Conquer Low Back Pain with a Mind-Body Program

Achieve short-term relief and increase function.

Loss of independence and mobility is one of the most dreaded consequences of aging. Thus, preserving physical function in older age is critical to maintaining independence.

Millions affected

Chronic pain affects approximately 100 million adults in the United States and in many cases impacts their ability to function. Among adults age 65 and older, the prevalence of pain is 52.9 percent, with the back being the most common site, impacting 30.3 percent of that number, according to the National Health and Aging Trends Study.

Adults who experience pain exhibit decreased physical function compared to adults without pain. And many older adults are reluctant to take opioids or nonsteroidal anti-inflammatory drugs for fear of addiction or side effects, leaving few non-pharmacologic treatment options.

Mindfulness Meditation Technique

  • Create a daily window of time for meditation; find a quiet place where you can meditate without being disturbed.
  • Sit comfortably, close your eyes, and slow your breathing.
  • Focus on your breathing, or on a simple word or syllable uttered as you exhale.
  • Be aware of sensory perceptions, but remain detached.
  • When your mind wanders, bring it gently back to your breathing or focus word.
  • After 20 minutes or so, open your eyes and sit quietly for a moment, letting yourself gradually return to your normal state.

Adapted from Massachusetts General Hospital’s Benson-Henry Institute for Mind Body Medicine
—Alexander Turchin, MD

Mindfulness Meditation

But a new study at the University of Pittsburgh School of Medicine that employed a mindfulness meditation program to bring about back pain relief found that such programs can help reduce severe pain and increase function for older adults with chronic low back pain. (JAMA Internal Medicine, online February 22, 2016).

The study was small, with only 282 participants age 65 and older, but results showed that the mind-body program helped with pain management even six months after the program ended. The eight-week program taught participants commonly used methods of mindfulness.

Intervention vs. Control.

The intervention group was taught four methods of mindfulness meditation based on the 8-week Mindfulness-Based Stress Reduction program. These techniques take regular activities, such as sitting, walking, and lying down, and transform them into a meditation through directed breathing and mindful awareness of thoughts and sensations. The methods included the body scan, sitting practice, walking meditation, and mindful stretching.

The comparison (control) group was given an eight-week health education program known as the 10 Keys to Healthy Aging, which teaches an interactive, energetic program to older adults on health topics relevant to healthy aging, such as hypertension management. The same chair stretches taught in the intervention program were taught in the control program.

What You Should Know

about Mindfulness Meditation
According to the most recent National Health Interview Survey, 18 million Americans tried meditation in 2012. This interest in meditation is associated with a growing evidence base on its health benefits. In particular, a recent meta-analysis found mindfulness meditation has a moderate effect on decreasing pain, anxiety, and depression.

Positive results

The intervention group improved significantly in short-term function at eight weeks, but did not sustain the functional improvement. The intervention group also showed significant reductions in current and most severe pain (for the past week) during the course of the six-month follow-up.

The mindfulness group also had a statistically and clinically significant 30 percent improvement in current and most severe (in the past week) pain intensity compared with the control group. Participants also perceived improvement in pain as a result of the intervention—80.3 percent described improvement in their back pain symptoms immediately after the eight-week intervention, compared with 37 percent in the control group. At six months, 76.1 percent confirmed at least minimal improvement, compared with 42.2 percent in the control group.

Both groups showed improvement in self-efficacy by six months. The eight-week mind-body program resulted in significant improvements in short-term physical function and long-term current and most severe pain intensity (in the past week). But, functional improvement was not sustained, suggesting that refinement of the mindfulness program could focus on longer-term gains in functional improvement, the authors said.

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