Importance: Back pain is among the most common, disabling, and costly conditions managed in primary care in the US, but current treatment options often do not provide adequate relief. Mindfulness-based interventions have demonstrated effectiveness in individuals with chronic low back pain (CLBP); however, mindfulness remains underused in part because it is not integrated into most outpatient...
Pain MedicineMarch 25, 2026Lorena S Nunes, Angela C. Incollingo Rodriguez, Benjamin C. Nephew et al.
Dear Editor, Chronic low back pain (cLBP) is increasingly prevalent across populations and ages.1 Low back pain is currently the leading cause of disability worldwide.2 Beyond widespread effects on individual functioning and well-being, the financial,3 psychological,4 and social5 implications of cLBP are vast. Mindfulness-based stress reduction (MBSR) is effective in decreasing various pain...
Introduction: Engaging community members and context experts is increasingly recognized as key to developing research that is responsive to community needs. Here, we describe a protocol for incorporating stakeholder feedback using rapid qualitative techniques into OPTIMUM (Optimizing Pain Treatment In Medical settings Using Mindfulness), a pragmatic clinical trial comparing a...
Abstract Mindfulness is recommended as a first-line non-pharmacologic treatment for chronic low back pain (cLBP). However, accessibility is challenging. The OPTIMUM trial (Optimizing Pain Treatment In Medical settings Using Mindfulness) compared a telehealth-delivered group mindfulness program for primary care patients with cLBP to usual care. Here we describe the methods of this investigation,...
Chronic low back pain is globally prevalent and associated with significant impairment in quality of life. Furthermore, people from historically marginalized communities are less likely to receive treatment, contributing to health inequities. Group mindfulness-based interventions improve pain and function, and virtual delivery has been demonstrated to be feasible. Little is known about how...
Mindfulness research and clinical programs are widespread, and it is important that mindfulness-based interventions are delivered with fidelity, or as intended, across settings. The MBI:TAC is a comprehensive system for assessing teacher competence, yet it can be complex to implement. A standardized, simple fidelity/engagement tool to address treatment delivery is needed. We describe the...
Mindfulness meditation has become a successful treatment of both physical and psychosocial ailments over the past decade. Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) are now implemented in various clinical and hospital settings for the treatment of stress, depression, substance abuse, and chronic pain. However, given mindfulness meditation’s...
In 2017, the American College of Physicians (ACP) designated Mindfulness-Based Stress Reduction (MBSR), an eight-week group program, as first-line non-pharmacological treatment for chronic low back pain. However, interprofessional collaboration between mindfulness instructors and Primary Care Providers (PCP) remains largely unknown. We developed a survey to assess communication between...
Mindfulness-based stress reduction (MBSR) is an evidence-based non-pharmacological approach for chronic low back pain (cLBP), yet it is not readily available or reimbursable within primary care clinics. Primary care providers (PCPs) who wish to avoid prescribing opioids and other medications typically have few options for their cLBP patients. We present the protocol of a pragmatic clinical...
Pain MedicineFebruary 23, 2021Anna M. Polaski, A. Phelps, Thomas J. Smith et al.
OBJECTIVE This pilot trial examined the effects of a combined intervention of mindfulness meditation followed by aerobic walking exercise compared with a control condition in chronic low back pain patients. We hypothesized that meditation before exercise would reduce disability, pain, and anxiety by increasing mindfulness prior to physical activity compared with an audiobook control group....
The current opioid crisis has spurred the need for nonpharmacological therapies for chronic low back pain. In a study published in JAMA Internal Medicine, we reported that in 282 older adults with chronic low back pain, an 8-week mind-body group program modeled on Mindfulness-Based Stress Reduction (MBSR) decreased long-term pain and increased short-term function. Barriers to uptake remain such...
Pain MedicineNovember 1, 2018José G Luiggi-Hernandez, Jean Woo, Megan Hamm et al.
Abstract: Objective: Mindfulness is a nonpharmacologic mind-body therapy that has been shown to be effective in older adults with chronic low back pain (cLBP). There are few first-person accounts in the literature that describe the older adult experience and perspective while learning mindfulness and meditation to treat pain. The objective of this study was to investigate dominant themes...
To describe estimates of the number and characteristics of persons who had used mindfulness meditation in the U.S. Data from 108,131 adults from the 2012 National Health Interview Survey were weighted to produce national estimates representative of the U.S. Persons who used mindfulness meditation were identified by their response to the question "During the past 12 months, did you use...
Importance: Treatment of chronic low back pain (LBP) in older adults is limited by the adverse effects of analgesics. Effective nonpharmacologic treatment options are needed. Objective: To determine the effectiveness of a mind-body program at increasing function and reducing pain in older adults with chronic LBP. Design, setting, and participants: This single-blind, randomized clinical trial...
Chronic low back pain (CLBP) is widespread among older adults (≥ 65 years) and is often treated inadequately. With a rapidly growing aging population, CLBP will increase and so will the demand for treatment. We believe that mind-body therapies can help to meet this demand. We present the methodology of a randomized, controlled clinical trial of 300 individuals with CLBP aged 65 years or older....
Determine the impact of an 8-week mindfulness meditation program on disability, psychological function, and pain severity in community-dwelling older adults with chronic low back pain, and to test the education control program for feasibility. Randomized controlled trial. Participants. Forty community-dwelling older adults with moderate low back pain or greater for at least the previous 3...
To identify the effects of mindfulness meditation on older adults with chronic low back pain (CLBP), we conducted a qualitative study based on grounded theory and used content analysis of diary entries from older adults who had participated in a clinical trial of an 8-week mindfulness meditation program. Participants were 27 adults > or = 65 years of age with CLBP of at least moderate severity...
The objectives of this pilot study were to assess the feasibility of recruitment and adherence to an eight-session mindfulness meditation program for community-dwelling older adults with chronic low back pain (CLBP) and to develop initial estimates of treatment effects. It was designed as a randomized, controlled clinical trial. Participants were 37 community-dwelling older adults aged 65 years...
Anna M. Polaski, Amy L. Phelps, Thomas J. Smith et al.
preprint
ABSTRACT Integrative and complementary non-pharmacological treatments have proven efficacious in treating both the physiological and psychological symptoms of chronic pain conditions but the potential of many combined therapies is unknown. This study examined the effects of a combined intervention of mindfulness meditation followed by aerobic walking exercise in chronic low back pain (cLBP)...
Akshit Soota, Angela C. Incollingo Rodriguez, Benjamin C. Nephew et al.
preprint
ABSTRACT Millions of people each year suffer from chronic low back pain (cLBP), which adversely affects their physical and mental health. While non-pharmacological interventions such as mindfulness are known to be effective in treating cLBP, not all patients experience the same benefit. Determining who these treatments might work best for is difficult, as there are no reliable predictors of the...