A groundbreaking study reveals that mindfulness and cognitive behavioral therapy provide significant, lasting relief for chronic low back pain patients, reducing their reliance on opioids and enhancing their quality of life.
Chronic low back pain affects one in four Americans and is a leading cause of disability worldwide. A multi-institutional team led by researchers from the Penn State College of Medicine and the University of Wisconsin-Madison reported that eight weeks of mindfulness or cognitive behavioral therapy (CBT) training effectively improved physical function and quality of life and reduced both pain and opioid use among adults suffering from chronic low back pain. The findings, published in JAMA Network Open, highlight the lasting benefits of these behavioral therapies.
Chronic low back pain often requires opioid medication, which poses risks of addiction. Remarkably, the study found that both mindfulness and CBT were safe and effective, even helping to reduce opioid doses over time.
“Both mindfulness and cognitive behavioral therapy were shown to be safe, effective treatments, providing lasting benefits for people with opioid-treated chronic back pain,” lead author Aleksandra Zgierska, a professor of anesthesiology and of perioperative medicine and public health sciences at the Penn State College of Medicine, said in a new release. “These evidence-based behavioral therapies should be standard of care available to our patients.”
Chronic pain is complex and often persists for months or years. Chronic low back pain is particularly prevalent and heavily treated with opioids, yet effective treatment options have been limited. Previous research indicated potential benefits from behavioral therapies, but studies were typically small and short-term.
The study aimed to evaluate the effectiveness and long-term impacts of mindfulness compared to CBT. Both therapies help patients manage their pain by altering their perceptions and reactions to it.
The team, which designed the study with input from an advisory panel of clinicians, community representatives and chronic pain patients, enrolled 770 adults in a randomized clinical trial across three sites: Madison, Wisconsin; Boston, Massachusetts; and Salt Lake City, Utah.
“The people in this study had quite severe back pain that interfered with their life and was bad enough to need opioid medication. Usually, in that condition, people don’t really get better over time on their own,” added co-lead author Bruce Barrett, a professor of family medicine and community health at the University of Wisconsin-Madison.
Participants were assigned to either mindfulness-based therapy or CBT, with both groups attending two-hour sessions for eight weeks. They were encouraged to practice independently for 30 minutes daily, six days a week during the 12-month study period. Though not instructed to reduce their opioid use, many participants chose to decrease their dosage after learning new pain management skills.
“The goal of pain management is to improve quality of life, increase function and reduce the sense of suffering. The study’s interventions likely helped reduce the participants’ sense of suffering, which probably allowed them to function a whole lot better,” added co-author and advisor Penney Cowan, the founder of the American Chronic Pain Association. “People can live with pain, but they need to know how to do it. This study provides a sense of hope. It says you can do this and help yourself to a better quality of life.”
The improvements observed in the participants’ pain levels, daily activities and opioid use underscore the potential of behavioral therapies. These tools help individuals build inner resilience and make meaningful lifestyle changes without the adverse effects often associated with medication or surgical interventions.
“These therapies aren’t a total cure, but they teach people how to develop the inner resources they need to cope with chronic pain and to live a better life,” added senior author Eric Garland, an endowed professor in health sciences and a professor of psychology at the University of California, San Diego. “Mindfulness is a self-regulated tool that comes from within, unlike surgery or medication where something is being done to you from the outside. By learning these techniques, patients continue to experience lasting benefit.”
Source: Pennsylvania State University