At some point in their lives, about 80% of Americans suffer from back pain, most often in the lower back, according to the National Institute of Neurological Disorders and Stroke (NINDS). Rest and over-the-counter pain relievers help most people get over a bout of back strain and muscle aches. But for about 20%, the condition becomes chronic — which the NINDS defines as low back pain that persists for 12 weeks or longer after treatment.
It’s not surprising that this ongoing discomfort can negatively impact all areas of life, including the ability to work productively. In fact, the NINDS points out that low back pain is a leading reason why employees miss workdays and the most common cause of job-related disability.
Pain relievers seem like logical choices for treating ongoing low back pain, but research shows they offer little relief and may create new problems. A recent analysis of data from 20 studies involving almost 7,300 people with chronic low back pain found that many were prescribed opioid drugs, which can be highly addictive. The results of the study, published in JAMA Internal Medicine, showed opioids were generally ineffective for low back pain and did little to prevent or improve disability.
Another recent study of about 5,000 Americans with chronic low back pain found a worrisome connection to drug abuse. The back pain sufferers were far more likely to take highly addictive opioid medications than people without low back pain – and they frequently used illicit drugs (including cocaine, heroin and methamphetamines), too.
Obviously, workers with a chronic and uncomfortable condition who are at risk for drug addiction and abuse because of their pain can impact the workplace. But there’s good news on the research front, too. Non-drug strategies – a specific kind of meditation called mindfulness-based stress reduction (MBSR) and talk therapy known as cognitive behavioral therapy (CBT) — can help those with low back pain cope and significantly improve their symptoms, according to a study published in JAMA.
A team of researchers from the Group Health Research Institute (GHRI) and the University of Washington randomly assigned 342 volunteers between the ages of 20 and 70 – all suffering from low back pain – to 3 different groups. One group attended 8 weekly, 2-hour group training sessions to learn MBSR. Another group received CBT for the same length of time, and the third group only received their usual care, which included medication and/or physical therapy, for their back pain.
Compared to research participants who received their usual care, those who had either MBSR training or CBT sessions were far more likely to feel better, with at least a 30% improvement in both their functional limitations and in their perception of how much their pain bothered them. What’s more, for both the MBSR and the CBT groups, the improvements lasted long term.
“We are not saying, It’s all in your mind,” says study leader Daniel Cherkin, Ph.D., senior investigator at GHRI. “Rather, as recent brain research has shown, the mind and the body are intimately intertwined, including in how they sense and respond to pain. Both mindfulness and CBT involve the brain as well as the body.”
Although meditation and CBT worked equally well, the researchers noted that meditation may have some advantages. Although CBT has been shown in previous studies to help several chronic pain conditions, patient access to affordable and available sessions with therapists offering CBT tends to be limited.
Meditation-based stress reduction focuses on increasing awareness and acceptance of moment-to-moment experiences, including difficult emotions as well as physical pain and discomfort. Once the technique is learned, it is something people can practice by themselves to relieve stress, reduce their perception of low back pain and increase their ability to function better — and it’s free.
“Our findings are important because they add to the growing evidence that pain and other forms of suffering involve the mind as well as the body,” Cherkin said. “Greater understanding and acceptance of the mind-body connection will provide patients and clinicians with new opportunities for improving the lives of persons with chronic back pain and other challenging conditions that are not always effectively managed with physical treatments alone.”