Mindfulness-based stress reduction has been shown to help relieve chronic lower back pain

While health club classes such as pilates may help people suffering from back pain, combining them with mindfulness-based activities could improve results even further according to recent research.

Mindfulness-based stress reduction focuses on increasing awareness and acceptance of moment-to-moment experiences, including physical discomfort and difficult emotions.

A study published in the The Journal of the American Medical Association in March* showed that, among adults with chronic lower back pain, both mindfulness-based stress reduction and cognitive behavioural therapy resulted in greater reduction in pain when compared with usual care.

Mindful interventions
Daniel C Cherkin and colleagues at the Group Health Research Institute in Seattle, US, randomly assigned 342 adults aged 20 to 70 years with chronic lower back pain to receive mindfulness-based stress reduction, cognitive behavioural therapy, or usual care.

Cognitive behavioural therapy (training to change pain-related thoughts and behaviours) and mindfulness-based stress reduction (training in mindfulness meditation and yoga) were delivered in eight weekly two-hour groups. ‘Usual care’ included whatever other treatment, if any, the participants received. Average age of the participants was 49 years; the average duration of back pain was 7.3 years.

Meaningful improvement
The 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 mindfulness-based stress reduction (61 per cent) and cognitive behavioural therapy (58 per cent) than for usual care (44 per cent). The authors wrote: “The effects were moderate in size, which has been typical of evidence-based treatments recommended for chronic low back pain....These findings suggest that mindfulness-based stress reduction may be an effective treatment option for patients with chronic low back pain.”

Jennifer A Haythornthwaite and Madhav Goyal of Johns Hopkins University School of Medicine, Baltimore, US, wrote that the challenge is how to ensure that these mind-body interventions are available.

“Most physicians encounter numerous obstacles in finding appropriate referrals for mind-body therapies that their patients can access and afford,” they said. “High-quality studies such as the clinical trial by Cherkin et al create a compelling argument for ensuring that an evidence-based healthcare system should provide access to affordable mind-body therapies.”

A recent study from Case Western Reserve University in Cleveland, Ohio, US, also found that mindfulness in the workplace is shown to improve employee focus, attention and behaviour.

* Cherkin, DC et al. Effect of Mindfulness-Based Stress Reduction vs Cognitive Behavioural Therapy or Usual Care on Back Pain and Functional Limitations in Adults With Chronic Lower Back Pain. JAMA, March 2016