If you’ve ever had back pain, you know it’s one of the worst kinds of pain to have. Chronic low back pain affects millions globally and is often very hard to treat. In many cases, it can be debilitating. Pain drugs like opioids were cavalierly prescribed for back pain in the past, leading many down the difficult road of addiction and seeding an opioid overdose crisis in the US. Now, more and more physicians and patients are seeking alternative ways to manage and treat chronic pain. A study at the University of Queensland in Australia may have found one solution – Mindfulness-based cognitive therapy (MBCT).
MBCT combines the best of standard cognitive therapy, which helps people become aware of negative thought patterns and behaviors, with mindfulness-based strategies, which help people form a new relationship to thoughts and behaviors. MBCT consists of guided meditations and breathing practices, mindful movements like walking, and exercises aimed at understanding the stress-pain connection and identifying automatic thoughts that intensify pain. Through MBCT you learn to train the mind to identify and interrupt automatic thoughts, feelings, and reactions to pain and build a new relationship with discomfort.
Studying MBCT for Chronic Pain
To pilot test whether MBCT was better at relieving chronic low back pain than other commonly used therapy approaches, researchers had 23 people attend MBCT classes, while another 23 received mindfulness meditation training and 23 more underwent cognitive therapy. Those who didn’t receive MBCT were given the option to try it once the study was over.
Everyone received 8 weeks of instruction and were asked to do at-home practices for 45 minutes per day, 6 days a week. Their pain experiences, mood, physical functioning, and medication use were evaluated immediately after training, and 3 and 6 months later.
Following training, participants in all three groups reported significant results:
- Decreased pain interference, which is the degree to which pain interferes with functioning
- Decreased pain intensity
- Decreased feelings of depression
- Improved physical function
Improvements in pain interference over time were greater in the MBCT group than in the cognitive therapy or mindfulness groups alone. For physical functioning, both the MBCT and cognitive therapy groups showed more improvement over time than adults in the mindfulness meditation group.
Improvements in pain interference over time were greater in the MBCT group than in the cognitive therapy or mindfulness groups alone.
Researchers also checked to see if opioid use might differ for those who’d received MBCT training versus cognitive therapy or mindfulness meditation instruction. There were no significant differences by therapy type in opioid medication use from before treatment (48%) to after treatment (43%) or 6 months later.
Results from the study build on prior research finding that mindfulness-based approaches may be effective for pain management. Authors of the study note that the “three treatments investigated in this trial are designed to be empowering interventions that teach specific, long-lasting skills that patients can continue to use after treatment completion to maintain and even build upon gains made during treatment.”
These study findings also reveal that what works best for pain may depend on the individual. For some, cognitive therapies may be more fitting, empowering and effective, while others may gain more from meditation, or a combination of mindfulness principles and cognitive therapy.
Regardless of the approach, this study holds promise for those seeking to alleviate chronic low back pain using an alternative to pain medication.