Imagine a totally natural treatment that can ease arthritis pain.

More Information: Mind-Body Therapy Guide    How to Meditate

Taken daily, it can untangle tension, fight fatigue and even lower your blood pressure. It can lift your spirits and help you find inner peace. What's more, it costs nothing, has no side effects and doesn't require medical help.

The "treatment" is meditation, an ancient practice that has gained modern medical approval in many quarters.

Research shows meditation can help relieve many arthritis symptoms, such as pain, anxiety, stress and depression, as well as ease the fatigue and insomnia associated with fibromyalgia. It affects many body processes connected with well being and relaxation. Recent studies suggest meditation may balance the immune system to help the body resist disease, and even heal.

"There is significant data that meditation can enhance healing," says Saki Santorelli, executive director of the Center for Mindfulness in Medicine, Health Care and Society at the University of Massachusetts in Worcester, Mass. "It can improve the quality of your life and may well reduce your medical and psychological symptoms," he says.

In fact, your doctor may have already recommended adding meditation to your treatment regimen. These days, meditation is taught in many clinics, hospitals and HMOs, and endorsed by universities as prestigious as Harvard and Stanford. In just a few decades, it has gone from a counter-culture oddity to an accepted therapy for many chronic conditions. It is even being paid for by some cost-conscious insurers because it requires no special equipment or clothing, doesn't involve drugs, surgery or other pricey treatment and, according to some studies, it cuts down on office visits.

"Once you have learned it, no one can take it away from you. You don't have to come back and get another treatment," says Betsy B. Singh, PhD, dean of research at the Southern California University of Health Sciences in Whittier and author of studies on meditation and fibromyalgia. "These skills can help people begin to control their arthritis instead of having disease control them," Singh explains.

Response vs. Reaction
Meditation involves using any number of awareness techniques to quiet the mind and relax the body. Concentration practices and mindfulness meditation are perhaps the best known.

Concentration techniques help you quiet your mind by focusing on the silent repetition of a word, a sound, or the feel of your own breathing. Transcendental meditation (TM) uses a holy phrase called a mantra, for example. Thoughts or feelings that arise during meditation are allowed to pass by. When attention wanders, it is brought gently back to the meditation object or field of attention.

Mindfulness meditation (also known as Vipassana meditation) cultivates a nonjudgmental awareness of the present moment. You start with a one-pointed focus (such as your breath) and then expand the field to include thoughts, emotions and sensations in your body. This approach is taught in many stress reduction programs.

In all kinds of meditation, you sit quietly, allowing internal thoughts and external stimuli to flow by or "just be" without getting caught up in them.

Meditation won't take away your pain. But it can move physical and emotional pain and distress out of the forefront of your focus.

Some meditation experts suggest thinking of your mind as a glass of muddy water. When you shake it up, particles swirl around and cloud the water. But if you let the glass sit for 20 minutes, all of the debris suspended in the water settles, leaving the water clear. In a similar way, sitting in meditation helps quiet the "debris" swirling around your head and leaves you feeling clear and peaceful. Meditation is a way of becoming more awake, more deliberate about what you are doing, and to learn how to respond rather than react to situations in your daily life.

Meditation sounds simple, and it can be under the right circumstances — but it's not always easy. It takes discipline to remain still, physically and mentally, and not react to all of the stimulants in the world, and in your own mind and body. It also takes at least 20 minutes of daily practice, which can be very difficult for most people to squeeze into their busy lives. This repetition and stillness are at the core of meditation and the source of its many benefits.

An Ancient Practice
Meditation has its roots in our earliest religions as a way to attain enlightenment, peace or closeness with God. Prayer is perhaps the oldest and best-known concentration practice in the West.

Long practiced in Asia, meditation became well known in the West in the 1960s when celebrities like the Beatles began studying transcendental meditation with the Indian guru Maharishi Mahesh. Around the same time, scientists began to study the seemingly supernatural abilities of Asian monks to control what had been believed to be automatic body functions. These studies confirmed that long-time meditators could indeed affect many autonomous physical functions, such as heart rate, blood pressure and the production of stress chemicals like cortisol.

One of those researchers, Harvard University professor Herbert O. Benson, MD, showed that religious belief wasn't necessary to reap the benefits of meditation. It is the repetitive practice, and not a specific technique or intent, that brings about what he called the relaxation response. The relaxation response is an antidote to stress and the many conditions caused by stress, says Dr. Benson, who is president of the Mind/Body Medical Institute at Beth Israel Deaconess Medical Center in Boston.

By the 1990s, meditation was becoming accepted as medicine, especially through the stress reduction program at Harvard and at the Center for Mindfulness in Medicine, Health Care and Society at the University of Massachusetts Medical School. Today, more than 240 programs around the country are modeled on the University of Massachusetts program.

Meditation and Arthritis
So far, few of the hundreds of studies on meditation look specifically at arthritis or related conditions.

However, stress is believed to be associated with flares in many kinds of arthritis, including rheumatoid arthritis, lupus and fibromyalgia. Many studies have shown meditation can significantly lower stress, chronic pain and anxiety.

There are several studies that show meditation can be effective for fibromyalgia. In a 1993 study of 77 patients with fibromyalgia who participated in a 10-week meditation-based relaxation program, all showed some improvement in global well-being, pain, fatigue and sleep disturbances, and 51 percent had moderate to marked improvement.

Meditation is also effective when combined with other mind-body techniques. (See "Mind-Body Therapy Guide,") A 1998 University of Maryland study of 28 women with fibromyalgia found that an eight-week program of mindfulness meditation — combined with the Chinese movement therapy qi gong and counseling in pain management techniques — resulted in significant improvement in pain threshold, depression, coping and function. And those results lasted four months after the program ended, says Singh, an author of that study.

Meditation might also help with psoriatic arthritis. In a randomized, controlled trial of people with psoriasis undergoing ultraviolet light therapy, skin lesions cleared up significantly faster in those given a mindfulness-meditation audio tape to listen to during therapy sessions compared to those who did not meditate.

Other studies suggest meditation may have far-reaching effects.

Scientists now know meditation changes the way our brain works, and shows that thoughts can influence the brain and the body, says Dr. Benson. When his research team used MRI imaging to study the brains of four people meditating, he says the team found increased activity in specific areas involved in attention and control of the autonomic nervous system.

Meditation has also been shown to slow heart and breathing rates, lower blood pressure and cortisol levels, and increase alpha brain wave activity. It may also increase the body's production of melatonin, which is needed for healthy sleep (a problem for many with fibromyalgia and chronic pain). And a startling study last spring found twice-daily TM meditation actually reduced fatty buildup in artery walls as effectively as heart medications.

There's also evidence that meditation moderates the immune response, says Richard Kradin, MD, an immunologist and psychiatrist at Harvard University. Meditation may affect the nervous and vascular systems, as well as the immune system, which in turn would affect joint function and inflammation.

Unanswered Questions
"There are clearly beneficial effects [from meditation] in people with arthritis. I've seen it in my patients," says Dr. Kradin. "But we need more and better research."

There are many unanswered questions. Not all people benefit from meditation. Why is that? Does meditation make people feel better, but not affect underlying disease? Can it actually modify disease progression? What is the correct "dose" to get an effect? Does it matter which technique is used, or how intense the practice is?

Researchers say many techniques work. "Certainly there's evidence that the relaxation response developed by Dr. Benson and mindfulness meditation as used in the Stress Reduction Clinic have positive effects as well," says Santorelli.

"There are scores of techniques that evoke the relaxation response," agrees Dr. Benson, listing yoga, tai chi, qi gong, as well as praying the rosary. "No one is better than another."

And while meditation doesn't appear to have any side effects, several rheumatologists were concerned some people may put too much faith in it. "If you give too much credence to mind-body therapies, people who get sick and don't get better could feel themselves a failure, and that they are too weak to turn things around," says Dr. Benson.

There is also concern people will give up conventional treatments in favor of meditation. Don Goldenberg, MD, a rheumatologist in Wellesley, Mass., who co-authored a study on meditation and fibromyalgia, says meditation can improve symptoms. However, he cautions against thinking you can meditate your illness away.

"Meditation sounds like a good idea, and I recommend it to my patients," says Frederick Wolfe, MD, a rheumatologist and director of the National Data Bank for Rheumatic Diseases in Wichita, Kan. "But I don't know if any of them ever do it, or what percentage who do find it helpful. It's one thing to show it works in a clinic with highly motivated people, and another to show it works in the real world," Dr. Wolfe adds.

But Singh says people who completed an eight-week training program demonstrated that treatment effects lasted long after the program ended. "They learned to think differently and behave differently and continued to improve," she says. "People who are miserable from chronic pain and have not been given much hope for change, and then they feel better from a treatment are smart enough to continue what makes them feel better."

Doctors Heal Themselves
Meanwhile, many health professionals practice what they prescribe.

"A meditation practice can change the quality of your life," says Singh, who meditates daily. "It offers each person a few moments to quietly refocus and just be in a moment of peace."

Dr. Goldenberg, a fibromyalgia expert who has struggled with chronic ailments himself, practices yoga and meditation. Santorelli's expertise in stress reduction has its roots in his long-time meditation and yoga practice.

Dr. Benson says he resisted using mind-body therapy for 15 years after he first described the relaxation response because he thought people would question his scientific objectivity. Getting older made him reconsider his stance.

"Now I evoke the relaxation response every morning," says Dr. Benson.

Judith Horstman is a contributing editor to Arthritis Today.