“Mindfulness meditation and CBT-based interventions have the potential to safely reduce pain severity in patients with chronic lower back pain that’s treated with opioids,” said Dr. Aleksandra Zgierska, assistant professor of family medicine.
Madison, Wisconsin – Mindfulness meditation, combined with elements of cognitive behavioral therapy (CBT), reduced pain in people with opioid-treated chronic lower back pain, according to a study published by the University of Wisconsin School of Medicine and Public Health.
“Mindfulness meditation and CBT-based interventions have the potential to safely reduce pain severity in patients with chronic lower back pain that’s treated with opioids,” said Dr. Aleksandra Zgierska, assistant professor of family medicine. “For patients who suffer this disabling condition, long-term opioid use is often only marginally effective for chronic pain and can have some serious side effects including addiction and death.”
Zgierska calls chronic lower back pain that requires long-term opioid therapy one of the most challenging conditions in clinical practice and one of the most frustrating and painful conditions for patients.
In the study, 35 patients with opioid-treated chronic lower back pain took an eight-week course of mindfulness meditation and selected chronic-pain specific CBT techniques. Twenty-one were randomly assigned to the meditation group and 14 to the control group. All received their usual care during the 26-week evaluation period. All study participants were assessed before the start of the intervention, immediately after the course and 18 weeks after. Those in the intervention group underwent training for two hours a week for eight weeks. In addition, they were encouraged to practice meditation on their own for six days a week and 30 minutes per day. The meditation-CBT program was led by two psychologists experienced in treating pain patients.
Zgierska said that participants in the meditation-CBT group reported a pain score reduction of eight percent at eight weeks and 26 weeks while pain scores increased by eight percent at eight weeks and 10 percent at 26 weeks for participants in the control group, a statistically-significant difference between the two groups. In addition, the meditation-CBT participants were found to have reduced pain sensitivity to heat stimuli compared to the control group.
“We didn’t find a statistically-significant decrease in the use of opioid medications during the study, but it’s plausible that a significant opioid dose reduction could be accomplished with a longer follow-up period or larger sample size,” said Zgierska.
Zgierska said the findings of the pilot study call for further evaluation of the meditation-CBT intervention to understand the effects and mechanisms of action of meditation and/or CBT therapies for opioid-treated chronic lower back pain.
The study was published in the journal Pain Medicine: Mindfulness Meditation and Cognitive Behavioral Therapy Intervention Reduces Pain Severity and Sensitivity in Opioid-Treated Chronic Low Back Pain: Pilot Findings from a Randomized Controlled Trial
Published: March 2016