If you’re like most people, your mind typically runs in a hundred different directions. But you may not realize that bringing it to a focus in the present moment — a process known as mindfulness — may actually improve pain and other symptoms of rheumatoid arthritis (RA).

“Drugs are effective for rheumatoid arthritis, but they don’t affect the stress pathways that are so fundamental to the condition,” says Michael Irwin, MD, a professor of psychiatry at the University of California in Los Angeles and the director of its Mindful Awareness Research Center (MARC). Stress symptoms, he says, activate inflammation and even heighten the perception of pain. “A mindfulness-based intervention, which targets the multiple components of the body’s stress response, can decrease overall pain severity and increase quality of life.”

How Mindfulness May Help Relieve Pain and Improve Quality of Life for People With RA

Mindfulness is a process of continually being aware of your thoughts and feelings. It is "paying attention, on purpose, in the present moment,” as described by Jon Kabat-Zinn, PhD, probably the method's best-known advocate and the founding executive director of the Center for Mindfulness in Medicine, Health Care, and Society at the University of Massachusetts Medical School in Worcester. Importantly, this attention involves not judging the thoughts and emotions that arise, but rather observing them from a place of dispassion.

Perception and Response Play a Role in the Experience of Joint Pain

The mindfulness method is based on the idea that your view of stressful experiences in large part determines how your body responds. Changing the way you perceive these difficulties, primarily by distancing your emotions from them, reduces your stress level, affecting your mind and body.

Try Mindfulness Awareness Practices (MAPs) as Healthy Daily Habits

Mindfulness-based practices include walking and sitting meditations, eating with focus, and noticing sensations in your body without becoming alarmed about them. The idea of these mindful awareness practices, or MAPS, is to learn to develop a greater awareness of what is happening in your mind and body — again, without judgment — and then bring that mindfulness into your everyday life, Dr. Irwin says.

History and Effectiveness of the Mindfulness Method

Mindfulness-based therapies got their start in the late 1970s at the University of Massachusetts, when Dr. Kabat-Zinn turned his attention from molecular biology to the mind-body interaction that facilitates healing. Eventually, he created the famed Mindfulness Based Stress Reduction (MBSR) program, now offered through UMass Memorial Health Care.

Because Kabat-Zinn is a scientist, he wanted evidence for what happens after people do mindfulness practices, especially regarding their physical condition. One of his earliest studies, in 1988, documented how people improved healing from psoriasis when they added mindfulness to their ultraviolet phototherapy treatments.

Research Shows Myriad Benefits of Mindfulness Practice, but Studies Are Small

Since then, a number of studies have been done on MAPS, including several in people with rheumatoid arthritis. Most are small studies with few people, and experts like Irwin agree that more research is needed.

Mindfulness May Reduce Inflammation Markers in Some People

When 149 stressed adults with low-grade inflammation were taught to monitor and accept their thoughts, markers of inflammation did go down in a subset of people: those who were midlife or older and everyone with a high body mass index. For others, however, the mindfulness training did not lead to reductions in those markers, researchers reported in July 2019 in the journal PLoS One.

Change the Experience of Rheumatoid Arthritis Symptoms; Reduce Joint Stiffness and Tenderness

Research published in November 2014 in the Annals of the Rheumatic Diseases looked at a small group of women with RA; half completed an eight-week MBSR course while the other half went about their regular lives. In follow-up assessments, those who had practiced mindfulness reported less stiffness, pain, and tenderness in their joints. They didn’t objectively reduce the amount of swelling in their joints or C-reactive protein levels, a marker of inflammation, leading researchers to conclude that this “may imply that a change in MBSR participants’ experience of RA rather than in underlying joint inflammation is responsible for the reduction in rheumatoid arthritis disease activity.”

Less Distress and Improved Well-Being Linked to Mindfulness Practice in People With RA

A study published in Arthritis and Rheumatism found that mindfulness did not alter RA disease activity. But six months after completing an MBSR program, participants reported less psychological distress and an improved sense of well-being.

Can a Mindfulness Practice Lead to Less Pain?

A review published in January 2016 in Australian and New Zealand Journal of Psychiatry found “some emerging evidence that mindfulness-based stress reduction may be useful in pain conditions,” although they said studies were too small to draw large-scale conclusions.

Mindfulness May Help Symptoms of RA-Related Issues: Depression, Fatigue, Insomnia

Irwin’s own research, published in JAMA Internal Medicine, found that mindfulness practices help people with insomnia. MAP participants in the study had better sleep quality and, as a result, less depression and fatigue, than a control group.

Find the Right Mindfulness Training Program For You

The classic MBSR program is offered through the UMass Memorial Health Care and by MBSR-certified trainers around the world. It is an eight-week program, typically offered in person, with classes two and a half hours a week plus one all-day class on a Saturday or Sunday.

About the Mindfulness-Based Stress Reduction (MBSR) Program and Classes

During the course, participants learn about mindfulness and undertake many mindfulness practices — while sitting, lying down, standing, and moving. The objective is to bring those practices beyond the classroom to your everyday life, which is why a daily homework practice of 45 to 60 minutes is included.

Consider Virtual Versions of MBSR Courses

That course is also offered as an eight-week live online program. Information can be found on the website of the Center for Mindfulness.

MBSR courses are expensive, running many hundreds of dollars, but tuition assistance may be available.

Southern California residents may want to look into the UCLA MARC program. They offer a variety of mindfulness programs in person and online.

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