Mindfulness Apps for Chronic Pain: A Chiropractor’s Perspective

We talked about mindfulness practice last week because the latest lower back pain clinical guidelines recommend mindfulness as a second-line treatment for lower back pain. If you are looking for treatment for your lower back or neck pain, mindfulness practice could be a good place it start.

Today, we discuss three apps that we have tried and how they may help with your pain management.

#1 Waking Up with Sam Harris – Download for iPhone or Android

The free version of the app gives you access to five meditation sessions and five lessons. While it is not a lot, I still find it helpful. I consider it high value content and it was totally worth my time.

This is by far my favourite app!

(I have only tested three apps.)

According to their website, Sam Harris is a neuroscientist, philosopher, and best-selling author. It shows in his app because the first five meditations (available for free) are structured in a well-thought out progression. Every session had an introduction of new element(s) and, by the time I was done with the fifth, I didn’t feel it was “too-easy-for-me”.

I will confess that I only listened to the first free lesson – The Logic of Practice before working my way through the five meditation sessions.

I will also confess that it was hard for me to do it every morning. It took me two weeks to complete the five meditation sessions. Although each session is pretty short, it still takes commitment.

It probably also wasn’t ideal that I listened to four of them in the morning while I was still in bed. I did the last meditation on the train and I highly DO NOT recommend it. It was way too challenging.

Meditation Lesson 1: The Logic of Practice

Sam Harris started the lesson with Socrates’s quote, “The unexamined life is not worth living.”

The lesson is largely focus on how mindfulness practice, or meditation, can change how you live and perceive your life.

In his example, you can be angry for an hour or a day because you mind is manufacturing the emotions that drive the anger – even without you knowing you are thinking about it. But if you are able to focus on the rising of the emotion (e.g. anger) and processing it – instead of thinking why you have every right to be angry – the emotion will take only a few moments of your time.

One of his arguments is that we spend too much time and pay too much attention to things that don’t matter.

I am inclined to agree.

In Sam Harris’s words, the quality of your mind determine the quality of your life.

What really impressed me, which I think you would be hard-pressed to find in other apps, is his inclusion of phenomenology (study of consciousness, a branch of philosophy) into his mindfulness practice.

I guess this is why education matters. Most apps would only have audio-guided mindfulness or meditation practice sessions. Sam Harris went beyond and included lessons – again, in my opinion awesome – to help you understand why you are doing what you do.

He highlighted that both happiness and suffering – no matter how extreme – are mental events whereby the mind depends on the body, and the body depends on the world. Everything – good or bad – must appear in the conscious mind for it to matter.

This is also the most important thing I would like you, and all of my clients, to understand when it comes to chronic pain management.

This lesson is short – 6 minutes and 38 seconds – and I invite you to give it a listen.

I highly, highly recommend it.

Waking Up Course: Day 1

In this audio-guided meditation, Sam Harris gives an introduction to meditation and mindfulness practice. In his words, mindfulness practice is a quality of the mind which he refers to as undistracted attention.

This is a five-minute meditation session that is focused on mindful breathing.

If you have no previous experience with meditation or mindfulness practice, this is a great non-intimidating introduction.

The guidance through the session is on point. In my opinion, it addresses what a person new to meditation or mindfulness practice will experience. He also explains what they are during the meditation and, most importantly of all, was supportive and encouraging.

Waking Up Course: Day 2

This session also starts with mindful breathing.

Sam Harris elaborates more about the concept of mindful breathing during the meditation. He also starts to add verbal prompts to get you to consider other aspects of your breathing. This is important to me: progression.

At the same time, there were reminders for you to enhance your mindful breathing experience. I feel they were well-timed. They facilitate – rather than disrupt – my mindfulness practice.

Towards the second half of the session, he added counting (progression!!). I can’t speak to his intent but counting would act as an outcome measure. Perhaps you could be focus on your breathing for a span of two breaths or perhaps five breaths? This gives you an idea of how clear or how scattered your mind may be.

I love it!

Waking Up Course: Day 3

Not surprising, this session also starts with mindful breathing.

Just note that each session is a build up from the previous. While it may seem you are repeating the same activity, there is always something extra. It’s hard to tell as you work your way through it because Sam Harris is that good at structuring his guided meditation. Also one of the reasons why I am such a big fan.

He introduced body scan – I believe for the first time – in this session. Body scan is when you start to bring your awareness to the sensations in your body.

In his words, you are not producing the sensations or producing the awareness. What you are doing is to allow yourself to become aware of the sensations as they occur #phenomenology

This is probably the first step to utilising mindfulness practice as a pain management strategy.

In this session, Sam Harris also encouraged students to take a moment – even if it is half a breath – to practise mindfulness for that day. I’ll leave you to listen to that session for further instructions.

I think it’s amazing what he is trying to get his users to do. It’s remarkably empowering.

Waking Up Course: Day 4

This session revolves around mindful breathing. Throughout the session, Sam Harris starts to challenge your mind and your attention:

Are you able to notice a thought coming into consciousness? Can you hold on to the thought a moment longer? Can you hold on to the sound of his voice?

Waking Up Course: Day 5

This is the last free guided meditation that comes with the app.

It is the first time pain is brought up. There was nothing specific in the session that directly addressed pain.

However, the practice of paying attention to the discomfort with seating and paying attention to when they need to shift around arises is good practice to help with pain management. He also suggested choosing to not move despite of the discomfort. In his words, fully surrendering yourself to whatever sensation is there.

In this session he also brought up the concept of equanimity – calmness and composure in a difficult situation.

This is probably the session that I enjoyed the most. I’ll leave you to experience it for yourself.

Final thoughts on Waking Up with Sam Harris

I’ve only tried out three apps so far and Waking Up with Sam Harris really stands out.

I don’t find my lack of commitment to the program to be an issue. It took me two weeks to go through one lesson and five guided meditations – one of which I did in the train.

The progression is well spaced. While it may be a bit repetitive to do always start with the mindful breathing, I found it to be a non-issue as long as you are willing to put the thought away.

From what I have had experienced so far, this app is largely religion-neutral. Not surprisingly since Sam Harris is a proponent of secular meditation (as opposed to religions meditation). If it concerns you, he did study meditation under both Buddhist and Hindu teachers. However, he largely identifies with atheism.

When it comes to mindfulness practice or meditation, I think Waking Up with Sam Harris is most congruent with evidence-based practice. I also think it is easy enough beginners to pick up, with well-spaced progression for self-development.

#2 Insight Timer

Insight Timer came highly recommended by one of my friends who has been practising medication for a number of years.

It is an app with multiple practitioners and the guided sessions are grouped into purpose/intent such as managing stress, improve your sleep, coping with anxiety, etc. I didn’t find one for pain management.

I was trying this app out last night before sleep so I went with the “improve your sleep” options.

Yoga Nidra For Sleep

The first session I tried was Yoga Nidra For Sleep as part of Your Guide to Deeper Sleep – a 10-day course. I stopped the audio within a minute to look for another session. Personally, I found the lady’s speaking voice to be distracting.

The speaking speed was also quick while the pauses were too short for me to process what she was trying to get me to do. I am a terribly impatient and fast-paced person so I am quite surprised to hear myself say this.

I am sure this might just be me because it is related 4.5 stars and it as 6.6 million plays.

The Dream For Sleep

The second session I tried was The Dream For Sleep as part of Body Love for Women. Also a 10-day course.

This was a bit better. There was accompanying background music. The lady’s voice was still probably distracting but she spoke really slow and there were lots of pauses in between.

I did fall asleep before the 24-minute guided session was over. There was quite a bit of tossing and turning on my part at the stage so I’d say it worked pretty well.

So needless to say, my experiences with it would not have helped with pain management because I self-selected sleeping as an objective.

There is a learn to meditation section.

5 Minute Meditation

This was found under the Basics section. The session started with a loud chime and the words “come into stillness.” That alone, for some one with minimal experience with meditation, was a lot to process.

The guided-session was somewhat geared towards clearing your mind. It was mainly verbal instructions with close to no explanation of what is going on or what should happen. Beginners may find it abstract or hard to grasp.

It included multiple elements of meditation within a five-minute session. I think most beginners will struggle to experience all, if any, of them. This is probably a true guided meditation in the sense that it has, in my opinion, no education component.

This was rated 4.5 stars with 70k players.

Ten Minutes of Mindfulness

This guided audio has background music and also some introduction to what is about to happen. It started with a body scan for tension (rather than the mindful breathing).

Again, the speaking speed was really quick and I struggle to keep up with the verbal cues.

The session also included mindful breathing.

This session was also rated 4.5 stars and has 76k players.

Final thoughts on Insight Timer

I am sure there is valuable in the guided meditations offered in the app. As mentioned, I did fall asleep rather quickly.

What is missing from the app is consistency and structure. For some one who is new to mindfulness practice, there is no indicator of where to start. As a result, it progression is not clear. From what I can see on the app, there is no education component. This, in my opinion, makes it difficult for beginners to follow or understand what is expected of them. It will probably also be difficult for them to process what they are experiencing as they are working their way through the session.

Lastly, none of the four sessions I listened to addressed expectations. In Waking Up with Sam Harris, there were words of encouragement and also verbal prompts on what is expected. For me, discussing the challenges a beginner may face is important for them to know they are on the right track and that it’s normal.

I would not recommend this app to users who are new to mindfulness practice. I also don’t think users will be able to utilise the app as a pain management strategy.

#3 Headspace

I only downloaded this because one of my clients did. I wanted to know what he was listening to. He chose it randomly without recommendation.

The app is complicated. I had to answer a whole bunch of questions before I could start. I also wasn’t sure if my responses made a difference to what I had access to for the free version. I couldn’t find a way to change my responses to test that out.

On the second time I login, there were also questions they were asking and there were little snippets of encouraging words. I think that is a nice touch but I am not sure of its long term value. It probably took me a minute to work through the questions and snippets. I don’t think there’s a “skip this” option.

At the end, they did recommend an audio guided meditation for me to listen to but I decided to opt out so I can see the full list of sessions available.

There’s a lot of stuff to tap through on the app which annoys me a little. I believe this is just my personal preference.

As an introduction, there was an animation clip on how to get started. This was surprisingly useful. It talks about how to sit, what to do before you get started.

Session 1 starts with mindful breathing. The pace was probably slightly faster than I’d prefer but it is reasonable. I don’t feel like I am running behind. They also included elements of body scan into the session.

There are various duration options for first session: 3 minutes, 5 minutes, or 10 minutes. That’s actually quite clever!

Preliminary thoughts on Headspace

I can’t really comment much on their content because the user experience was frustrating for me. That kinda defeats the purpose.

There are certain nice touches: 1) introductory animation on how to start, 2) choice of duration for each session, 3) choice of male or female speaker

Unlike Insight Timer, Headspace has some educational component included into each session. It is also organised in a way for clear progression although I think Waking Up with Sam Harris has a better structure for progression.

I haven’t tried out the app enough to make a recommendation for or against it.

Mindfulness for chronic pain: final takeaway lessons

  1. Not all apps are created equal
  2. Personal preferences count – speaking voice, speaking speed, pauses in between verbal cues
  3. Education matters – I find myself having more awareness of what I was trying to do with Sam Harris’s app
  4. Education matters – in Sam Harris’s app, there was enough discussion to how to apply it to your daily life by the third session
  5. None of the free versions have meditation content dedicated to pain management
  6. It’s possible to have too much features (which may be frustrating to get through)

Are you experienced with mindfulness practice? Let us know if you have thoughts on any of the three apps or if you have suggestions to what we should look into via the contact form below.

Square One is an evidence-based chiropractic clinic. We deliver long-term solutions to help our clients achieve pain-free living. Over 80% of our clients will leave our care within four to seven visits. To book an appointment with our chiropractor, reach out to us via the form below or book directly with our online calendar.