Daily Meditation Helps Arthritis Patient With Chronic Pain

Ingrid Hein

October 24, 2018

Raquel Masco, who suffers from polyarthritis, at ACR 2018. (Source: Darbe Rotach, Medscape)

The day she got rear-ended by an 18-wheeler in 2017, Raquel Masco finally got a diagnosis for her pain, after more than 10 years of suffering.

"I don't know why he took his foot off the break at a red light," she said. But after an MRI at the hospital after the accident, Masco was given a diagnosis of inflammatory polyarthritis.

The previous decade had been difficult. She first noticed bald spots on her head when she was 33, she said, and "I had this weird pattern on my face." However, "x-rays and blood tests came back fine." Over the years, suffering with fatigue, difficulty getting out of bed, and pain, she knew something was wrong.

In 2016, she was given a diagnosis of osteoarthritis but no explanation for her other symptoms, and prescribed indomethacin and ibuprofen for the pain. As a single mom, "you just keep on going," she told Medscape Medical News. You "just suck it up."

But "I knew I wasn't making it up," she said. There were days when she was so sapped of energy that she had to crawl up the stairs.

Toothache a Path to Meditation

Just after her diagnosis, Masco, who is executive director and cofounder of SingleMoms Created4Change Advocacy and Empowerment Center, found herself with a really bad toothache.

Through her suffering, she told herself, "I need to center myself and breathe." It helped. Having tried meditation with her friend, a yoga instructor, she thought it would be good to explore the practice further for her chronic pain.

"I've always had a racing mind. In the beginning, when I began to meditate, I was a control freak. It took time to learn to surrender to the process," she said. Today, Masco does a daily meditative walk in the mornings, "even in the rain," and in the afternoon, she closes her office door and does a sitting meditation.

"It helps me have more control over my mental health, and helps me live with chronic pain," she told Medscape Medical News. Meditation helps her "accept" what is going on in her body and gives her more control over the pain.

Masco described how meditation helps her during her patient-poster presentation at the American College of Rheumatology 2018 Annual Meeting in Chicago.

Another Component of Disease

As a patient, it's important to address what living with this disease does to you, she said. "You feel lost or you feel it's a punishment when the medication isn't a cure-all."

Of course, an evidence-based approach is important, she acknowledged, "but there's another component. I'm more than just science. There's a part of me that medication can't help."

Masco started taking duloxetine (Cymbalta) earlier this year, along with ibuprofen, but still uses meditation to help her get through the chronic pain.

"Meditation takes the focus off the pain and everything that's going on and brings me to a more centered place as a person and as a woman," she explained. It helps her know that there's more to her than chronic illness and pain. "I'm a person beyond this pain. Focusing on the breath, on the breath of life inside of me, I can be in a higher place, one that is the opposite of the pain."

In addition to meditation, Masco participates in patient and facilitated support groups online. "I do Lupus Chat regularly," she reported. She also volunteers at the Arthritis Foundation.

"Meditation takes the focus off the pain and everything that's going on," Masco told Medscape Medical News. (Source: Darbe Rotach, Medscape)

More Education Needed

More education about meditation would be helpful for patients with chronic pain. "Not everyone understands what it is," said Masco. "We need to take that sort of mythical cultish perception off of it." It could help if it was suggested by a doctor; there could be brochures in doctors' offices.

It is important for doctors to encourage patients who want to try different approaches to disease management, as long as they are not physically harmful, she added.

"From one skeptic to another; I can tell you, there are real benefits to it," she said.

You have to do it because you really want to try it, not because you think it's a fad, she said. "You have to do it at your own pace and find what really works for you. Give yourself space and compassion to grow and to learn — to surrender to the process."

Masco still has disease flares. Chronic pain can be discouraging and it's important to find things that are uplifting, she said. "Find a support group; talking to people who understand what you are going through is a vital part of healing."

Scientific Approach to Mindfulness and Meditation

It is notoriously difficult to find scientific evidence supporting the benefits of meditation, but providers need alternatives to offer patients in chronic pain, especially in light of the ongoing opioid crisis.

In a study presented earlier this year at the American Pain Society meeting, response to treatment improved when patients with chronic low back pain who were prone to catastrophizing took up mindfulness meditation, as reported by Medscape Medical News.

And a 2017 study, also reported by Medscape Medical News, showed that short-term physical functioning was significantly better with mindfulness stress-reduction therapy than with usual care, although improvements were not sustained over the long term.

Masco has disclosed no relevant financial relationships.

American College of Rheumatology (ACR) 2018 Annual Meeting: Presented October 21, 2018.

Follow Medscape Rheumatology on Twitter @MedscapeRheum and Ingrid Hein @ingridhein

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