Hope for Chronic Back Pain Sufferers: Mind-Body Therapy

Hope for chronic low back pain sufferers does exist as reported in the Journal of the American Medical Association. And believe it or not, it does not involve taking a pill.

The study showed how mind-body approaches worked better than usual care for improving pain and function associated with chronic low back pain. The mind-body approaches used in the study included mindfulness-based stress reduction (MBSR) and cognitive-behavioral therapy (CBT). These meditation techniques deal with stress and counterproductive outlooks. The techniques allow the practitioner to have a detached perspective of their painful condition. Breathing techniques and yoga are among the methods that increase the objective awareness.

In the study, the mind-body sessions were delivered in group sessions of 2 hours per week for 8 weeks while the control group received “usual medical care” which consisted of whatever therapy they had received previously. Despite receiving the therapy over a 2 month time period, study subjects had benefits that lasted a year or longer. Improvement was measured by decreased pain and improved function. What was essential for the sustained benefit was the continued use of the mind-body techniques throughout the year.

A number of questions are raised by the findings of this study. What is the mechanism that results in the prolonged benefit of these techniques? Is it more the issue of chronic pain versus the location in the low back that is important? Chronic pain is different than acute pain. Acute pain has a purpose to prevent injury. Chronic pain does not serve a useful purpose and is handled by the nervous system in a different way. This study suggests that rewiring the central nervous system to look at chronic pain in an objective versus subjective way results in an overall improved outcome.

Whether yoga alone without stress management would work as well is not known. More yoga studios are available than mindfulness seminars or CBT classes so yoga may be a good place to start.

Take home message – There are techniques available other than medicines that can help decrease chronic low back pain. Think out of the box to get your mind to change so you experience less pain and improved function.

Reference: Cherkin DC, Sherman KJ, Balderson BH et al. Effect of mindfulness-based stress reduction versus cognitive behavioral therapy or usual care on back pain and functional limitations in adults with chornic low back pain: a randomized clinical trial. JAMA doi:10.10001/jama.2016.2323

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