Mind-Body Therapy Bests Usual Care for Back Pain
Written by Editor   
Sunday, April 17, 2016 01:00 PM

Two psychosocial approaches worked better than usual care for mitigating disability in chronic low back pain, researchers found.

In a randomized controlled trial, both mindfulness-based stress reduction (MBSR) and cognitive behavioral therapy (CBT) improved function (P=0.04) and diminished pain "bothersomeness" to a significantly greater extent than usual care at 26 weeks.

The biopsychosocial approach to pain management has been gaining ground, most recently with last week's release of the National Pain Strategy, which emphasized the interdisciplinary approach over other forms of treatment.

"Following only 8 weeks of group treatment, patients who received MBSR or CBT showed some improvement at least up to one year later. This is an important finding that few other treatment options provide. The difficulties of managing chronic low back pain demand such long-term solutions."

CBT has been widely recommended for chronic low back pain, but patient access remains limited, the researchers said. Mindfulness-based stress reduction involves meditation and yoga.

The proportion of patients with clinically meaningful improvement in disability was significantly higher for both MBSR and CBT compared with usual care (61% and 58% versus 44% ), and the proportion of patients with clinically meaningful improvement in pain bothersomeness was higher for both MBSR and CBT (44% and 45% versus 27%), the researchers reported.

 

At 1 year, there were still significant differences in both outcomes for MBSR versus usual care, but the benefits for CBT disappeared at that time, the researchers said.  Still, they concluded that "mind-body treatments such as MBSR and CBT may provide patients with long-lasting skills effective for managing pain."

The next challenge for physicians treating pain patients, they said, is finding appropriate referrals for mind-body therapies that patients can access and afford.


Source:  http://www.medpagetoday.com/Neurology/PainManagement/56850