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.
Study Goal
The researchers aimed to assess the benefits of mindfulness meditation combined with cognitive behavioral therapy (CBT) for reducing pain severity and improving function in adults with opioid-treated chronic low back pain (CLBP).
Results Summary
The meditation-CBT intervention significantly reduced pain severity and sensitivity to thermal pain stimuli compared to usual care alone, with no reported adverse events. Exploratory analyses suggested a dose-response relationship between meditation practice and intervention benefits.
Population
Adults with CLBP prescribed ≥30 mg/day of morphine-equivalent dose (MED) for at least 3 months, predominantly female (80%), with severe disability and moderate pain severity.
Effective Dosage
Eight weekly group sessions plus 30 minutes/day, 6 days/week of at-home practice.
Duration
26 weeks (including 8-week intervention phase).
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
mindfulness meditation and cognitive behavioral therapy (CBT)-based intervention | decrease | pain severity ratings | Adults with CLBP, prescribed ≥30 mg/day of morphine-equivalent dose (MED) for at least 3 months | between-group difference in score change reaching 1 point at 26 weeks | reduced | #1 |
mindfulness meditation and cognitive behavioral therapy (CBT)-based intervention | decrease | pain sensitivity to thermal stimuli | Adults with CLBP, prescribed ≥30 mg/day of morphine-equivalent dose (MED) for at least 3 months | - | decreased | #2 |
mindfulness meditation and cognitive behavioral therapy (CBT)-based intervention | increase | magnitude of intervention benefits | Adults with CLBP, prescribed ≥30 mg/day of morphine-equivalent dose (MED) for at least 3 months | - | suggested a relationship | #3 |
OBJECTIVE: To assess benefits of mindfulness meditation and cognitive behavioral therapy (CBT)-based intervention for opioid-treated chronic low back pain (CLBP). DESIGN: 26-week parallel-arm pilot randomized controlled trial (Intervention and Usual Care versus Usual Care alone). SETTING: Outpatient. SUBJECTS: Adults with CLBP, prescribed ≥30 mg/day of morphine-equivalent dose (MED) for at least 3 months. METHODS: The intervention comprised eight weekly group sessions (meditation and CLBP-specific CBT components) and 30 minutes/day, 6 days/week of at-home practice. Outcome measures were collected at baseline, 8, and 26 weeks: primary-pain severity (Brief Pain Inventory) and function/disability (Oswestry Disability Index); secondary-pain acceptance, opioid dose, pain sensitivity to thermal stimuli, and serum pain-sensitive biomarkers (Interferon-γ; Tumor Necrosis Factor-α; Interleukins 1ß and 6; C-reactive Protein). RESULTS: Thirty-five (21 experimental, 14 control) participants were enrolled and completed the study. They were 51.8 ± 9.7 years old, 80% female, with severe CLBP-related disability (66.7 ± 11.4), moderate pain severity (5.8 ± 1.4), and taking 148.3 ± 129.2 mg/day of MED. Results of the intention-to-treat analysis showed that, compared with controls, the meditation-CBT group reduced pain severity ratings during the study (P = 0.045), with between-group difference in score change reaching 1 point at 26 weeks (95% Confidence Interval: 0.2,1.9; Cohen's d = 0.86), and decreased pain sensitivity to thermal stimuli (P < 0.05), without adverse events. Exploratory analyses suggested a relationship between the extent of meditation practice and the magnitude of intervention benefits. CONCLUSIONS: Meditation-CBT intervention reduced pain severity and sensitivity to experimental thermal pain stimuli in patients with opioid-treated CLBP.