The Cure for Lower Back Pain? Mindfulness and Therapy

Mindfulness-based stress relief and cognitive behaviorial therapy work better than conventional treatments in patient trials

Lower Back Pain
PASIEKA/Science Photo Library/Corbis

Chronic back pain is a scourge, with up to 25 million people in the United States reportedly living with the condition. It leads to millions of lost work days, reduced physical activity, and depression. Opioid medications, physical therapy, spinal decompression, and dozens of other treatments can offer some relief, but there are few options for controlling long-term pain. But new research shows two non-invasive, drug-free therapies may have big benefits: psychological counseling and meditation.

Researchers from Group Health Cooperative and the University of Washington analyzed changes in lower back pain symptoms of 342 subjects who underwent cognitive behavioral therapy or mindfulness-based stress reduction.

Mindfulness-based stress reduction is a technique based on Buddhist meditation and yoga poses that teaches participants to become more aware of their body sensations and how to cope with them. Cognitive behavioral therapy, on the other hand, is a type of talk therapy that helps participants deal with negative thoughts and change negative behaviors, according to the study recently published in The Journal of the American Medical Association.

After six months of treatment, 58 percent of participants in the cognitive behavioral therapy group and 61 percent in the meditation group felt meaningful improvement in their functioning after six months. Both of these groups beat out the 44 percent reporting improvement after conventional pain therapies, according to Roni Caryn Rabin at The New York Times.

“This new study is exciting, because here’s a technique that doesn’t involve taking any pharmaceutical agents, and doesn’t involve the side effects of pharmaceutical agents,” Dr. Madhav Goyal of Johns Hopkins University School of Medicine tells Rabin.

The study also confirms what other studies have revealed in recent years, that mindfulness and CBT can be powerful tools in dealing with pain, anxiety, and other chronic problems. “I’ve been doing research on back pain for 30 years,” Daniel Cherkin, lead author of the study tells NPR. “The biggest revolution has been the understanding that it's not just a physical problem with physical solutions. It’s a biopsychosocial problem.”

Still, he points out in a press release, that the suffering is not just in the head. “Our findings are important because they add to the growing evidence that pain and other forms of suffering involve the mind as well as the body,” he says “Greater understanding and acceptance of the mind-body connection will provide patients and clinicians with new opportunities for improving the lives of persons with chronic back pain and other challenging conditions that are not always effectively managed with physical treatments alone.”

The biggest obstacle to the treatment, however, may be bureaucratic. Cherkin points out that treatments like meditation, even if they’re highly recommended and effective, are not covered by many insurance policies. And a lack of certified meditation trainers and cognitive therapists means that in many areas there aren’t enough practitioners to perform the treatments.