Scalable mindfulness model can help treat chronic low back pain
Low back pain affects over 600 million people and is the single leading cause of disability worldwide. New research from Boston Medical Center (BMC), the largest essential hospital in New England, suggests that the Optimizing Pain Treatment In Medical settings Using Mindfulness (OPTIMUM) trial, in which an adapted group mindfulness program is delivered through primary care telehealth for patients with chronic low back pain, produced sustained reductions in pain and improvements in patients' daily lives. The findings, published in JAMA Internal Medicine, highlight a scalable, nonpharmacological approach to treating chronic pain.
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Not only can chronic low back pain limit a person's ability to walk, work, sleep and socialize, but it can also negatively affect a person's mental health and overall well-being. Low back pain is also one of the most common reasons people visit their primary care physician , yet the treatment options routinely available are limited. Medications carry risks, surgery helps only a narrow subset of patients, and effective nonpharmacological therapies can be difficult to access.
"What our program does is give people real, repeatable skills for how to respond to pain differently," said Natalia Morone, MD, MS, the study's lead author and a primary care and internal medicine clinician at BMC. "Once patients have those skills, they also seem to carry them forward, and we see improvements lasting beyond the program."
The researchers tested a version of Mindfulness-Based Stress Reduction (MBSR) adapted specifically to treat pain as a stressor. A total of 451 participants across three states attended 120-minute group sessions over eight weeks. The sessions were led by a trained mindfulness instructor and a primary care physician. Rather than referring patients to a separate program, the OPTIMUM trial brought the clinician into the room and gave every participant direct access to a physician as an integrated part of the experience.