Can Mindfulness Meditation Effectively Reduce Back Pain?

Chronic pain is a leading neurological complaint. Chronic low back pain is the most common pain condition and a leading cause of disability and the impairment of many activities of daily living. Low back pain is often made worse by common movements such as bending over or doing even gentle exercises. Currently, there are no known treatments that can be administered to immediately alleviate movement-evoked chronic back pain. A recent study investigated the potential effectiveness of mindfulness meditation on chronic low back pain.

What is mindfulness meditation?

Mindfulness meditation is a self-help technique that involves maintaining non-reactive attention to sensory stimulation or internal thoughts. Participants are encouraged to gently push away distracting thoughts and external stimuli. Although there is some preliminary evidence that mindfulness meditation is useful for lower back pain, there are few placebo-controlled clinical trials. In addition, it is not easy to train participants in the method and the training is a lengthy process. This has hindered the clinical translation of this technique for the treatment of chronic pain.

A recent study addressed these concerns using a “sham mindfulness meditation” technique. The sham method was designed to isolate the various factors involved, such as the subjects’ beliefs and expectations about the benefits of mindfulness meditation, changes in respiration, the variable degree of conditioning of each subject, and hopefully any other placebo-related effects. The sham conditioning method simply asked subjects to “take slow, deep breaths” in a resting posture but omitted any standard mindfulness-specific instructions. Studies have shown that these sham conditions can reduce heat-induced pain.

Can mindfulness meditation work quickly to reduce pain?

The study examined the effects of mindfulness meditation on acutely induced pain in individuals who suffer from chronic low back pain. Their responses were compared to the mindfulness-specific placebo. The study also considered the potential role of the body’s endogenous opioid system. The opioid system modulates the experience of incoming pain signals and is responsible for the pain relief induced by placebos.

The present clinical trial employed a randomized, double-blind, crossover design to determine the benefits of mindfulness meditation, as compared to sham mindfulness meditation. Subjects with chronic low back pain were asked to perform the straight leg raise test to quickly induce low back pain.

Mindfulness meditation training was more effective at reducing movement-evoked chronic pain as compared to a placebo-mindfulness technique. In addition, the analgesia achieved by mindfulness was not reversed by blocking the endogenous opioid system. Apparently, the endogenous opioid system is not responsible for the pain relief elicited by mindfulness-based meditation.

The mindfulness meditation group reported lower pain before and after the straight leg-raise test when resting and during meditation when compared to the sham mindfulness meditation group. Thus, mindfulness-specific teachings could improve chronic pain outcomes relative to slow breathing interventions.

Subjects in both groups reported that “attending” to their breath sensations was an important feature of their meditation. Most of the mindfulness meditation group, but none in the sham mindfulness meditation group, reported that they successfully employed non-reactive awareness during their practice and experienced lower pain.

The findings demonstrate that mindfulness meditation can be used to quickly reduce movement-evoked pain through non-opioid treatments. Overall, mindfulness-based training was more effective at reducing evoked back pain than slow-breathing meditation and may offer relief to the millions of individuals living with chronic pain seeking fast-acting, user-friendly, and non-opioid pain treatment.