← Patient information   ·   Practical skills for living with persistent pain
A little space in a difficult moment

Pause.
Notice.
Choose your
next step.

When pain takes up a lot of your attention, a brief pause can be an opportunity to practise a different response. Explore a few ways to begin, at your own pace.

Find a practice ↓

Optional skills for adults with persistent pain.
No experience required. No need to feel a particular way.

A pause is a practice.
It does not have to change your pain.
What this is for

A skill you can explore.
No test to pass.

Mindfulness means practising attention to what is happening now, and noticing when your mind moves elsewhere. You can then choose where to place your attention again.

Your pain is real. These practices offer a way to explore your response to sensations, thoughts and emotions alongside your wider care. Some people find them useful; others prefer different approaches.

The aim here is to give you choices. You can use a sound, the support of a chair or natural breathing as an anchor. You can keep your eyes open, change position or stop at any time.

Before you try

Choose a safe place where you can pause. Do not use a guided practice while driving, operating equipment or doing something that needs your full attention. Sit or rest in a position that suits you; there is no special posture to achieve.

If inward attention makes you more anxious, overwhelmed or disconnected, stop and look around the room. If you have previously had distressing experiences with meditation, discuss a suitable approach with a clinician or qualified teacher.

01 / Choose a short practice

What would be useful
right now?

These are introductory exercises written for this guide, rather than individually trialled treatments. Start with whichever feels most approachable. Reading the script is also a way to practise.

Your guided practice

Find an anchor

A gentle introduction to placing and returning your attention.

Breathing is optional. Let it find its own pace; no deep breaths, counting or breath-holding are needed.

Uses your browser’s device voice, where supported. You can follow the same prompts silently.

Ready when you are2:00
Before you begin

You can keep your eyes open.

Choose a comfortable position and a safe place to pause. You can stop or change position whenever you need to.

The timer leaves quiet space between prompts. You can move on sooner or simply read at your own pace.

If the practice feels uncomfortable, you can finish, look around and return to an ordinary activity. A pause in the practice is a choice, not a failure. The player pauses when you leave this tab.

Read all three practice scripts

Find an anchor

Suggested duration: 2 minutes. You can take more or less time.

Arrive

Let your eyes stay open or soften your gaze if you prefer. Notice where you are. Adjust your position so it feels workable; you do not need to hold still.

Choose a place to return

Choose one option below.
Sounds: Notice a sound close by, then perhaps one further away. Let sounds arrive without needing to identify every one. If it is quiet, you can simply notice that.

Support: Notice a comfortable point of contact with the chair, floor or bed. Let it be a simple reference point. If this draws you towards discomfort, choose sounds instead.

Natural breathing: If it feels comfortable, notice one place where you sense your natural breathing. Let it find its own pace. If attention to breathing feels difficult, choose sounds or the support beneath you instead.

Notice the wandering

Your mind may move towards plans, worries or sensations. When you notice, you can quietly acknowledge that your attention has moved. Nothing has gone wrong.

Return gently

Bring your attention back to your chosen anchor. There is no need to push thoughts away or change what you feel. You can begin again whenever you choose.

Take the next moment

Look around and notice the room again. Choose what you want to do next. There is no particular feeling you need to achieve before finishing.

Widen your attention

Suggested duration: 3 minutes. You can take more or less time.

Begin with the room

Keep your eyes open if that suits you. Notice a colour, a shape or a sound around you. You do not have to turn your attention towards pain.

Find an anchor

Choose one option below.
Sounds: Notice a sound close by, then perhaps one further away. Let sounds arrive without needing to identify every one. If it is quiet, you can simply notice that.

Support: Notice a comfortable point of contact with the chair, floor or bed. Let it be a simple reference point. If this draws you towards discomfort, choose sounds instead.

Natural breathing: If it feels comfortable, notice one place where you sense your natural breathing. Let it find its own pace. If attention to breathing feels difficult, choose sounds or the support beneath you instead.

Notice what takes your attention

If pain or a difficult thought draws your attention, you might quietly acknowledge: this is here. There is no need to investigate it or stay with it. Return to the room whenever you want.

Include something else

See whether you can also notice a sound, the light in the room or a comfortable point of support. If this feels like effort or increases distress, simply look around and finish.

Let attention move

You can allow your attention to move between your surroundings and your chosen anchor. You do not need to hold a wide focus or force any sensation to change.

Finish in your surroundings

Notice where you are, and choose a simple next action. That might be changing position, taking a break or continuing with your day. Pain does not have to disappear for you to finish.

Pause before activity

Suggested duration: 2 minutes. You can take more or less time.

Make a little room

Pause somewhere safe before beginning your activity. Notice the room and how you are positioned. You can adjust your position or keep your eyes open.

Find an anchor

Choose one option below.
Sounds: Notice a sound close by, then perhaps one further away. Let sounds arrive without needing to identify every one. If it is quiet, you can simply notice that.

Support: Notice a comfortable point of contact with the chair, floor or bed. Let it be a simple reference point. If this draws you towards discomfort, choose sounds instead.

Natural breathing: If it feels comfortable, notice one place where you sense your natural breathing. Let it find its own pace. If attention to breathing feels difficult, choose sounds or the support beneath you instead.

Notice the thoughts

You may notice anticipation, worry or a wish to get on with things. You can acknowledge these thoughts without needing to settle every one before acting.

Choose a starting point

Think of a small, manageable version of the activity you want to do. Use your usual clinical advice and the exercise guide to decide on an amount. You can also choose to seek advice or rest.

Return to your day

Look around, check you feel ready to move safely, and choose your next step. You can finish here even if your mood or pain has not changed.

02 / What to notice

You do not need
to clear your mind.

Thoughts will turn up. Your attention may wander. The practice is noticing that and returning gently, as often as you choose.

03 / Take it into everyday life

A pause.
Then a choice.

You can try a brief practice on an ordinary day, rather than saving it for the most difficult moment.

Before a walk

Notice, then choose your starting point.

Take a moment to notice your surroundings and how you are feeling. Choose a route and amount that seem manageable today. You do not need to feel completely calm before beginning.

Make a starting plan in the exercise guide →
During a difficult day

Make the next step a small one.

You might adjust your position, take an ordinary break or ask for support. A mindful pause can sit alongside those choices. It should never delay assessment of new or worsening symptoms.

How often should I practise?

There is no established therapeutic dose for these brief website exercises. Try a short practice when it fits, then decide whether it feels useful and sustainable. The research programmes described below involved repeated sessions and home practice over weeks.

What would count as useful?

You might notice a little more choice about your next action, less struggle with a thought, or an easier return to an activity. Your pain may be unchanged. If the practice adds distress or feels unhelpful, it is reasonable to choose something else.

04 / The evidence, in proportion

Promising programmes.
Real limitations.

Research supports considering structured mindfulness-based programmes for some people with persistent low back pain. A few brief prompts on a website are a different intervention.

Cherkin et al. · JAMA · 2016

A trial with a usual-care comparison

61%Mindfulness programme
44%Usual care

Approximately 61% of people allocated to mindfulness-based stress reduction had at least 30% improvement in back-related functional limitation at 26 weeks, compared with 44% receiving usual care. CBT was approximately 58%.

The trial included 342 adults. The programme used eight weekly two-hour group sessions, including meditation and yoga, with home practice encouraged. Participants could not be blinded. There was no statistically significant difference between mindfulness and CBT. [1]

These percentages concern improvement in function, not the proportion cured or made pain-free. They are not expected outcomes for this webpage.

Zgierska et al. · JAMA Network Open · 2025

A comparison with another active therapy

A trial of 770 adults with opioid-treated chronic low back pain compared an eight-week mindfulness-based therapy programme with CBT. Mindfulness did not demonstrate superiority over CBT.

Both groups improved over follow-up, but there was no usual-care control. Improvement within the groups therefore cannot be confidently attributed entirely to either therapy. Loss to follow-up also limits interpretation. [2]

What this page can claim
It introduces attention practices informed by mindfulness principles. These scripts, the timer and the brief format have not been tested as a treatment programme. They complement assessment, activity and other appropriate care.
Sources and further information
  1. Cherkin DC et al. Effect of mindfulness-based stress reduction vs cognitive behavioral therapy or usual care on back pain and functional limitations in adults with chronic low back pain. JAMA. 2016;315:1240–1249. DOI: 10.1001/jama.2016.2323. Original trial ↗
  2. Zgierska AE et al. Mindfulness vs cognitive behavioral therapy for chronic low back pain treated with opioids. JAMA Network Open. 2025;8:e253204. DOI: 10.1001/jamanetworkopen.2025.3204. Original trial ↗
  3. NHS: mindfulness ↗ — an introduction, including why mindfulness may not suit everyone.
  4. NCCIH: meditation and mindfulness, effectiveness and safety ↗ — a broader evidence overview.
05 / When a little support would help

You can explore
this with someone.

Some people prefer the guidance of a trained teacher, psychologist or pain rehabilitation team.

If you would like a structured programme, ask your clinician about a pain management programme, CBT or a suitable mindfulness-based course. Check the teacher’s training, experience with persistent pain and how they adapt practice if difficulties arise.

Discuss suitability before starting if you have significant mental health difficulties, a trauma history that makes inward attention difficult, or previous adverse experiences with meditation. You are free to choose a different approach.

When symptoms need medical attention

Mindfulness does not assess the cause of symptoms. Go to A&E immediately for new bladder or bowel problems, numbness around the genitals or bottom, or pain, tingling, weakness or numbness in both legs with back pain. New severe or rapidly worsening weakness also needs urgent medical assessment. Do not use this page to work through those symptoms.

NHS guidance on back pain and when to get help ↗

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