Mind-Body Therapy for Chronic Lower Back Pain

Several studies about mind-body therapy as a way to manage chronic lower back pain have demonstrated favorable outcomes in helping people reduce pain intensity, stress and anxiety, while improving functional ability. Often considered part of complementary alternative or integrative medicine that include movement- and energy-based therapies, mind-body therapies may promote holistic or whole-body healing and can include a fitness component to enhance the brain’s interaction with physical function.

 mindfulness behavior chartMindfulness-Based Stress Reduction and Cognitive Behavioral Therapy are two different types of mind-body therapies your doctor may recommend to help you manage lower back pain. Photo Source: iStock.com.

A wide range of medical and healthcare specialists (eg, primary care, spine surgeons, pain management) see patients with chronic lower back pain benefit by including complementary alternative mind-body therapies in treatment. In some cases, holistic care is combined with usual medical treatment.1

Mindfulness-Based Stress Reduction (MBSR) and Cognitive Behavioral Therapy (CBT)

  • Mindfulness-Base Stress Reduction is an intensive 8-week program that may be held at a hospital or university. One-day a week the patient attends class and practices what they are learning one hour each day at home. Sometimes the program is held as a weekend retreat. The MBSR program was designed by Jon Kabat-Zinn, PhD, in 1979 and combines meditation, body awareness and mindful movement.2 People who practice MBSR become aware of their thoughts and feelings in the present moment and learn to choose an appropriate response.
  • Cognitive Behavioral Therapy combines psychotherapy (talk therapy) and behavior therapy to help people understand life’s challenges, readjust their attitudes, thoughts and perceptions, and learn how to problem-solve. The CBT therapist leads the person through a goal-oriented treatment to learn how to reduce stress, anxiety, depression, and sleep problems.3

MBSR and CBT were the focus of a research study published in the Journal of the American Medical Association (JAMA). The goal of the study was to measure the effectiveness of MBSR versus CBT in people with chronic low back pain. The authors noted MBSR has not been extensively studied in adults with chronic low back pain.4

There were 342 adult participants with chronic lower back pain enrolled the clinical trial who were randomly selected to receive MBSR, CBT or usual care (eg, nonoperative treatments). The number of people in each group were nearly equivalent. Two hours each week for 8-weeks, study participants received MBSR, CBT or usual care.

  • The MBSR group received classroom style education and mindfulness practices, such as breathing awareness, meditation and yoga. However, the MBSR program did not focus specifically on pain.
  • The CBT group received instruction about chronic low back pain, which included its relationship to emotions and physical reactions. They were also taught how to change improper thinking and pain-coping action plans, and included meditation, muscle relaxation techniques, deep breathing, yoga, and guided imagery (escape mentally).
  • Both MBSR and CBT groups were provided workbooks, audio CD’s and instructions for home-based practice.

What was the outcome of the study? Clinical trial participants with chronic low back pain treated with MBSR or CBT—when compared to usual care—reported improvement in their low back pain and functional ability.2

Movement- and Energy-Based Therapies May be Combined with Mind-Body Healing

Authors of a chapter published in the textbook, The Comprehensive Treatment of the Aging Spine, outlined complementary alternative therapies based on movement and energy and their potential benefit to older people with spine conditions and/or chronic pain.1

Movement- and/or energy-based therapies may be part a patient's lower back pain treatment plan that may include mind-body therapy. For example, movement-based therapies help teach patients how to breath and concentrate during movement, while improving their flexibility, balance and building core muscle strength—Tai Chi is an example.

Energy-based therapies manage the flow of “Qi” (pronounced “chee”); the body’s energy force.1 Acupuncture is a complementary alternative treatment that is performed to unblock and/or balance the body’s Qi. In her article about Traditional Chinese Medicine, Laurie Morse, LAc, MTOM, explains Qi and back pain according to Chinese Medicine—If there is free flow, there is no pain; If there is no free flow, there is pain.5

If you are interested in mind-body therapy, such as mindfulness-based stress reduction, cognitive behavioral therapy, acupuncture, Tai Chi, or any other integrative care, ask your doctor, chiropractor, other healthcare practitioner, or health insurance provider for a referral. Doing so can help you find the best specialist with the proper credentials and licensing in your state.

Updated on: 11/21/19
Continue Reading
Traditional Chinese Medicine (TCM) and Back Pain
Continue Reading:

Traditional Chinese Medicine (TCM) and Back Pain

Acupuncture specialist discusses Traditional Chinese Medicine (TCM) and provides an alternative angle of understanding low back pain through the model of TCM.
Read More