I say this as a Zen meditator for over 20 years: meditation isn’t a cure all for pain. It can even harm you.

Such well worn techniques as counting your breath aren’t right for a lot of people with pain. You may tense up your body without realizing it. If you have muscle spasms, this is just going to make it more intense. Tension can also trigger off other types of pain, leading to a vicious cycle that’s hard to break out of.

Deep breathing can also be a problem for many pain sufferers. You could be pushing things too hard. It’s also not a good idea to try to control your breathing without knowing how.

Another problem is that meditation drops you into your body. While this is a good thing for many people, it’s not necessarily one for those of us who struggle with pain. Sometimes, being present inside ourselves is too much.

That said, you can still take advantage of mindfulness in the larger sense to help cope with chronic pain.

Here are the best ways I’ve found:

1. Scan the body. Do this lying down. Start with your head. Ask yourself to give “the head” light attention. It’s important to say “the head” in your mind rather than “my head.” This gives you some distance from your body. In a similar way, instructing yourself with the phrase “light attention” sends your mind the message that there’s no need to go too deep into the body. Next, tell yourself to scan around the head, without making any judgments. After about a minute, move to the neck, repeating the process, then down to the chest, belly, pelvis, legs and feet. Repeat this process several times until you feel your body relaxing.
2. Practice “no judgment” during flare ups. This is kind of like a spot version of the body scan. When pain goes up, the mind snaps into action. It worries that the pain is never going to go back down. This leads to anxiety, which tenses you up and makes everything worse. This is when it helps to give the painful parts some attention—but not so much you’re overloaded. Ask yourself what exactly you’re feeling. Again, say “the” in your mind to refer to the body part. So, ask, “what do I feel in the leg?” Is it tightness? Stabbing? Something you don’t have a word for but you know? Whatever it is, give yourself a few minutes to conduct this investigation of the pain, area by area. If the pain doesn’t go down or gets worse, back off. You can also say to yourself “no judgment, no judgment” over and over.
3. Breath into your chest. This is a technique I learned from Dr. Farias, who works with dystonia sufferers like myself. It works by tapping into the vagus nerve, which controls much of our body’s functions. It takes some practice but once you nail it, it’s magical. It relaxes you on a deep level and the pain can melt away as a result. Even better, you can use it any time, any place. When you’re first learning, do it lying down. Place your hand on the point of your lower breastbone where it comes together in an upside down “V. Breathe in normally, putting your focus on your hand. Breathe out through your mouth—not blowing, just a natural outbreath. You should feel your hand rise and fall just slightly with each in and out breath. Eventually you can work your way up to doing it in a seated position.
4. Find healing in nature. Nature is life’s great healer. If you’re able, go outside and find a wild place where you can sit or walk among the trees. I’ve found a place like that at the edge of my apartment complex—I don’t even need to drive anywhere. If you’re not up to going outside, look outside your window, or at a picture of a natural scene. You can also watch nature shows on TV—seek out the ones that are peaceful and calm. Streaming video has a ton of these. One of my favorites is Garden Wild on Amazon Prime. I must’ve watched it 50 times, and it never fails to bring down my pain by at least a point.
5. Find stillness. This is something that health coach Tom Seaman recommends for people with chronic illness and pain. Read his book for more ideas. When pain acts up, many of us try to walk or even exercise it off. Remind yourself to slow down when you’re dealing with pain. It’s okay to lie down and do nothing at all. Tune in and decide what’s best. But whatever you choose, have it come from a place of calm rather than a desire to outrun it. If you’re struggling to control this, tell yourself you don’t have to make any decisions right now. All you have to do is get through this moment.

Remember that chronic pain isn’t something you can turn off. Unless you’re one of the few fortunate ones to have medications or other treatments that work that well, you’re going to be dealing with it some or even most of the time.

So be easy on yourself. Take each day as it comes. This is the essence of mindfulness. And of course remember that you have every right to take whatever treatments and medications your doctor recommends. Some flare ups call for an extra, as needed dose, and if that’s in your treatment plan then don’t beat yourself up for it. The most important thing is to care for yourself.