Mindfulness-based stress reduction for low back pain. A systematic review.
Study Goal
The researchers aimed to systematically review the effectiveness of Mindfulness-Based Stress Reduction (MBSR) in improving pain intensity and disability in patients with chronic low back pain.
Results Summary
The review found inconclusive evidence for MBSR's effectiveness in improving pain intensity or disability in chronic low back pain patients, though limited evidence suggested improvements in pain acceptance. Results varied by population, with one RCT showing short-term benefits for failed back surgery syndrome patients, while two others on older adults showed no significant improvements.
Population
Chronic low back pain patients, including those with failed back surgery syndrome and older adults (age ≥ 65 years).
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
Mindfulness-based stress reduction (MBSR) | decrease | pain intensity | patients with failed back surgery syndrome | clinically important | reported significant and clinically important short-term improvements | #1 |
Mindfulness-based stress reduction (MBSR) | decrease | disability | patients with failed back surgery syndrome | clinically important | reported significant and clinically important short-term improvements | #2 |
Mindfulness-based stress reduction (MBSR) | no change | pain | older adults (age ≥ 65 years) with chronic specific or non-specific low back pain | no significant change | reported no short-term or long-term improvements | #3 |
Mindfulness-based stress reduction (MBSR) | no change | disability | older adults (age ≥ 65 years) with chronic specific or non-specific low back pain | no significant change | reported no short-term or long-term improvements | #4 |
Mindfulness-based stress reduction (MBSR) | increase | pain acceptance | - | larger | reported larger short-term improvements | #5 |
Mindfulness-based stress reduction (MBSR) | no change | pain intensity | chronic low back pain patients | inconclusive | found inconclusive evidence of effectiveness | #6 |
Mindfulness-based stress reduction (MBSR) | no change | disability | chronic low back pain patients | inconclusive | found inconclusive evidence of effectiveness | #7 |
Mindfulness-based stress reduction (MBSR) | increase | pain acceptance | - | limited evidence | there is limited evidence that MBSR can improve | #8 |
BACKGROUND: Mindfulness-based stress reduction (MBSR) is frequently used for pain conditions. While systematic reviews on MBSR for chronic pain have been conducted, there are no reviews for specific pain conditions. Therefore a systematic review of the effectiveness of MBSR in low back pain was performed. METHODS: MEDLINE, the Cochrane Library, EMBASE, CAMBASE, and PsycInfo were screened through November 2011. The search strategy combined keywords for MBSR with keywords for low back pain. Randomized controlled trials (RCTs) comparing MBSR to control conditions in patients with low back pain were included. Two authors independently assessed risk of bias using the Cochrane risk of bias tool. Clinical importance of group differences was assessed for the main outcome measures pain intensity and back-specific disability. RESULTS: Three RCTs with a total of 117 chronic low back pain patients were included. One RCT on failed back surgery syndrome reported significant and clinically important short-term improvements in pain intensity and disability for MBSR compared to no treatment. Two RCTs on older adults (age ≥ 65 years) with chronic specific or non-specific low back pain reported no short-term or long-term improvements in pain or disability for MBSR compared to no treatment or health education. Two RCTs reported larger short-term improvements of pain acceptance for MBSR compared to no treatment. CONCLUSION: This review found inconclusive evidence of effectiveness of MBSR in improving pain intensity or disability in chronic low back pain patients. However, there is limited evidence that MBSR can improve pain acceptance. Further RCTs with larger sample sizes, adequate control interventions, and longer follow-ups are needed before firm conclusions can be drawn.