Mindfulness, Meditation and Movement – The 3M Exercise for Chronic Pain and Anxiety

The 3M Exercise for chronic pain and anxiety aims to help you to do 10 minutes each of mindfulness, meditation and movement everyday.

In hindsight, 2020 has been an awful year, both universally and for people with chronic pain & anxiety in particular. We have had access to our regular treatments and all the things that made life bearable.

So I had to learn a lot of things to manage my pain and anxiety during a difficult year. The 3 things that made the most difference were mindfulness, meditation and movement. I thought I will make a regular practice out of these, starting from scratch, in an inclusive and sustainable manner.

What are the 3Ms?

The 3Ms are Mindfulness, Meditation and Movement. The strategy of this exercise is very simple. It aims to get you to try:

• gentle movement to strengthen the body
• mindfulness to sharpen the mind, and
• meditation to bring peace to your soul.

How does the exercise work?

This exercise aims to get you to do 10 minutes of all the 3Ms per day. You can choose the pace at which you want to do it.

You will pick one of the 3Ms first, start at 1 or 2 minutes a day. You can slowly build it up to 10 minutes. Then, you add another M, build it up to 10 minutes and finally the last M. My recommendation would be to start with Mindfulness first, as it does not involve any preparation. It can be incorporated into your daily life. You can, after this, move on to meditation (to get you in a good mindset for the next M). In the end, you can tackle Movement.

The hope is you will be able to do 10 minutes each of mindfulness, meditation and movement every day. You could aim for just 2 of the 3, in your own way and at your own pace. The slow build up, with customizable options, is to ensure that you are not overwhelmed or disheartened. This helps to make it more sustainable even after the exercise period has finished.

At the end of this post, you will find plenty of resources for each of the 3Ms. I hope that you can give this 3M exercise a try and do let me know how it goes! You can find me on twitter (@renudhinakaran), Instagram (renukadhinakaran), Facebook (A Painful Identity). Tag me with #3Mexercise if you decide to give this a go!

Mindfulness

Mindfulness is popularly understood to mean living in the moment. That is not the entire picture. Mindfulness is the practice of intentionally and actively being  in the present moment, irrespective of what that moment may contain. It teaches you to pay attention to your body, emotions and thoughts, and to train you to notice the connection between the three. It teaches you to observe, with curiosity, and without judgment or the desire to fix things.

The struggle I faced with mindfulness was that I simply did not want to experience the present moment. The present moment was painful. The more I focused on my body, the more difficult it became to be non-judgmental about my pain and the impact it was having on my life.

This changed, as I moved my focus to my thoughts. I noticed that more than the pain itself, the thoughts that followed it made it worse. The thoughts I had when I was in horrible pain usually ranged from “my life is hell and pointless” to “I was, personally, worthless”. These thoughts carried on with me after I had gotten out of a flare up as well. I felt worthless, because I sincerely believed that my pain was holding me back from living life the way I wanted to. It does, of course, but not necessarily to the extent that my thoughts would have me believe.

Being actually and actively mindful of these thoughts, without confronting them head on but just observing them, seemed to help me. Thoughts are not facts. This obvious statement blew my mind from my first mindfulness lesson. Observing my thoughts has helped me either nudge them away from catastrophizing or reframe them in a purposeful manner (not necessarily positive or negative).

Likewise, being mindful of an emotion that developed at certain times actually helped me get a diagnosis. For instance, I had severe anxiety and panic attacks (still do) almost always surrounding my menstruation. Mindfulness practice helped me identify this as until then I was under the impression that I was just like this always.

The mindfulness practice in this 3M exercise is designed to be a daily activity based one. Instead of sitting down to observe your body, thoughts or emotions, you will simply be mindful and completely focused on an activity that you do (and choose to focus on) every day. I will give you an example that my mindfulness teacher gave me: brushing your teeth.

When you brush your teeth, observe the colour of your toothbrush, your toothpaste tube, the letters on it; notice the smell of your tooth paste; notice how the paste comes out of the tube, how the taste feels in your mouth, how the water touches your mouth, etc. Focus on every small aspect of this activity and nothing else. If your mind wanders into anything else (including any pain your wrist may have felt when your squeezed the paste on to the brush), just gently bring it back to the activity – without any judgment.

If brushing teeth is an activity that could be triggering, as it often is when it comes to those of us with chronic pain, choose something that is comforting instead. It could even be just watching cat videos but being fully aware of every aspect of what you are watching – doing it mindfully and with a purpose.

Keep changing the activity every day. This is especially if you have chronic pain and you cannot do a given activity every day, as that could trigger its own range of emotions. So just focus on an activity that you are doing or know can do that day.

Start with a very short activity (for about 2 minutes or so) and gradually increase it to a longer activity ranging for 10 minutes. If you are going to do “movement”, you could combine your mindfulness practice with that. Or you could do it during several short activities, choosing to be mindful with each of them.

Meditation

You must be thinking, isn’t this already part of the first M? You’d be surprised to find out that it is not (not entirely, at least). Mindfulness is a complete awareness of something. Meditation, on the other hand, is an awareness of completely nothing.

Meditation is an ancient practice, predominantly from the East, which trains your brain to let go of any and all thoughts, to achieve a state of nothingness. This is not the goal of our exercise, before you start to go all cynical on me.

Over the years, research has shown that meditation can increase your brain’s gray matter, which is key when it comes to any form of control – muscle control, controlling your emotions or just self-control. Increased gray matter also increases concentration and improves decision making. Research has also shown that meditation helps increase serotonin and reduces cortisol. All of these can significantly improve the quality of life when it comes to a person suffering from chronic pain, brain fog, anxiety or depression.

In fact, while the long term effects (such as strengthening of the pre-frontal cortex) of meditation are impressive, even the short term effects (such as marked clarity of thought and reduced secondary wave of pain, i.e., the pain that arises from our thoughts about the pain) are remarkable.

I wish to make something very clear here. Meditation is not a cure for chronic pain or anxiety. It is not even a treatment, when it comes to that. What it is, is a significant tool in your kit to live well with chronic pain and anxiety.

There are two key factors here though: choosing a type of meditation that suits you physically as well as mentally and consistency. I learned them both the hard way. For someone with chronic pain, starting with a body scan meditation is absolutely painful & can actually be counter productive. So I’d rather you started with a type of meditation that has an external focus (such as a visualization meditation), rather than internal (such as body scan or breath based).

Meditating every day can be of great help especially to those who have an anxiety disorder, as it is basically training your brain and giving it that muscle memory you can use in situations that cause or trigger your anxiety.

Start with a 2 to 5 minute meditation, to begin with and aim to increase it to 10 minutes by the end of the week (or 10 days). It would be great if you could do longer ones but please listen to your body first. Choose a meditation that allows you to do it in a posture that is comfortable for you – sitting, walking, standing, lying down, anything that puts you in ease.

Personally, I love Yoga Nidra. It is a form of restorative meditation, a state between sleep and awareness, where you can go into deep rest, reset your body and mind.

Movement

I know that exercise is a term that both scares and angers chronic pain sufferers. We know and understand its theoretical benefits but we cannot make healthy people understand the excruciating pain, fatigue and even immobility we have endure after just 3 minutes of exercise.

This is not about exercise. It is about movement. Movement means just that – moving, of any kind, ranging from gentle walks or seated/lying down stretches to vigorous running or pilates (who am I kidding, who has the energy or muscle power for those!).

Pick a physical activity that you like, can do on most days (except on very bad flare up days), and does not make you sore the next day. This is a tall order for people with chronic pain and illnesses, I know. It has been a struggle for me as well – on some days, even the most gentlest of walks or yoga stretches seem to make me lose my balance or increase my pain.

I have, however, managed to stick to restorative yoga – even on the worst of my flare days. My friend Melissa Reynolds, from Melissa vs. Fibromyalgia, has wonderful restorative yoga videos for free on YouTube (or through lessons in her studio). Her videos and lessons range from breath based gentle stretching, desk yoga, chair/seated yoga to full flows. Her yoga in bed series helps me on days I cannot leave my bed at all. I wrote all about it here.

So pick some physical activity that you can and like to do and start at 1 or 2 minutes on the first day. Increase it slowly to get to 10 minutes by the end of the week (or longer, as your body lets you). Pick a time of day when you can do this undisturbed and not have it disturbing the rest of your day either.

I wrote more about exercising and chronic pain here – https://medium.com/invisible-illness/how-exercise-can-help-manage-chronic-pain-b3fb07d5b02e and about restorative yoga here – https://www.apainfulidentity.com/fibromyalgia/restorative-yoga/.

I hope that you can give this 3M exercise a try and do let me know how it goes! You can find me on twitter (@renudhinakaran), Instagram (renukadhinakaran), Facebook (A Painful Identity). Tag me with #3Mexercise if you decide to give this a go!

RESOURCES FOR THE 3MS

MINDFULNESS

• Academic research papers

https://www.researchgate.net/publication/312387895_Effects_of_mindfulness_meditation_on_chronic_pain_A_randomized_controlled_trial

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5368208/

https://academic.oup.com/abm/article/51/2/199/4564147

Why does mindfulness help for chronic pain?

https://bjgp.org/content/65/635/e387

• Practical Articles

https://www.pathways.health/mindfulness-for-chronic-pain/

Mindfulness for Pain Relief in Five Simple Steps

https://buddhify.com/managing-chronic-pain-mindfulness-meditation/ (Personal story)

MEDITATION

Note: Most of these meditations are for 10 minutes or so). YouTube based recommendations could have ads in between, unless you subscribe to a premium membership, so please keep that in mind.

• Audio-Visual

2 minutes: https://anesthesiology.hopkinsmedicine.org/two-minute-meditation/

5 minutes: Headspace has great options but it is a paid service. This link here has a 5 minute meditation for free – https://www.headspace.com/meditation/5-minute-meditation

10 minutes (& more):

Mindfulness Meditation – https://www.youtube.com/watch?v=QCNXi_0lsCk

For Acute or Chronic Pain (with and without background music) – https://www.fragrantheart.com/cms/free-audio-meditations/healing/guided-meditation-for-acute-or-chronic-pain

• Transcript –

This is a UCLA resource for guided meditations, with both audio and transcripts in English and Spanish.

https://www.uclahealth.org/marc/mindful-meditations

This is a wonderful transcript I recently tried and I hope it helps you too (but it is a longer one, please note). https://medium.com/the-innovation/a-full-transcript-of-a-1-hour-meditation-session-93f70910baed

• Meditation for Fibromyalgia (including Yoga Nidra)

1 minute –

5 minutes –

10 minutes

Resources on Meditation for Chronic Pain

https://askthescientists.com/brain-meditation/#:~:text=Meditation%20is%20shown%20to%20thicken,lower%2Dorder%20brain%20activities%20decrease.

https://www.healthline.com/health/meditation-for-chronic-pain#takeaway

MOVEMENT

I am not going to providing a lot of resources here, except for some YouTube videos that I have personally tried – restorative yoga for fibromyalgia and gentle exercises for ME/CFS (which I break down into shorter time periods as my body allows).

Yoga for fibromyalgia (Playlist)

Tips for exercising with ME/CFS

Low grade seated exercises ( 2 – 10 minutes)

2 minutes: https://www.youtube.com/watch?v=WpdkghCd-ws

5 minutes: https://www.youtube.com/watch?v=g_Y3Ea9HQC8

Exercises in bed

5 minutes – https://www.youtube.com/watch?v=UW8UWZ2gvd0

5 minutes – https://www.youtube.com/watch?v=Bzb1gkZrt5c