A new study may have found a solution to back pain – Mindfulness-based cognitive therapy (MBCT).
Chronic low back pain affects millions globally and is often very hard to treat. In many cases it can be debilitating. In the face of the opioid overdose crisis, 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 with mindfulness-based strategies. It consists of mindful movements like walking, guided meditation and breathing practices, and exercises aimed at understanding the stress-pain connection and identifying automatic thoughts that heighten pain. It also involves training the mind to identify and interrupt automatic thoughts, feelings and reactions to pain and accept discomfort.
To test whether MBCT was better at relieving chronic low back pain than other commonly used 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 3 groups reported significant decreases in pain interference – the degree to which pain interferes with functioning - pain intensity, depression, and better physical function. Improvements in pain interference over time were better in the MBCT group than the other approaches.
For physical functioning, both the MBCT and cognitive therapy groups showed more improvement over time than adults in the mindfulness meditation group.
Researchers also checked to see if opioid use might differ for those who’d received MBCT training versus cognitive therapy or mindfulness meditation instruction. All 3 groups had a roughly equivalent drop in recent opioid use 3 months after treatment, but not 3 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.”
Findings suggest that what works 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.