Can mindfulness help your back pain?
Updated: May 9, 2022
It is 2022, and by now, almost everyone has heard the term mindfulness. What was once the realm of the esoteric and quirky has now become cliche, with discussions regularly occurring in the media. There is mindful parenting, mindful working, mindful walking...most supermarkets have magazines dedicated to the wide variety of topics it covers. But the term is so widespread that we can overlook its actual meaning. What is mindfulness? And, more importantly, can it help your health condition?
Researchers have been asking if mindfulness can help with various health conditions since about 1979. In the 1990s, research began to pick up pace, and by the early 2000's publications listed in pubmed were on a geometric curve, doubling every few years. Currently, there are enough new high quality randomised controlled trials (RCTs) and even systematic reviews of the RCTs. As a reminder, quality RCTs help determine if our treatment is more effective than a comparator, usually another treatment that is considered effector. The comparator might also be an inert treatment, such as a placebo. Both of these designs will tell us if, in this study, there was any benefit to the new treatment. And, as another reminder, systematic reviews with meta-analysis then combine the results of multiple RCTs to determine if there are bigger patterns which emerge with larger sample sizes. Generally speaking, larger sample sizes help us determine if a trial may be an anomaly, or part of a larger trend. Better healthcare decisions are obviously chosen from the big data sets with repeated results and findings.
There is a growing body of research evidence to suggest that indeed, mindfulness based stress reduction (MBSR), sometimes called mindfulness for short, is beneficial for patients with certain health conditions. Included in this set of health conditions is chronic back pain.
The overall body of research commenced with work by Jon Kabbat-Zinn, who introduced the MBSR program into hospital settings in the USA in the 1970s, 80s and 90s. He systematically structured the program so that it could be scaled up and studied in a variety of scientific settings, free from previous cultural dogmas. Since then many thousands of people have taken the course. The structure of the course is that it runs over 8 weeks, with weekly group classes for 2.5 hours a week. There is also home practice for 45 minutes a day, and other exercises that one can incorporate. The structure of the course has been described in his book, Full Catastrophe Living.
There are some systematic reviews now of chronic back pain in the context of Mindfulness Based Stress Reduction. One has been published in the Annals of Internal Medicine. Like many of the studies with back pain, the results are modest. However, The Lancet Low Back Pain Series and multiple clinical practice guidelines recommend MBSR as one treatment for chronic low back pain.
An example of a body scan, led by Jon Kabat-Zinn, is here. This example is 30 minutes, but the typical body scan in a course is 45 minutes. And there are a variety of times and techniques of guided meditation.
To give the program a fair trial, participants will need to enrol in an 8 week course and adhere to the program to the best of their abilities. Dr. Bulman is currently undergoing training to offer this as one of the many treatments under his provision. He has been a meditation practitioner since 2004 and recommends it to those who express an interest in the subject.