An eight-week mindfulness meditation program is feasible for older adults aged 65 and older with chronic low back pain. In this pilot randomized trial, 37 participants were assigned to either the meditation program or a wait-list control. At the end of the intervention, 81% completed assessments, average class attendance was 6.7 out of 8 sessions, and participants meditated about 4.3 days per week for an average of 31.6 minutes per day. Compared to the control group, the meditation group showed significant improvements in pain acceptance (specifically the total score and activities engagement subscale) and physical function. The program may lead to better pain acceptance and physical function.
Mindfulness meditation has become widely used for stress, depression, substance abuse, and chronic pain, but reports have raised concerns about adverse events such as anxiety, pain, and even psychosis. This viewpoint argues that common emotional or physical reactions during meditation are not true adverse events but expected parts of the process. More severe outcomes like psychosis are confounded by factors such as practice intensity, psychological stressors, and psychiatric history. Programs like MBSR and MBCT are shorter and less intense, designed to avoid inducing pain or panic. The authors urge consistent use of a definition of adverse events limited to severe outcomes or hospitalization.
A combined intervention of mindfulness meditation followed by aerobic walking exercise (MedExT) improved disability, mindfulness, and pain intensity and unpleasantness in adults with chronic low back pain. Thirty-eight adults completed either MedExT (n=18) or an audiobook control condition (n=20). Over four weeks, the MedExT group performed 12-17 minutes of guided meditation followed by 30 minutes of moderate intensity walking five days per week. MedExT significantly improved disability compared to the control group, increased mindfulness, and reduced mean ratings of low back pain intensity and unpleasantness, but had no significant effect on quantitative sensory testing of the low back.
Machine learning applied to data from a clinical trial of mindfulness for chronic low back pain identified distinct phenotypes that predict who will respond to the intervention. Among 132 participants in the mindfulness arm, 49 were responders and 83 were non-responders. The top three responder phenotypes correctly identified 26 of the 49 responders with 92-100% precision, and the top three non-responder phenotypes identified 36 of the 83 non-responders with 100% precision. These results may help clinicians and patients decide whether mindfulness is likely to be beneficial, improving treatment efficiency and outcomes.