Focusing on the mind might help treat back pain. New research reveals that mindfulness-based stress reduction and cognitive behavioral therapy could be better at treating back pain than traditional care.
Researchers at Johns Hopkins University said the latest findings are important because more than 65 million Americans have chronic lower back pain, making it the second most common cause of disability in the United States. Researchers noted that chronic back pain can be hard to treat because many cases do not have a specific underlying cause.
The latest study involved 342 adults between the ages of 20 to 70 who all experienced chronic lower back pain. Researchers divided and randomly assigned the participants into three different groups: mindfulness-based stress reduction, cognitive behavioral therapy and usual care.
Participants assigned to the mindfulness-based stress reduction group were trained in mindfulness meditation and yoga, and those in the cognitive behavior therapy group were trained in altering pain-related thoughts and behaviors. Participants were both these groups went for 2-hour weekly sessions for eight weeks. Participants in the control group were assigned to the usual care or whatever other treatment they received before the start of the study.
Study results at 26 weeks revealed that participants in the mindfulness-based stress reduction and cognitive behavior therapy groups were more likely to experience improvement in their symptoms compared to those in the usual care group.
The findings revealed that 61 percent of the mindfulness group, 58 percent of the cognitive behavior therapy group and 44 percent of the usual group experienced clinically meaningful improvement in functional limitations at 26 weeks. Study results also revealed that 44 percent of the mindfulness group and 45 percent of the cognitive behavioral therapy group experienced meaning improvement in pain bothersomeness compared to only 27 percent of participants in the usual care group.
"Among adults with chronic low back pain, both mindfulness-based stress reduction and cognitive behavioral therapy resulted in greater improvement in back pain and functional limitations at 26 and 52 weeks when compared with usual care. There were no meaningful differences in outcomes between mindfulness-based stress reduction and cognitive behavioral therapy," researchers wrote in the study.
"These findings suggest that mindfulness-based stress reduction may be an effective treatment option for patients with chronic low back pain," they concluded.
Other experts not involved in the study say that the latest findings are important because it can help millions of patients suffering from debilitating, hard-to-treat pain.
"Although understanding the specificity of treatment effects, mechanisms of action, and role of mediators are important issues for researchers, they are merely academic for many clinicians and their patients. For patients with chronic painful conditions, options are needed to help them live with less pain and disability now," write Dr. Madhav Goyal and Jennifer A. Haythornthwaite of Johns Hopkins University School of Medicine, Baltimore.
"The challenge is how to ensure that these mind-body interventions are available, given the existing evidence demonstrating they may work for some patients with chronic low back pain. Most physicians encounter numerous obstacles finding appropriate referrals for mind-body therapies that their patients can access and afford. High-quality studies such as the clinical trial by Cherkin et al create a compelling argument for ensuring that an evidence-based health care system should provide access to affordable mind-body therapies," they concluded.
The findings and the accompanying editorial were published in the journal JAMA.
