Mindfulness-Based Stress Reduction May Not Help Chronic Back Pain

Meta-Analysis of Existing MBSR Research on Lower Back Pain Returns Inconclusive Results

A meta-analysis of 7 randomized controlled trials conducted by researchers from University of Duisburg-Essen, Germany, concludes that mindfulness-based stress reduction (MBSR) does not produce clinically meaningful reduction of chronic low back pain that is sustained over time. Although previous studies have indicated positive results for MBSR interventions in other pain presentations, the question of efficacy for chronic low back pain has not been rigorously evaluated, according to the authors. The present research reviewed the cases of 854 patients with low back pain, comparing MBSR with usual care, or active intervention that included cognitive behavioral therapy. Primary outcomes were pain intensity or pain related disability assessed at 8 weeks and 6 months post-intervention. The findings were published earlier this week in the Annals of Internal Medicine.

At 8 weeks postintervention, MBSR techniques were associated with statistically significant improvement in pain intensity, compared to improvement gained from usual care. But the authors report that the recorded improvement still was below the threshold for clinically important difference. Assessments of MBSR efficacy at 6 months postintervention found neither statistically significant nor clinically relevant differences in pain intensity between the groups. The authors note, however, that deficiencies in the studies considered in the meta-analysis render their conclusions as being of a preliminary nature only, and that "Rigorously designed, large [randomized controlled trials] are needed in order to understand the effectiveness and safety of MBSR interventions for the management of patients with low back pain."

Read the journal abstract.

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