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Mindfulness meditation
A study conducted at Group Health Research Institute found that mindfulness meditation can be as effective as cognitive behavioral therapy and medication for treating low back pain. (Credit: JAMA via YouTube)

Mindfulness meditation can give a boost to treatments for chronic low back pain for a wide spectrum of patients, a study conducted by Seattle’s Group Health Research Institute has found.

The study, published today by the Journal of the American Medical Association, assessed treatment outcomes over the course of a year for 342 Group Health back-pain patients, ranging in age from 20 to 70.

The patients were divided into three groups. The control group continued their usual treatment plan, including medications and physical therapy. The other two groups went through two-hour training sessions, once a week for eight weeks, in two different types of mental techniques for addressing stress and pain.

One technique is known as cognitive behavioral therapy, or CBT, which has previously been used to treat back pain as well as other conditions such as depression. CBT helps patients reframe how they think about pain to manage it more successfully. It also helps them change behaviors that may contribute to pain.

The other technique is mindfulness-based stress reduction, or MBSR. Practitioners are trained to observe, acknowledge and accept their thoughts and feelings, including their sensation of pain. The training also promotes body awareness through yoga.

The CBT and MBSR patients were allowed to receive other types of care independent of the study.

Group Health’s researchers found that the CBT and MBSR patients were more likely to experience at least a 30 percent improvement in function, as well as in their self-reported assessments of how much they were bothered by back pain. The improvement leveled out after 26 weeks for the CBT patients, but continued to rise for the MBSR patients.

Researchers and public health officials said the Seattle study supports the view that mindfulness medication could be a clinically valuable, drug-free option for treating low back pain. Previous research showed that to be the case for older adults, but the newly published study suggests that the benefit extends to young and middle-aged adults as well.

“It is vital that we identify effective non-pharmacological treatment options for 25 million people who suffer from daily pain in the United States,” Josephine Briggs, director of the National Center for Complementary and Integrative Health, said in a news release. “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.”

Daniel Cherkin, the study’s principal author and a senior researcher at the Group Health Research Institute, emphasized that the study does not prove back pain is “all in your mind.”

“Rather, as recent brain research has shown, the mind and the body are intimately intertwined, including in how they sense and respond to pain,” Cherkin said in a news release. “Both mindfulness and CBT involve the brain as well as the body. We found that these approaches were as helpful for people with chronic back pain as are other effective treatments for back pain.”

Cherkin said he and his fellow researchers are now focusing on whether the benefits of CBT and MBSR training persist for more than a year, and whether the two strategies work for people in similar or different ways.

In addition to Cherkin, the authors of “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” include Karen Sherman, Benjamin Balderson, Andrea Cook, Melissa Anderson, Rene Hawkes, Kelly Hansen and Judith Turner. Check out Cherkin’s blog post for more about mind-based back pain treatments.

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