Mindfulness physical therapy, pain management, rehabilitation

Mindfulness and Low Back Pain

In a recent study, published in the Journal of the American Medical Association, 342 individuals with chronic low back pain with a mean pain duration of 7.3 years were randomized to receive Mindfulness-Based Stress Reduction (MBSR), Cognitive Behavioral Therapy (CBT) or usual care (UC).1 I was fortunate to be an instructor for subjects receiving MBSR. At 52 weeks from trial entry, the percentage of participants with clinically meaningful improvement on the Roland Disability Questionnaire (RDQ) was highest for those receiving MBSR (68%) compared to CBT (58.8%) and UC (48.8%).


In addition, researchers evaluated pain bothersomeness in the past week, measured on a 0 – 10 scale (0 indicates not at all bothersome; 10 indicates extremely bothersome). Again, at 52 weeks from trial entry, the greatest improvements were seen in the MBSR group (48.5%) compared to CBT (39.6%) and UC (31.0%).

As subjects continued to show significant improvements at one year from trial entry, researchers suggest that MBSR may provide patients with long-lasting skills effective for managing pain. These results do not surprise me. By learning mindfulness principles and practices, patients receive education and skills training that can serve them long after initial instruction is completed. They can integrate strategies such as mindful breathing and body awareness into activities of daily living. They can bring mindful awareness to their reactions to life circumstances and make conscious choices that reduce stress and promote well-being.

1 Cherkin DC, Sherman KJ, Balderson BH, et al. Effect of mindfulness-based stress reduction vs cognitive behavioral therapy or usual care on back pain and functional limitations in adults with chronic low back pain: A randomized clinical trial. JAMA. 2016;315(12):1240-9.