Lower back pain is the second most prominent cause of disability among the adult population of the United States. Eighty percent of the population will encounter this condition at some point in their life, robbing them of optimal mobility, productivity, motivation, and overall well-being. As well as being highly detrimental to the individual, lower back pain damages the collective by draining hundreds of billions of dollars from the economy on an annual basis.
Sensations of lower back pain can range from dull aches to sharp stabbing agony. Short term pain derived from injury is often classified as acute and is most likely the cause of a muscle strain, whereas long term suffering falls into the chronic category.
A plethora of treatments are currently utilized to attempt to treat this epidemic condition. Conventional procedures include invasive surgery, nerve root block injections, and pain medications such as acetaminophen, ibuprofen, and naproxen. More alternative and less side-effect-saturated approaches include spinal manipulation, acupuncture, and physical therapy. However a recent scientific study may have just revolutionized the way lower back pain is treated. What makes this new avenue different from already existing techniques? Well, for starters, it bares a huge focus on the mind.
A research team led by Dr. Daniel Cherkin at Group Health Research Institute in Seattle explored and compared the results of different methods of treating chronic lower back pain and published the findings in a paper now archived in the U.S. National Library of Medicine.
The objective of the study was to evaluate the effectiveness of mindfulness-based stress reduction (MBSR) versus cognitive behavioral therapy (CBT) or traditional care. 342 people between the ages of 20 and 70 who suffered from back pain with an elusive cause for over 3 months were enrolled in the study. Subjects were randomly divided into one of the three treatment groups.
MBSR is a program based upon the utilization of certain mindfulness-based techniques such as bodily awareness, meditation, and yoga. The goal of this practice, developed at the University of Massachusetts Medical Center, is to reduce stress, induce relaxation, and improve an individual’s quality of life. Such outcomes contribute to an increased awareness and acceptance of direct perceptual experiences such as physical pain and negative emotions. Subjects assigned to the MBSR group participated in practices such as sitting meditation, walking meditation, and yoga.
CBT on the other hand is even more of a mind-centered endeavor. It is a psychotherapeutic approach that enables patients to recognize how thoughts and feelings can influence behavior. Central to the practice is the realization that although the patient may not be in control of what happens to them, they can control how they perceive and act upon their circumstances. During such treatment, patients learn how to identity and transmute detrimental thought patterns that would previously have manifested into negative behavior. According to a report published by the National Institute of Health regarding the aforementioned study, “CBT group participants focused on changing dysfunctional thoughts, setting and working towards behavioral goals, relaxation skills, and pain-coping strategies.”
So how did these seemingly unlikely strategies fare in the study? Well, according to the results: exceptionally well.
Patients receiving CBT and MBSR training participated in a total of 8 weekly 2-hour group sessions augmented by tools such as workbooks and CDs for home practice, whereas the patients receiving usual care were free to elect conventional treatment of their choosing.
The results from each treatment group were measured using a specialized questionnaire. Six months into the research, functional improvement was highest in the MBSR group with a rating of 61 percent. The CBT group achieved 58 percent, leaving the usual care group with the lowest score of 44 percent.
Other measurements were accomplished using a self-reported back pain “bothersomeness” scale ranging from one to ten. Here the CBT group saw a 45 percent improvement, followed by a 44 percent improvement in the MBSR group, and a 27 percent improvement score in the usual care group. The authors of the study noted that in comparison to more traditional treatment options, the MBSR and CBT based therapies resulted in a greater improvement in back pain and functional limitations.
Head researcher Cherkin stated: “The research suggests that training the brain to respond differently to pain signals may be more effective — and last longer — than traditional physical therapy and medication.”
NCCIH Director Dr. Josephine Briggs also acknowledged the effectiveness of these treatments: “The results from this research affirm that non-drug/non-opioid therapies, such as meditation, can help manage chronic low-back pain. Physicians and their patients can use this information to inform treatment decisions.”
This study highlights the use of CBT and MSBR as non-invasive, side-effect free treatments for those experiencing chronic lower back pain. Both are multi-faceted and self-empowering strategies that will not only assist in instances of lower back pain, but bare side effects that can positively spill into other areas of a patient’s life.
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