Meditation, yoga and cognitive behavioural therapy may result in greater improvement among adults with back pain when compared with usual care, researchers, including one of Indian-origin, have found.
Mindfulness-based stress reduction (MBSR) focuses on increasing awareness and acceptance of moment-to-moment experiences including physical discomfort and difficult emotions.
Researchers from Johns Hopkins University in the US assigned 342 adults aged 20 to 70 years with chronic low back pain to receive MBSR, cognitive behavioural therapy (CBT), or usual care.
CBT (training to change pain-related thoughts and behaviours) and MBSR (training in mindfulness meditation and yoga) were delivered in 8 weekly 2-hour groups.
Usual care included whatever other treatment, if any, the participants received. The average age of the participants was 49 years; the average duration of back pain was 7.3 years.
Researchers found that at 26 weeks, the percentage of participants with clinically meaningful improvement on a measure of functional limitations was higher for those who received MBSR (61 per cent) and CBT (58 per cent) than for usual care (44 per cent).
The percentage of participants with clinically meaningful improvement in pain bothersomeness at 26 weeks was 44 per cent in the MBSR group and 45 per cent in the CBT group, vs 27 per cent in the usual care group. Findings for MBSR persisted with little change at 52 weeks for both primary outcomes.
The effects were moderate in size, which has been typical of evidence-based treatments recommended for chronic low back pain, researchers said.
These benefits are remarkable given that only 51 per cent of those randomised to receive MBSR and 57 per cent of those randomised to receive CBT attended at least 6 of the 8 sessions, they said.
“These findings suggest that MBSR may be an effective treatment option for patients with chronic low back pain,” researchers said.
“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,” said Madhav Goyal from Johns Hopkins University.
“For patients with chronic painful conditions, options are needed to help them live with less pain and disability now,” Goyal said. The findings were published in JAMA journal.