Mindfulness And CBT Beat Usual Care For Chronic Back Pain

Mind-based therapies, namely mindfulness and cognitive-behavioral therapy (CBT), may be more effective in easing chronic back pain than usual treatments, according to a new study.

Researchers found that both approaches can help patients who have not experienced benefits from other programs.

“Maybe it’ll make a difference for them,” lead author, Daniel Cherkin of Group Health Research Institute in Seattle, said.

The team randomly assigned 342 subjects with chronic low back pain — ages 20 to 70 — to one of the two mind therapies or the usual care for a year. The cause of their pain, which lasted for at least three months, was unknown.

Participants assigned to use mindfulness-based stress reduction (MBSR) and CBT underwent two-hour group session, once weekly for eight weeks, and enriched their at-home practice using workbooks and CDs.

At both 26 and 52 weeks, those using the two mind-based therapies saw greater improvement in their function and back pain than the standard-care group.

After six months, “meaningful improvement” manifested in around 61 percent of mindfulness patients, 58 percent of CBT patients, and 44 percent of those in standard care. About 44 percent of the mindfulness and 45 percent of the CBT group, too, had noticeable decreases in their pain’s level of bothersomeness.

After one year, both mind-based therapies continued to fare better than usual care on those same measures.

Cherkin explained that CBT has already been seen effective for other kinds of pain, while MBSR has not been studied much for these other kinds.

“I would expect it would be helpful for a variety of chronic conditions because it is not specifically focused on back pain or other specific conditions,” he said.

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

Doctors and their patients can start exploring non-drug, non-opioid therapies such as meditation, she added.

While MBSR integrates various elements of mindfulness, yoga, and meditation, CBT is a psychotherapeutic technique that encourages modifying certain thoughts and behaviors.

The findings were discussed in the Journal of the American Medical Association.

Photo: Brian Lockwood | Flickr

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