For those living with persistent low back pain, the choices offered until now have largely stayed within the boundary of painkillers and physiotherapy. Researchers at Boston Medical Center (BMC) have now released clinical findings suggesting that a mindfulness meditation programme delivered beyond the screen can help ease both pain and the disruption it causes in everyday life. The results of this randomised trial of 451 adults were published in the 29 June issue of JAMA Internal Medicine, an international academic journal.
Instead of erasing pain, changing how people respond to it
The programme designed by the research team is called OPTIMUM. The name reflects its aim: to optimise pain treatment through mindfulness in clinical practice. According to BMC, it is a form of the widely known Mindfulness-Based Stress Reduction (MBSR) course adapted for pain management. Participants took part remotely in weekly group sessions lasting 120 minutes over eight weeks. Each session was co-led by a trained meditation instructor and a primary care physician, with gentle stretching plus breathing and awareness exercises. The key was not to force pain itself to disappear, but to help participants change the way they respond to the sensations of pain.
451 participants randomised, with significant improvement in pain and daily-life measures after six months
In the clinical trial, 451 participants recruited from three sites were assigned to a meditation programme group of 224 and a usual care group of 227. The average age was 52.1, and women made up 70.5%. The primary assessment at the six-month point used the PEG scale (0 to 10), which looks at pain, enjoyment in life and daily activities. The meditation group improved by an average of 1.21 points, a bigger improvement than the 0.59-point decrease seen in the usual care group, and the difference between the two groups was 0.62 points, a statistically meaningful level (P=.002). However, the paper said the research team’s pre-set threshold for a ‘clinically meaningful minimal difference’ of 1 point was not reached. The improvement continued through the 12-month follow-up point.
A billable group meditation consultation that lowers the barrier to care
The aspect drawing attention in this study is the delivery method, more than the magnitude of the effect. It is delivered via remote video, and it is designed so that a doctor participates directly in sessions, allowing it to be recognised as formal group medical care and billed within the existing healthcare reimbursement system. Patients who find it hard to travel, or who do not have a pain clinic nearby, can take part from home, which means lowering the barrier for those who may previously have been left out of mindfulness programmes. Natalia Morone, MD, who led the research, said: “Our programme gives people practical skills that help them respond differently to pain, and that they can use repeatedly.” Against the backdrop of ongoing concerns in healthcare about expanding pain management methods that do not rely on medication, the results indicate a trend in which meditation is carving out a place as another strand of hospital care.