Among adults with chronic low back pain, both mindfulness-based stress reduction and cognitive behavioural therapy resulted in greater improvement in back pain when compared with usual care, according to a study appearing in the March 22/29 issue of The Journal of the American Medical Association.

Mindfulness-based stress reduction focuses on increasing awareness and acceptance of moment-to-moment experiences, including physical discomfort and difficult emotions.

Daniel C. Cherkin, Ph.D., of Group Health Research Institute, Seattle, and colleagues randomly assigned 342 adults age 20 to 70 years with chronic low back pain to receive mindfulness-based stress reduction, cognitive behavioural therapy, or usual care.

Cognitive behavioural therapy (training to change pain-related thoughts and behaviours) and mindfulness-based stress reduction (training in mindfulness meditation and yoga) were delivered in eight weekly 2-hour groups. Usual care included whatever other treatment, if any, the participants received. The average age of the participants was 49 years; the average duration of back pain was 7.3 years.

The researchers found that at 26 weeks, the percentage of participants with clinically meaningful improvement on a measure of functional limitations was higher for those who received mindfulness-based stress reduction (61 percent) and cognitive behavioural therapy (58 percent) than for usual care (44 percent).

"The effects were moderate in size, which has been typical of evidence-based treatments recommended for chronic low back pain,” the authors wrote. "...These findings suggest that mindfulness-based stress reduction may be an effective treatment option for patients with chronic low back pain."

Madhav Goyal, M.D., M.P.H., and Jennifer A. Haythornthwaite, Ph.D., of Johns Hopkins University School of Medicine, Baltimore, wrote that the challenge is how to ensure that these mind-body interventions are available.

“Most physicians encounter numerous obstacles finding appropriate referrals for mind-body therapies that their patients can access and afford,” they said. “High-quality studies such as the clinical trial by Cherkin et al create a compelling argument for ensuring that an evidence-based health care system should provide access to affordable mind-body therapies."

A recent study from Case Western Reserve University also found that mindfulness in the workplace is shown to improve employee focus, attention and behaviour.