ALTERNATIVE MEDICINE

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Mindfulness Meditation and Relief For Low-Back Pain

 

Mindfulness based stress reduction (MBSR) brings together elements of mindfulness meditation and yoga while cognitive-behavioral therapy (CBT) is a form of psychotherapy that trains individuals to modify specific thoughts and behaviors. Mindfulness-based stress reduction (MBSR) has not been rigorously evaluated for young and middle-aged adults with chronic low back pain. As a result, a study published in the Journal of the American Medical Association (2016;315:1240-1249) was performed to evaluate the effectiveness for chronic low back pain of MBSR vs cognitive behavioral therapy (CBT) or usual care.

 

The study was a randomized, interviewer-blind, clinical trial which included 342 adults aged 20 to 70 years with chronic low back pain randomly assigned to receive MBSR (n=116), CBT (n=113), or usual care (n=113). Treatments were delivered in 8 weekly 2-hour groups. Usual care included whatever care participants received. The main outcome measures were the co-primary outcomes of the percentages of participants with clinically meaningful (>30%) improvement from baseline in functional limitations (modified Roland Disability Questionnaire [RDQ]; range, 0-23) and in self-reported back pain bothersomeness (scale, 0-10) at 26 weeks. Outcomes were also assessed at 4, 8, and 52 weeks.

 

Of the 342 randomized participants, the mean age was 49.3 (range 20-70) years, 224 (65.7%) were women and the mean duration of back pain was 7.3 years (range, 3 months-50 years), 123 (53.7%) attended 6 or more of the 8 sessions, 294 (86.0%) completed the study at 26 weeks, and 290 (84.8%) completed the study at 52 weeks. In intent-to-treat analyses at 26 weeks, the percentage of participants with clinically meaningful improvement on the RDQ was higher for those who received MBSR (60.5%) and CBT (57.7%) than for usual care (44.1%) (P=0.04; The percentage of participants with clinically meaningful improvement in pain bothersomeness at 26 weeks was 43.6% in the MBSR group and 44.9% in the CBT group, vs 26.6% in the usual care group (overall P=0.01). Findings for MBSR persisted with little change at 52 weeks for both primary outcomes.

 

The authors concluded that among adults with chronic low back pain, treatment with MBSR or CBT, compared with usual care, resulted in greater improvement in back pain and functional limitations at 26 weeks, with no significant differences in outcomes between MBSR and CBT. However, since findings for MBSR persisted with little change at 52 weeks for both primary outcomes, the findings suggest that MBSR may be an effective treatment option for patients with chronic low back pain.

 

According to the NIH, it is vital that effective non-pharmacological treatment options be identified if at all possible for the 25 million people who suffer from daily pain in the United States and that results from this study affirm that non-drug/non-opioid therapies, such as meditation, can help manage chronic low-back pain, and that physicians and their patients can use this information to inform treatment decisions.

 

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