Lower back pain is one of the most common conditions worldwide, accounting for one-third of all work-related disabilities. Yet, the painkillers and muscle relaxants that patients are typically prescribed are rarely effective, and more than half of people who suffer from chronic pain seek alternative treatments for relief.

Despite the obvious need for new, effective methods of lower back pain treatment, very few clinical trials have ever evaluated the effectiveness of mindfulness techniques, like meditation and yoga, for chronic back pain. Seeking to fill this gap in the research, scientists from the Group Health Research Institute conducted a study, which is now published in Journal of the American Medical Association.

The study separated a group of 342 adults aged 20 to 70, who had been suffering from chronic back pain for an average of 7.3 years, into three treatment groups. One group received mindfulness-based stress reduction (MBSR), including yoga and meditation, which focuses on increasing the patient’s awareness and acceptance of physical discomfort. The second group received cognitive behavioral therapy (CBT), which trains patients to change pain-related thoughts and behaviors to more positive ones. Both of these treatments were offered eight times a week in two-hour sessions. The final group was given no additional treatment, but continued their usual care.

After six-and-a-half months, participants who received MBSR or CBT showed increased functionality by 61 and 58 percent, respectively, which meant they were better able to go about their daily activities without being burdened by pain. Meanwhile, the usual care group only saw a 44 percent increase in functionality. When it came to how much the patients were bothered by their pain, MBSR and CBT groups expressed a 44 and 45 percent improvement, respectively, while the usual care patients only improved by 27 percent.

“These benefits are remarkable given that only 51 percent of those randomized to receive MBSR and 57 percent of those randomized to receive CBT attended at least six of the eight sessions,” the study authors wrote. "These findings suggest that MBSR may be an effective treatment option for patients with chronic low back pain.”

The researchers also indicated that the benefits of MBSR persisted with little change by the end of a year.

"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,” commented Dr. Madhav Goyal and Dr. Jennifer A. Haythornthwaite of Johns Hopkins University School of Medicine, in a press release. “Most physicians encounter numerous obstacles finding appropriate referrals for mind-body therapies that their patients can access and afford.”

While it will initially be challenging to get patients widespread access to affordable and effective MBSR treatments, the study’s results offer a compelling argument to begin a transition from prescription medicines to mindfulness therapies in treating lower back pain.

Source: Cherkin DC, et al. Effect of mindfulness-based stress reduction versus cognitive behavioral therapy or usual care on back pain and functional limitations in adults with chronic low back pain. JAMA. 2016.