|
 Patients who took part in such programs were more likely to have
noticeable and lasting improvements in back pain than those who
stuck to their usual routines, investigators found.
Both of the approaches tested in the study - mindfulness-based
stress reduction (MBSR) and cognitive behavioral therapy (CBT) - can
be helpful for people who haven't benefited from other therapies,
said lead author Daniel Cherkin, of the Group Health Research
Institute in Seattle.
"Maybe it’ll make a difference for them," he told Reuters Health.
MBSR attempts to increase a person's attention to thoughts, emotions
and sensations in the moment through yoga and meditation, the
researchers explain in in the Journal of the American Medical
Association. CBT educates people about pain and its relation to
reactions and activities. CBT also provides instructions and tools
to cope with pain.
While CBT is known to be effective for chronic pain and is
recommended for lower back pain, before now only one other study had
looked at MBSR for chronic low back pain, the researchers say.
Cherkin and colleagues randomly assigned 342 adults with chronic low
back pain to one of three groups. The pain had no known cause and
had lasted for at least three months.
One group continued whatever they were doing to manage their pain. A
second group also received MBSR and a third took part in CBT.
Participants in the two mind-body therapy groups were offered eight
weekly two-hour group sessions. The MBSR group was also offered a
six-hour retreat.
Overall, about 54 percent attended six or more sessions.
After six months, there was "meaningful improvement" in about 61
percent of the MBSR group, 58 percent of the CBT group and 44
percent of the usual care group. Patients with meaningful
improvement were noticeably less disabled, the report suggests.
Likewise, about 44 percent of the MBSR group and 45 percent of the
CBT group ended up with noticeable reductions in the bothersomeness
of their pain, compared to 27 percent of the usual care group.
After one year, MBSR and CBT continued to outperform usual care on
both measures.
[to top of second column] |
"That’s a good chunk of the population with chronic low back pain
that could have a meaningful improvement," said Dr. Madhav Goyal,
who co-wrote an editorial accompanying the new study.
About 30 percent of people in the MBSR group and about 10 percent in
the CBT group reported adverse events, which were usually temporary
increases in pain.
Patients with chronic low back pain may have trouble finding people
qualified to administer CBT or MBSR, said Goyal, of the NorthBay
Center for Primary Care in Vacaville, California.
Even if they can track down practitioners, people may have to pay
out of pocket for the programs, he said.
"I’m not sure how well CBT is covered by insurance, but MBSR
certainly is not," said Goyal, who is also affiliated with Johns
Hopkins University School of Medicine.
An eight-week MBSR program can cost about $500, he said.
"The current treatments we have are not as effective as we believe
them to be and these alternatives that we think of as simple or what
we usually typically brush off are highly effective," said Dr. Jatin
Joshi, a pain specialist at Weill Cornell Medicine in New York.
"If you have a physician conscientious enough to bring these tools
to you, have an open mind," said Joshi, who was not involved with
the new study.
SOURCE: http://bit.ly/25k9bgn and http://bit.ly/25k9fg0 JAMA, online
March 22, 2016.
[© 2016 Thomson Reuters. All rights
reserved.] Copyright 2016 Reuters. All rights reserved. This material may not be published,
broadcast, rewritten or redistributed.
 |
