Edited by David G. Fairchild, MD, MPH
Mindfulness-based stress reduction (MBSR) and cognitive behavioral therapy (CBT) are associated with reduced pain and disability in patients with chronic low back pain, suggests a JAMA study.
Researchers randomized over 300 adults with moderate low back pain lasting at least 3 months to one of three 8-week options: MBSR, CBT, or usual care. For MBSR, patients were taught mindfulness meditation and yoga; for CBT, they were trained to alter pain-related behaviors and thoughts.
At 26 weeks’ follow-up, both interventions had significantly higher rates than usual care of clinically meaningful improvements in self-reported back-related functional limitation (MBSR: 61%; CBT: 58%; usual care: 44%) and in back pain (MBSR: 44%; CBT: 45%; usual care: 27%).
Dr. Thomas Schwenk with NEJM Journal Watch General Medicine called the results “impressive, especially given the relatively poor adherence to both interventions. The problem with these interventions, as has been noted in recent discussions of excessive use of opioids for chronic pain, is lack of access for primary care patients and clinicians to these nonpharmacological approaches; however, if such options are available, clinicians should encourage their use.”