for painful diabetic peripheral neuropathy and Patient Global Impression of Change using descriptive statistics, Student’s t test, and analysis of variance where applicable. Results Both Groups MM and PM experienced significant ( P < .05) reduction in average daily pain in last 24 hours at study end compared to baseline (28.7% and 39.7%, respectively). Group MM had more significant ( P < .01) reduction of pain compared to control, a score of 5.2 ± 1.2 dropped to 3.0 ± 1.1 by week 12 of treatment. Groups MM and PM showed significant improvement in patients’ impression at study end, 75 ± 5.1% (n = 36) and 61 ± 6.5% (n = 32), respectively. In Group MM, patient satisfaction scores increased significantly ( P < .05) to 3.8 ± 1.9 by week 12. Conclusion Integrative therapies such as mindfulness meditation can be part of a comprehensive pain management plan. Benefits include reduction of pain-related medication consumption, better treatment outcomes, improvement in comorbid conditions such as anxiety and depression as well as no risk of addiction or abuse.

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          The neuroscience of mindfulness meditation.

          Research over the past two decades broadly supports the claim that mindfulness meditation - practiced widely for the reduction of stress and promotion of health - exerts beneficial effects on physical and mental health, and cognitive performance. Recent neuroimaging studies have begun to uncover the brain areas and networks that mediate these positive effects. However, the underlying neural mechanisms remain unclear, and it is apparent that more methodologically rigorous studies are required if we are to gain a full understanding of the neuronal and molecular bases of the changes in the brain that accompany mindfulness meditation.
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            Neuropathic pain: diagnosis, pathophysiological mechanisms, and treatment.

            Neuropathic pain develops as a result of lesions or disease affecting the somatosensory nervous system either in the periphery or centrally. Examples of neuropathic pain include painful polyneuropathy, postherpetic neuralgia, trigeminal neuralgia, and post-stroke pain. Clinically, neuropathic pain is characterised by spontaneous ongoing or shooting pain and evoked amplified pain responses after noxious or non-noxious stimuli. Methods such as questionnaires for screening and assessment focus on the presence and quality of neuropathic pain. Basic research is enabling the identification of different pathophysiological mechanisms, and clinical assessment of symptoms and signs can help to determine which mechanisms are involved in specific neuropathic pain disorders. Management of neuropathic pain requires an interdisciplinary approach, centred around pharmacological treatment. A better understanding of neuropathic pain and, in particular, of the translation of pathophysiological mechanisms into sensory signs will lead to a more effective and specific mechanism-based treatment approach. Copyright 2010 Elsevier Ltd. All rights reserved.
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              Mindfulness Meditation for Chronic Pain: Systematic Review and Meta-analysis

              Background Chronic pain patients increasingly seek treatment through mindfulness meditation. Purpose This study aims to synthesize evidence on efficacy and safety of mindfulness meditation interventions for the treatment of chronic pain in adults. Method We conducted a systematic review on randomized controlled trials (RCTs) with meta-analyses using the Hartung-Knapp-Sidik-Jonkman method for random-effects models. Quality of evidence was assessed using the GRADE approach. Outcomes included pain, depression, quality of life, and analgesic use. Results Thirty-eight RCTs met inclusion criteria; seven reported on safety. We found low-quality evidence that mindfulness meditation is associated with a small decrease in pain compared with all types of controls in 30 RCTs. Statistically significant effects were also found for depression symptoms and quality of life. Conclusions While mindfulness meditation improves pain and depression symptoms and quality of life, additional well-designed, rigorous, and large-scale RCTs are needed to decisively provide estimates of the efficacy of mindfulness meditation for chronic pain. Electronic supplementary material The online version of this article (doi:10.1007/s12160-016-9844-2) contains supplementary material, which is available to authorized users.
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                Author and article information

                Journal
                J Evid Based Integr Med
                J Evid Based Integr Med
                CHP
                spchp
                Journal of Evidence-based Integrative Medicine
                SAGE Publications (Sage CA: Los Angeles, CA )
                2515-690X
                23 September 2019
                2019
                : 24
                : 2515690X19876599
                Affiliations
                [1 ]Al Ain University of Science and Technology, Abu Dhabi, UAE
                Author notes
                [*]Nadia Hussain, MBBS, MSc, PhD, College of Pharmacy, Al Ain University of Science and Technology, PO Box 64141, Al Ain, Abu Dhabi 64141, UAE. Email: nadia.hussain@ 123456aau.ac.ae
                Author information
                https://orcid.org/0000-0001-6314-2485
                Article
                10.1177_2515690X19876599
                10.1177/2515690X19876599
                6757487
                31544476
                988dd9ad-cfbd-4c0a-81f2-12808fa6d95a
                © The Author(s) 2019

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                : 20 June 2019
                : 12 August 2019
                : 25 August 2019
                Categories
                Original Manuscript
                Custom metadata
                January-December 2019

                meditation,mindfulness meditation,progressive relaxation meditation,type 2 diabetes mellitus,chronic pain,diabetes,older females,pakistan

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