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 “Most people would think mindfulness meditation would help stress,”
said lead author Dr. Natalia Morone of the University of Pittsburgh.
“They would not typically think it could actually lead to reduced
pain or lead them to have less pain interference during their day to
day activities.”
The researchers studied 282 older adults, with an average age of 74,
in the Pittsburgh area with functional limitations due to chronic
low back pain between 2011 and 2014.
The participants were randomly separated into two groups. Both
groups entered into an eight-week program followed by monthly
sessions for an additional six months.
In the mindfulness group, participants were taught four methods of
meditation, using directed breathing and mindful awareness of
thoughts and sensations in sitting, walking or lying down positions.
They also learned mindful stretching during the initial eight weeks.
During the six months of booster sessions, participants met to
meditate and discuss themes of the mindfulness program.
Those in the comparison group met for the same amount of time in
groups of the same size with the same amount of “homework” and time
with a facilitator, but instead focused on education based on the 10
Keys to Healthy Aging, which does not address pain. They learned
about managing high blood pressure and did the same chair stretches
as the mindfulness group.
The participants had monthly 15-minute phone interviews about the
back pain, function, mindfulness, and doctor or hospital visits.
Based on disability questionnaires, the people in the mindfulness
group had improved more after eight weeks than the control group,
though disability scores were again similar by the six-month point.
The mindfulness group also had more improved current and most severe
pain scores at the six-month point, as reported in JAMA Internal
Medicine.
“In terms of mechanism for pain reduction, the study gives us a clue
as patients in the mind-body program reported more self-efficacy
toward pain - they were able to better cope with their pain,” Morone
told Reuters Health by email.
She and her coauthors did not compare the mindfulness program to
other back pain treatments, but it should be seen as an option for
some patients that does not involve medication or surgery, she said.
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The authors did not report how consistently the treatments were
delivered or how faithfully participants practiced outside of their
sessions, which would be important information, Dr. M. Carrington
Reid of Weill Cornell Medical Center in New York and coauthors wrote
in a commentary alongside the paper.
But “chronic pain is one of the most common conditions encountered
by health care professionals, particularly among patients 65 years
and older,” and barriers often prevent treating it with medication,
so studies on non-medication options like mindfulness are important,
they wrote.
“The mind-body program teaches patients how to be more aware of
their thoughts, emotions, sensations and behaviors,” Morone said.
“As the patient learns to do this, they can become more aware of
behaviors or even thoughts or feelings about pain that make it
worse, or make it difficult for them to do activities.”
At the six-month point, almost half of people in both groups had
improved physical function, specifically with less pain interference
due to their back when they did physical activity such as putting on
socks, Morone said.
“To sustain the effects on physical function the person with chronic
low back pain could consider adding a brisk daily walking program
since we know this also helps patients with chronic pain,” she said.
The Mindfulness-Based Stress Reduction Program is offered in many
medical centers, communities and online, she said.
SOURCE: http://bit.ly/1Q9laDe JAMA Internal Medicine, online
February 22, 2016
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