Chronic Low Back Pain Responds to Mindfulness Therapy

Doctors seeking to find effective treatment for chronic low back pain, a condition affecting millions of Americans, published the results of a clinical trial in the Journal of the American Medical Association on March 22, 2016 in which participants achieved relief using mindfulness therapy.

Josephine Briggs, M.D., director of the National Center for Complementary and Integrative Health (NCCIH), explained the potential value of the study, “It is vital that we identify effective nonpharmacologic treatment options for 25 million people who suffer from daily pain, in the United States. The results from this research affirm that non-drug/non-opioid therapies, such as meditation, can help manage chronic low-back pain. Physicians and their patients can use this information to inform treatment decisions.” Briggs was referring to the clinical trial that was funded by NCCIH, part of the U.S. National Institutes of Health.

Chronic lower back pain

Chronic lower back pain is a leading cause of disability in many industrialized nations, causing hundreds of millions of lost work days in Europe and the United States alone (Image credit: https://twitter.com/BicyclingMag/status/712734664985853952)

In the clinical trial involving 342 adults between the ages of 20 and 70 years-of-age, the effectiveness of two mind and body practices, mindfulness-based stress reduction (MBSR) and cognitive behavioral therapy (CBT) were tested against usual care practices for chronic low back pain. During the trial period, September 2012 through April 2014, one group of participants received usual care for the condition, another group participated in eight weekly 2-hour sessions of MBSR and a third group participated in CBT.

 

Mindfulness-based stress reduction includes training in mindfulness meditation and yoga. Cognitive behavioral therapy, in the case of this clinical trial involved training to change pain-related thoughts and behaviors.

When interviewer-blind assessments were performed at 4 weeks, 8 weeks, 52 weeks and at the end of the trial, it was found that both groups who participated in the mind and body practices of mindfulness-based stress reduction or cognitive behavioral therapy had greater degrees of positive outcomes than did the participants who had received usual care for their chronic low back pain. Outcomes were measured both in reports of degrees of back pain and measurable physical functionality, according to the clinical trial’s report in JAMA.

Just as importantly, trial results showed no significant difference in the positive outcomes between MBSR and CBT, suggesting that mindfulness-based stress reduction may be a viable treatment option for chronic low back pain.

Whether this clinical trial will be enough to convince health practitioners to begin including mindfulness-based stress reduction in the care of chronic low back pain remains to be seen. The researchers involved in this trial are aware its limitations, including the fact that not all the participants and in the mind and body practices attended all eight of the sessions and 20 percent of both groups were lost to follow-up.


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