Mindfulness Meditation and Cognitive Behavioral Therapy Intervention Reduces Pain Severity and Sensitivity in Opioid-Treated Chronic Low Back Pain: Pilot Findings from a Randomized Controlled Trial
Aleksandra Zgierska, Cindy A. Burzinski, Jennifer Cox, John D. Kloke, Aaron J. Stegner, Dane B. Cook, Janice M. Singles, Shilagh A. Mirgain, Christopher L Coe, Miroslav Bačkonja
Pain Medicine March 10, 2016 DOI: 10.1093/pm/pnw006 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Pilot randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 35 |
| Population | Adults with chronic low back pain prescribed at least 30 mg/day of morphine-equivalent dose for at least 3 months |
| Intervention | Mindfulness meditation and cognitive behavioral therapy (CBT)-based intervention |
| Duration | 26 weeks (8 weekly group sessions with home practice; outcomes at baseline, 8, and 26 weeks) |
| Measures | Brief Pain Inventory, Oswestry Disability Index, pain acceptance, opioid dose, pain sensitivity to thermal stimuli, serum pain-sensitive biomarkers (Interferon-γ; Tumor Necrosis Factor-α; Interleukins 1ß and 6; C-reactive Protein) |
| Topics | Meditation |
| Citations | 145 |
| Key findings | The meditation-CBT intervention reduced pain severity ratings compared with usual care, with a between-group difference of 1 point at 26 weeks, and decreased sensitivity to thermal pain stimuli, without adverse events. Exploratory analyses suggested a relationship between the amount of meditation practice and the magnitude of benefit. |
Abstract
Objective: To assess benefits of mindfulness meditation and cognitive behavioral therapy (CBT)-based intervention for opioid-treated chronic low back pain (CLBP).
Design: 26-week parallel-arm pilot randomized controlled trial (Intervention and Usual Care versus Usual Care alone).
Setting: Outpatient. SUBJECTS: Adults with CLBP, prescribed ≥30 mg/day of morphine-equivalent dose (MED) for at least 3 months.
Methods: The intervention comprised eight weekly group sessions (meditation and CLBP-specific CBT components) and 30 minutes/day, 6 days/week of at-home practice. Outcome measures were collected at baseline, 8, and 26 weeks: primary-pain severity (Brief Pain Inventory) and function/disability (Oswestry Disability Index); secondary-pain acceptance, opioid dose, pain sensitivity to thermal stimuli, and serum pain-sensitive biomarkers (Interferon-γ; Tumor Necrosis Factor-α; Interleukins 1ß and 6; C-reactive Protein).
Results: Thirty-five (21 experimental, 14 control) participants were enrolled and completed the study. They were 51.8 ± 9.7 years old, 80% female, with severe CLBP-related disability (66.7 ± 11.4), moderate pain severity (5.8 ± 1.4), and taking 148.3 ± 129.2 mg/day of MED. Results of the intention-to-treat analysis showed that, compared with controls, the meditation-CBT group reduced pain severity ratings during the study (P = 0.045), with between-group difference in score change reaching 1 point at 26 weeks (95% Confidence Interval: 0.2,1.9; Cohen's d = 0.86), and decreased pain sensitivity to thermal stimuli (P < 0.05), without adverse events. Exploratory analyses suggested a relationship between the extent of meditation practice and the magnitude of intervention benefits.
Conclusions: Meditation-CBT intervention reduced pain severity and sensitivity to experimental thermal pain stimuli in patients with opioid-treated CLBP.
Comparable studies
Other randomized controlled trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment | 2003 | Randomized controlled trial | n = 41 |
| Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients | 2000 | Randomized controlled trial | n = 145 |
| Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults | 2008 | Randomized controlled trial | n = 139 |
| Short-term meditation training improves attention and self-regulation Undergraduate Chinese students | 2007 | Randomized controlled trial | n = 40 |
| Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients | 2004 | Randomized controlled trial | n = 73 |
Citations in the library
Cited by 28
- Pain, hedonic regulation, and opioid misuse: Modulation of momentary experience by Mindfulness-Oriented Recovery Enhancement in opioid-treated chronic pain patients Drug and Alcohol Dependence March 29, 2017
- Mindfulness-based Interventions for Chronic Low Back Pain: A Systematic Review and Meta-analysis. Clinical Journal of Pain February 1, 2024
- Enhancing Chronic Non-Cancer Pain Management: A Systematic Review of Mindfulness Therapies and Guided Imagery Interventions. Medicina (Kaunas, Lithuania) April 23, 2024
- What can we learn from randomized clinical trials about the construct validity of self-report measures of mindfulness? A meta-analysis June 4, 2019
- The effect of mindfulness meditation on the perceived duration of pain Journal of Cognitive Psychology December 7, 2022
and 23 more in the library
Cites 19
- The benefits of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology 2003
- Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical Psychology Science and Practice 2003
- Alterations in Brain and Immune Function Produced by Mindfulness Meditation Psychosomatic Medicine July 1, 2003
- Meditation Programs for Psychological Stress and Well-being JAMA Internal Medicine January 6, 2014
- Mindfulness‐Based Stress Reduction and Mindfulness‐Based Cognitive Therapy – a systematic review of randomized controlled trials Acta Psychiatrica Scandinavica April 28, 2011
and 14 more in the library